this post was submitted on 08 Nov 2024
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Summary

The FDA has proposed removing oral phenylephrine, a common ingredient in over-the-counter cold medicines like NyQuil and Sudafed, due to evidence that it is ineffective as a nasal decongestant.

The proposal follows a unanimous vote by FDA advisers last year, and recent studies showing less than 1% of the drug is absorbed into the bloodstream when taken orally.

The public comment period ends on May 7, after which the FDA may finalize the ban.

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[–] [email protected] 1 points 22 hours ago

Late reply, but I'm currently sick, and saw this as an opportunity.

I have never had much success with OTC cold medicines. The best I've seen is Alka Seltzer Plus and Mucinex, but I felt these always underperformed significantly. With other commenters offering advice, and the internet being vast, I did some research.

I ended up taking Sudafed (bought today) and Zyrtec (always have on hand). I also took Excedrin for pain relief (last dose I had).

I'm still sneezing occasionally, and my nose is slightly tingly, but I feel obviously better than before--much better success than I've seen with other OTC drugs.

I don't have ibuprofen, but I suggest that over Excedrin. Excedrin contains acetaminophin (and aspirin--important!), as well as caffeine. Essentially, I'd recommend doing the following, as directed on packaging:

Pseudoephedrine (DANGEROUS MAOI INTERRACTION--Non-Rx, non-OTC, works well for congestion)

Antihistamine (Zyrtec, Allegra--Benadryl if you feel like seeing the hat man)

Ibuprofin (NSAID--do NOT take with alcohol or other NSAIDs--reads more effective as an NSAID than aspirin and acetaminophen. Most effective NSAID of the three)

Caffeine (Tea is probably better than coffee--helps with pain slightly, but especially drowsiness, and therefore depends on time of day)

For something more unique, cannabis products are certain to help without all too much risk. I experience neck pain when I'm sick, so lightly smoking helped. CBD oil works super well for specific spots, and is probably better than THC for most people. This is a sure-fire way to help with pain and insomnia, but I hope you aren't that sick.

Finally, another unique suggestion, and one you'll only see from me. Proceed with reasonable caution and do your research, though. Red kratom strains, or green if you prefer something a little easier on the system--faster onset, too. Recent "gas station heroin" headlines are fearmongering and utter bollocks, in a surprise to nobody. Thanks, Nixon. Kratom helps considerably with pain/insomnia, but it's somewhat risky to use kratom with NSAIDs and antihistamines. Don't see issues with pseudoephedrine. I sincerely doubt a 4g toss-and-wash is going to do more harm than good, but please measure by weight, and not volume. Do the minimum effective dose. Yet again, do not drink with alcohol--it's horrible on the liver. Just don't drink in general, to be honest. All in all, I'd honestly suggest picking between either your NSAID of choice, or kratom--not both. If you're really being kept awake, or you're really in pain, then kratom is likely the better option over your Excedrins or Tylenols. Sorry this section's long--it's important that it's detailed, for obvious reasons.

Quite a lot at once--balance doses responsibly, experiment, see what works, and stick with that when you fall ill. It's a lot of information, but safety isn't something to compromise with. I hope I've been helpful. That's all, folks.

[–] [email protected] 122 points 2 weeks ago (1 children)

Yet the homeopathy pills can still be on the shelves right next to real medicine.

[–] [email protected] 43 points 2 weeks ago (4 children)

From my understanding they don’t need to be FDA approved. At that point blame the store, not the FDA. I’m just glad they’re getting this done before they’re purged by the next administration

[–] [email protected] 27 points 2 weeks ago

I'll blame both.

[–] [email protected] 16 points 2 weeks ago

Oh I'll blame both, thank you very much. It's well within certain governed agencies authority to say "you cannot sell that next to real medicine".

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[–] [email protected] 64 points 2 weeks ago* (last edited 2 weeks ago) (12 children)

Good. Now do something about homeopathy. I'm so sick of having to explain to people that homeopathy is not medicine in any shape or form. It's not even a home remedy. And it sits right next to actual medicine so people might accidentally buy it unwittingly.

