A loophole in FDA processes means older drugs like the ones in oral decongestants weren’t properly tested. Here’s how we learned the most popular one doesn’t work

In 2005, federal law compelled retailers nationwide to move pseudoephedrine, sold as Sudafed, from over-the-counter (OTC) to behind it, so as to combat its use in making illicit methamphetamine. This move changed the formulas of cough and cold medicines in the U.S… It also led me and my colleague Leslie Hendeles to prove that pseudoephedrine’s replacement, oral phenylephrine, was ineffective as a decongestant.

We petitioned the Food and Drug Administration (FDA) twice, yet it took the agency more than a decade and a half to act on our findings.

In September, an agency advisory panel finally agreed with our conclusion that this compound did little to quell congestion and recommended that products containing it be pulled from shelves. If FDA acts on this recommendation, oral phenylephrine could be the first OTC drug approved under the agency’s “monograph” process to be discontinued. But in the meantime, millions of people have been trusting the FDA’s OTC regulatory process to ensure that medications work, but instead have been wasting money for nearly two decades on ones that don’t.

  • monotremata@kbin.social
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    11 months ago

    It drove me nuts that they marketed phenylephrine as “Sudafed PE.” The name Sudafed was derived from the term pseudoephedrine. Once it contains no pseudoephedrine, it becomes pretty misleading to keep that name.

  • Got_Bent@lemmy.world
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    11 months ago

    Pretty much since 2005, I immediately realized that pseudoephedrine worked way better than whatever they replaced it with, so I went ahead and began signing my life away at the counter to continue getting it and using it. And by worked way better, I mean the replacement didn’t do shit.

    I don’t particularly like announcing to the government in writing that I’ve got the sniffles, but damnit, it’s actual relief from symptoms, so declare my snot balls I do and I’ll continue to do so.

  • Shelbyeileen@lemmy.world
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    11 months ago

    New Zealand banned pseudo, because of meth problems, and my family there won’t even use decongestants because it won’t work. They still have meth problems, but no relief from illness. The melatonin is prescription only, too, which is weird to me

  • workerONE@lemmy.world
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    11 months ago

    On a related note when they outlawed Sudafed (ephedrine), makers of methamphetamine started using a different manufacturing process that results in meth that is slightly chemically different, and it makes people really crazy, really fast. Meth always caused psychosis (craziness) but the new version that’s not made with ephedrine is way worse.

    https://www.theatlantic.com/magazine/archive/2021/11/the-new-meth/620174/

  • BradleyUffner@lemmy.world
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    11 months ago

    Weird… I figured it out by taking some when I was congested and noticing that it didn’t work.

    • R0cket_M00se@lemmy.world
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      11 months ago

      I was gonna write some version of this lol

      Yeah it just doesn’t seem to have any tangible effect, no better than a placebo.

  • 𝕸𝖔𝖘𝖘@infosec.pub
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    11 months ago

    For me, phenylephrine actually makes my congestion worse (in the sinuses and in the chest) and leads to longer recovery times. Did you know that some tussins contain phenylephrine? Yeah… I was too miserable the last time I was sick to read the actives list. Paid for it with an added week of recovery. Screw phenylephrine, those who approved it for sale, and those who added it to their meds.

  • el_abuelo@lemmy.ml
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    11 months ago

    This is infuriating.

    Sure - I noticed that my congestion had done fuck all…but I assumed that if I hadn’t taken the BS drug that I would have been even worse! To learn that I could have taken cheap-as-chips aspirin and it had the same effect as the BS tablets for 10x the price has me frothing at the mouth.

    Now I need to figure out how I pay 100x the price to get the the tablet that actually fucking works.

  • Pratai@lemmy.ca
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    11 months ago

    I take Claritin and it absolutely works. Is this not the same thing or am I missing something?

    EDIT: for all the idiots downvoting a simple question…

    Claritin-D has pseudoephedrine in it. THAT is why I asked my question. If you all want more people posting in lemmy, best not to insult people for asking simple questions like you used to on Reddit.

    • CrayonRosary@lemmy.world
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      11 months ago

      You could start by reading the body of the post and see what drug is mentioned. Then compare that to your bottle of Claritin.

