(Philip Crilly, Kingston University)
Nasal Decongestant Research: London: An advisory panel of the US Food and Drug Administration has found in research that a drug used in most cold and flu products does not work to clear blocked nose. The panel noted that phenylephrine in tablet, capsule and liquid form did not provide relief from blocked nose. However, it was reported that despite being ineffective, there were no concerns about its safety, so people should not panic if they are taking the drug. Additionally, the findings do not apply to the nasal spray version of the drug, which the panel considered effective.
Phenylephrine first began to be sold in the UK in the 1970s. It works by shrinking the blood vessels in the nose to improve air flow, making breathing easier. Today, phenylephrine is found in many of the leading UK cold and flu products, including Lemsip, Beechams, Sudafed and Benylin. Are included. Its popularity was further cemented when another decongestant, pseudoephedrine, was banned from sale in 2008 due to abuse concerns, and phenylephrine was chosen as the main decongestant for many products.
Concerns first arose in 2007
Given that it has been used since the 1970s, many may be wondering why it is only now that phenylephrine is being deemed ineffective. The answer lies in the way the drug’s effectiveness is measured today compared to when it was first launched, with concerns first raised in 2007.
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When taking any oral medicine – tablet, capsule, liquid – the medicine has to pass through the stomach before it can have any effect. Part of the drug is broken down in the stomach, the remainder is used by our bodies to treat our symptoms. Early research on phenylephrine has shown that about a third of the drug remains after it leaves the stomach. This was considered sufficient to open the blocked nose.
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However, recent research used more precise methods and found that less than 1% of the phenylephrine remained after leaving the stomach. This figure was considered too low for the drug to have any meaningful effect.
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This is why only oral forms of the drug are considered ineffective, as the nasal spray does not have to go through the stomach and acts directly where it is needed.
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Today, there are also more accurate ways to measure improvement in opening a blocked nose than when phenylephrine was first tested, and, again, using these new methods oral phenylephrine showed no effect at all. Didn’t show.
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So, will we see many of our family’s favorite medications removed from pharmacy shelves? In the US, the FDA says it needs to consider the advisory panel’s findings before taking any action. However, CVS Pharmacy, America’s largest chemist chain, has announced it will remove some oral cough and cold medicines from its shelves. It will remove phenylephrine products in which phenylephrine is the only active ingredient.
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Britain’s medicines regulator, the MHRA, has issued a statement. Alison Cave, the agency’s chief safety officer, said: “No new safety concerns have emerged with products containing phenylephrine and people can continue to use them as directed.”
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As the temperatures are getting cooler and cold and flu season is fast approaching, many people may now be confused about what to do for their blocked nose. It is important to remember that neither US nor UK drug regulators have recommended removing oral phenylephrine from pharmacy shelves.
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However, for those who want to try an alternative, the nasal spray version of phenylephrine is still considered effective. Additionally, pseudoephedrine tablets from behind the pharmacy counter, as well as steroid nasal sprays, saline nasal sprays, and steam inhalation therapy with menthol vapor rub are other options.
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As always, your local pharmacist is the best person to talk to about any medication questions, and for advice on the best treatment options for the coming cold and flu season.