[–] [email protected] 14 points 2 weeks ago (1 children)

This was so infuriating during covid as it was hard to find children's cold medicine already and half the time you'd see a couple bottles of "Children's cold and flu" on the shelf, buy it, and get home before you notice "homeopathic" written in 3pt font along the bottom of the bottle. Shit's completely useless.

[–] [email protected] 8 points 2 weeks ago

I've gotten into the habit of checking active ingredients after almost accidentally buying something homeopathic that was immediately adjacent the thing I actually meant to grab.

[–] [email protected] 6 points 2 weeks ago

The problem is, unlike homeopathy, this drug was ineffective for what it was approved for while actually causing side effects. At least the water doesn't do anything.

[–] [email protected] 6 points 2 weeks ago (1 children)

I'm sure the Trump Administration will get right on banning homeopathy, or even just labelling it properly. lol

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[–] [email protected] 55 points 2 weeks ago (2 children)

funny considering they caused the use of this garbage because we cant have real ephedrine cuz tweakers.

was anyone under the delusion this shit worked?

[–] [email protected] 38 points 2 weeks ago* (last edited 2 weeks ago) (9 children)

My former boss (Canada) kept a bag of ephedrine bottles in our produce cooler. Dude was twitchy as fuck. Very bird/dinosaur-like.

He would take several per day and chase them with coffee and energy shots. Then he would complain intermittently about vomiting blood due to his ulcers.

[–] [email protected] 23 points 2 weeks ago

He's probably dead now. Ulcers are no laughing matter.

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[–] [email protected] 25 points 2 weeks ago (2 children)

Who says you can't? I can walk up to the pharmacy counter and get some with ID. It's usually a helluva lot cheaper than the phenylephrine stuff, too.

[–] [email protected] 20 points 2 weeks ago

duude i totally forgot they hid it behind the counter.

i grew up being able to buy full bottles of almost pure ephedrine billed as a 'stay awake' thing for truckers and the like. like no-doze

[–] [email protected] 4 points 2 weeks ago

Yeah, you have to know about it to ask for it. Most people would buy the useless shit

[–] [email protected] 37 points 2 weeks ago (1 children)

I remember like a year or two ago when they officially announced these products are LESS effective than a placebo. How the hell is it taking so long to get them off the shelves?

[–] [email protected] 13 points 2 weeks ago* (last edited 2 weeks ago)

I assume they submitted the results and stated they need to be removed, then reviewed the supreme courts measure that stated they only have power to make measures if Congress grants them privilege to do so (precidence, set in Julyish of 2022 with the EPA) making the specialized divisions of government created by Congress illegitimate unless Congress votes on the measure afterwards, making them just superficial recommendations for Congress to wait and see what their lobbyists think is okay.

Aka will drug companies pay enough to keep us lying to the public, vs maybe we will go by the recorded data.

Exon mobile recorded their data of environmental impacts in what year? And we had battery powered vehicles traveling up to 100 miles before that time. Instead of doing what was best for the future of the people, we chose what was best for profits. Reference article for fun; https://www.corporateknights.com/transportation/half-a-century-ago-one-u-s-senator-fought-to-ban-gas-powered-cars-almost-won

Point being. what power did they have to remove them from the shelves. I assume they are launching these last ditch efforts before Biden leaves, and praying to get some support before they get chiseled away at.

Imagine where we would be if GM/Ford and such started forcing the R&D in 1975 instead of 2005, 2015 or whatever we call it now

[–] [email protected] 34 points 2 weeks ago

Fucking finally.

[–] [email protected] 27 points 2 weeks ago (1 children)

These products will mysteriously re-appear after inauguration.

[–] [email protected] 12 points 2 weeks ago

It won't even take that - you can sell products that don't work (airborn, homeopathy, etc.), you just can't claim that it does. So they'll slap the standard "this product is not intended to treat, cure, or prevent any disease" disclaimer on it and people will continue to buy it.

[–] [email protected] 19 points 2 weeks ago (1 children)

I have been railing about how this shit doesn't work for what feels like forever.