      • Pratai@lemmy.ca
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        11 months ago

        Lighten up man. It was just a simple question. It would have taking you far less effort to just not say anything at all.

          • Pratai@lemmy.ca
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            11 months ago

            For the record- Claritin-D has pseudoephedrine in it, genius. That’s why it’s relevant.

            Next time, don’t bother posting without checking your own relevance.

        • pohart@programming.dev
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          11 months ago

          CrayonRosary provided instructions for how to tell. If this change was relevant. And they were respectful about it.

          • Pratai@lemmy.ca
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            11 months ago

            And Claritin-D has pseudoephedrine in it. Which leaves my question unanswered.

            • CrayonRosary@lemmy.world
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              11 months ago

              ”pseudoephedrine” DOES NOT EQUAL ”phenylephrine". How is your question not answered?

              • Pratai@lemmy.ca
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                11 months ago

                5 second google results:

                Claritin-D 24 hour extended release tablets contain 10 mg loratadine in the tablet coating for immediate release and 240 mg pseudoephedrine sulfate in an extended-release core. Claritin-D 24 hour extended release tablets are white to off-white oval, biconvex, coated tablets branded in black with “CLARITIN-D 24 HOUR”.

        • CrayonRosary@lemmy.world
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          11 months ago

          A simple question which revealed you were too lazy to read the article before asking questions. You’re the worst kind of Lemmy user. Why should other people do the work for you just because you’re too lazy to do anything other than read the headline?

          You deserved a little bit of snark. Take your licks and go read the article now.

          • Pratai@lemmy.ca
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            11 months ago

            I read the article, asshole. Claritin-D has pseudoephedrine in it. Which is what I asked what I asked.

            YOU are the worst kind of lemmy user. You’re an arrogant blowhard that has to say shit when they could have just scrolled past and ignored what you didn’t understand.

            Take your likes and delete your embarrassing response.

            • CrayonRosary@lemmy.world
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              11 months ago

              Claritin-D has pseudoephedrine

              You clearly didn’t read the article which says nothing about pseudoephedrine not working. If you had, you wouldn’t have had to ask. Can you not tell the difference between the words pseudoephedrine and phenylephrine?

              Even if we give you the benefit of the doubt, and you were asking a sincere question after having read the article, it was a really poor one. You could have mentioned what your confusion was, but you were to lazy to do even that.

              what you didn’t understand.

              Funny.

              Take your likes

              Take my what now?

              • Pratai@lemmy.ca
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                11 months ago

                It took 5 seconds on google:

                Claritin-D 24 hour extended release tablets contain 10 mg loratadine in the tablet coating for immediate release and 240 mg pseudoephedrine sulfate in an extended-release core. Claritin-D 24 hour extended release tablets are white to off-white oval, biconvex, coated tablets branded in black with “CLARITIN-D 24 HOUR”.

                Stop being stupid.

                • CrayonRosary@lemmy.world
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                  11 months ago

                  Did you still not read the article? Pseudoephedrine WORKS! Oral Phenylephrine DOES NOT! Claritin does NOT contain Phenylephrine. The article says nothing about pseudoephedrine not working, and yet you still don’t get it!

                  No one ever said anywhere that Claritin-D doesn’t contain pseudoephedrine. No one! No one ever said pseudoephedrine doesn’t work. Who are you arguing against? Why are you so dense?

                  Article:

                  Phenylephrine doesn’t work.

                  You:

                  I swear Claritin works! I’m so confused!

                  Me:

                  Claritin isn’t phenylephrine, read the label.

                  You:

                  Nuh uh! Google says it contains pseudoephedrine!!

                  Me: 🤦‍♂️

    • the_artic_one@programming.dev
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      11 months ago

      Claritin is an antihistamine, this is about phenylephrine (Sudafed PE) which was used in just about every OTC daytime cold medicine.

    • Jessica@discuss.tchncs.de
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      11 months ago

      I am assuming you are mistaken and you meant Claritin-D, which does have pseudoephedrine so I don’t know why everyone is downvoting you… it’s also what I’ve always taken when I was congested and it works wonderfully.