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Health


COMMON DECONGESTANTS THAT DON’T ACTUALLY WORK


AN INGREDIENT FOUND IN MANY COLD AND FLU PRODUCTS WON’T RELIEVE YOUR STUFFY
NOSE

--------------------------------------------------------------------------------

By

Rachel Nania,

 
AARP

83 Comments
En español
Published September 18, 2023
/ Updated November 07, 2024
Tim Boyle / Getty Images
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With cold and flu season upon us, it’s time to take stock of what’s in the
medicine cabinet. This year, that process may involve not only getting rid of
any expired boxes and bottles but also rethinking certain remedies that never
worked in the first place. 




The U.S. Food and Drug Administration (FDA) is proposing that phenylephrine, a
common decongestant found in many over-the-counter cold medications, be removed
from these products. The proposal, issued Nov. 7, comes roughly a year after an
advisory panel of experts concluded the ingredient is ineffective at relieving
nasal congestion when taken by mouth. 

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“It is the FDA’s role to ensure that drugs are safe and effective,” Patrizia
Cavazzoni, M.D., director of the FDA’s Center for Drug Evaluation and Research,
said in a statement. “Based on our review of available data, and consistent with
the advice of the advisory committee, we are taking this next step in the
process to propose removing oral phenylephrine because it is not effective as a
nasal decongestant.”



Phenylephrine is supposed to work by reducing swelling of the blood vessels in
the nasal passages, making it easier to breathe. But when taken orally, “it
basically becomes deactivated before it enters your bloodstream,” says Stefanie
Ferreri, a professor of pharmacy at the University of North Carolina Eshelman
School of Pharmacy. “It’s almost like a placebo, a sugar pill, when it’s taken
orally.”  



Experts stress that phenylephrine, which has been sold for decades, isn’t
dangerous, and it is still effective when used as a nasal spray or as drops to
dilate the eyes.



But it can be harmful to your wallet if you’re buying a pill that’s ineffective
to relieve congestion, Ferreri says. Products containing phenylephrine —
including those sold by big brands such as Tylenol, Advil, Sudafed and Mucinex —
generated nearly $1.8 billion in sales in 2022, according to data presented by
the advisory panel in 2023. 

COMMON DECONGESTANTS THAT WON’T WORK

Here are examples of oral medications that may help your headache or sore
throat, but they won’t relieve your stuffy nose.


 1. Advil Sinus Congestion & Pain
 2. Tylenol Cold + Head Congestion Severe
 3. Mucinex Sinus-Max Severe Congestion & Pain Relief
 4. Benadryl Allergy Plus Congestion
 5. DayQuil Cold + Flu
 6. Sudafed PE
 7. Theraflu Severe Cold Relief Daytime
 8. Vicks Sinex Severe

This list is not exhaustive. Phenylephrine is found in a number of oral
over-the-counter products.


WHAT WORKS AND WHAT DOESN’T FOR A STUFFY NOSE



Phenylephrine, sometimes labeled PE on packaging, is sold on its own but is
often found in combination products that contain ingredients meant to knock out
a range of symptoms that can accompany congestion — sore throat, fever, body
aches and so on.




Because of this, you may not want to toss out everything containing
phenylephrine, says Sarah Westberg, a professor at the University of Minnesota
College of Pharmacy. That box of cold and flu medication could help with your
other symptoms, it just won’t unclog your nose.




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If you’re looking for a decongestant that will work, there are options — just be
sure to talk to your doctor or pharmacist before taking one, especially if you
take other medications, experts stress. Nearly half of older adults take at
least five drugs daily.



Pseudoephedrine is an effective oral alternative, Westberg says. It’s available
without a prescription, but it’s not as easy to buy as phenylephrine since
pseudoephedrine can be used to illegally make methamphetamine, a stimulant that
can be highly addictive. It’s technically behind the counter, so you’ll need to
ask the pharmacist for a product containing pseudoephedrine and will only be
able to purchase a limited amount at one time. “You can still get enough to
treat your cough and cold,” Ferreri says.

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Just know that pseudoephedrine can cause an increase in blood pressure, so it’s
important to talk to your doctor before taking it if you have high blood
pressure or heart disease. About 70 percent of adults 65 and older have high
blood pressure.



Another option: “Go straight to the source” and consider a nasal spray, Ferreri
says. A spray product containing phenylephrine will work fine when it comes to
relieving congestion, though this can similarly affect your blood pressure.
Saline nasal sprays that don’t contain medication can also provide relief.



“Consumers should know that a range of safe and effective drugs and other
treatments is available to temporarily relieve congestion symptoms due to
allergies or a common cold,” Theresa Michele, M.D., director of the FDA’s Office
of Nonprescription Drug Products, said in a statement. “Consumers can also talk
to their doctor or pharmacist about ways to treat these symptoms.”




THE DECONGESTANT AISLE COULD SHRINK



The FDA's order is just a proposal; only a final order will affect what products
can be marketed, the agency says.  



If the FDA removes phenylephrine from over-the-counter medications, it could
“have a big impact on the market,” Westberg says. “There are a lot of products
that will need to be reformulated.” (The FDA said it will give companies
“appropriate time” to do this.)



That’s not a bad thing, though, Ferreri says. “Right now, I think we have way
too many [options] on the market, and it’s almost confusing. You want to have
things on the market that are safe and effective, and [we need to] narrow it
down so you know what you’re buying is going to work,” she says.



Editor's note: This story, first published Sept. 18, 2023, has been updated with
new information. 


%{postComment}%

Rachel Nania is an award-winning health editor and writer at AARP.org, who
covers a range of topics including diseases and treatments. 


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