The entire cold/cough aisle is essentially a scam. Pick up some generic diphenhydramine, APAP, ibuP, and some Pseduophedrine. It will cheap as dirt and do all the things that overpriced shit will do. Anything else that actually helps with a cold/cough is prescription only.

[–] [email protected] 9 points 2 weeks ago (1 children)

Pseudoephedrine can't legally be sold in the aisles, and requires you to get out from the pharmacist's counter and provide an ID.

That's why they push the aid that doesn't work. It can be sold at a gas station and after hours.

[–] [email protected] 5 points 2 weeks ago (1 children)

Damn meth heads ruining it for the rest of us.

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[–] [email protected] 19 points 2 weeks ago (1 children)

Is this the shit they started using when they started using the original stuff to make meth?

[–] [email protected] 15 points 2 weeks ago

By my understanding yes, pseudoephedrine was being used for meth so they put it behind the counter and the name brand "Sudafed" made a PE line that was this, phenylephrine, to stay over the counter.

[–] [email protected] 19 points 2 weeks ago

Something tells me the Trump Administration won't allow this ban to go through.

[–] [email protected] 16 points 2 weeks ago (3 children)

Oooo! Do Guaifenesin next! That also has basically no evidence of effectiveness despite being on the market for ages.

[–] [email protected] 5 points 2 weeks ago

Guaifenesin works very very well for me as an expectorant.

[–] [email protected] 5 points 2 weeks ago

That I didn't know. Does that mean that the benefit from it just comes from drinking the insane amount of water it recommends?

[–] [email protected] 4 points 2 weeks ago

The entire cough/cold aisle is a gigantic scam of combo meds.

[–] [email protected] 12 points 2 weeks ago* (last edited 2 weeks ago)

It won't be pulled from the shelves - it'll just be getting some new fine-print.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

[–] [email protected] 11 points 2 weeks ago (1 children)

About time. Thankfully in Australia we can still get access to the ones containing psuedoephedrine, which works amazingly well.

Can't believe it has taken this long to see the inefficacy of these.

[–] [email protected] 4 points 2 weeks ago (3 children)

In the US, you can still get the stuff containing pseudoephedrine but you have to go to the pharmacy and ask for it and then show your ID. Out of curiosity, what's the process in Australia?

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[–] [email protected] 9 points 2 weeks ago

No worries, three months from now it'll all be back on the shelves again

[–] [email protected] 9 points 2 weeks ago (1 children)

Nobody is taking Nyquil to decongest, they're taking it to pass the fuck out.

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[–] [email protected] 8 points 2 weeks ago (1 children)

and Sudafed

Isn't Sudafed supposed to be short for pseudoephedrine , the stuff that actually works but they have to keep behind the counter?

[–] [email protected] 15 points 2 weeks ago

There's also Sudsfed PE which is Phenylephrine instead of pseudoephedrine. Presumably only the PE sub-brand would be banned under this rule

[–] [email protected] 8 points 2 weeks ago (6 children)

If you want some real solid advice: never buy the nasal spray that has phenylephrine. It may well be one of the most addictive substances man has ever made.

The pills do absolutely nothing. About once or twice a year I have to get the good stuff from the pharmacy, but I've refused to even buy the new stuff.

I can't help but feel like they could just put something in the regular Sudafed to make it not methy, but I took physics and not chemistry so idk.

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[–] [email protected] 5 points 2 weeks ago

I like in the article how it says they'll get some time to reformulate, but if it doesn't work, they could just turn off the widget inserting it and bobs your uncle!

[–] [email protected] 4 points 2 weeks ago (1 children)

Interesting. I use phenylephrine pills (no other active ingredients) for nasal congestion every time I'm sick, and it has always worked very well for me

I do tend to be extra sensitive to most drugs though, so maybe that has something to do with it

[–] [email protected] 13 points 2 weeks ago

Maybe for you it does, although you'd need to test with placebo to really know. It's amazing how much our minds can effect things if we expect things to change.

It could also be that your pills are a significantly higher dose. If 1% is absorbed orally, maybe that pill has 100x the dose required otherwise.

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