Thursday Throughput: Decongestant Edition

Photo by ParentingPatch, CC BY-SA 3.0 , via Wikimedia Commons

An advisory panel to the Food and Drug Administration agreed unanimously on Tuesday that a common decongestant ingredient used in many over-the-counter cold medicines is ineffective.

The panel’s vote tees up a likely decision by the agency on whether to essentially ban the ingredient, phenylephrine, which would result in pulling hundreds of products containing it from store shelves.

If the F.D.A. ordered their removal, a trade group warned that numerous popular products — including Tylenol, Mucinex and Benadryl cold and flu remedies — might become unavailable as companies race to reformulate them.

Agency officials generally follow the recommendations of the advisory panels, though not always, and it could take some months before a final decision is made. And the findings could be contested, prolonging any move toward product substitutions or removing certain stock at stores.

In the meantime, experts advised consumers not to panic or toss out all the drugs in their medicine cabinet. Even though the agency’s advisers have decided the ingredient, phenylephrine, doesn’t work to relieve nasal congestion when taken orally, it is not dangerous, and the products do contain other ingredients that will work to ease cold symptoms.

My response to this can not be printed in these family-friendly pages. Studies have shown that phenylephrine, while having other medical uses, is completely useless as a decongestant, since at least 2007. Consumers have been complaining for 16 years that stuff didn’t work. The only reason it was foisted on us in the first place was because of restrictions on pseudoephedrine. Pseudoephedrine is very effective as a decongestant but can also be used a precursor to the manufacture of methamphetamine. Therefore, state and federal governments, in their long-standing practice of responding to criminal activity by punishing innocent people, responding to the early 2000’s meth epidemic by imposing various restrictions on pseudoephedrine sales.

While there was an immediate drop in meth use immediately after the passage of the CMEA in 2005, it has since rebounded. There is little evidence that restricting pseudoephedrine availability cut meth use at all. At most, it moved the manufacturer to Mexico. In the meantime, 16 years later, here was are, a nation of 330 million people sniffing, snarking and snorting snot because a drug that has never demonstrated efficacy beyond placebo was foisted upon us as a replacement for a drug that actually, you know worked.

The panel’s advice is, as the name on the label suggests, advisory. The FDA is free to ignore it and will no doubt be under pressure from drug manufacturers desperate to have something, anything in their medicine they can remotely call a decongestant even if its decongesting powers are so slightly greater than inhaling mouse farts.¹

[ThTh2] Speaking of junk science, don’t throw away your iPhone 12. French authorities have found that, out of 140 phones, one phone emits slightly more non-harmful radiation than it should. Which is still harmless.

[ThTh3] So what has JWST been up to lately? Oh, nothing. Just parsing the atmosphere of planets dozens of light years away.

[ThTh4] Interestingly, orgasm does not use nerve pathway associated with pleasure, but with pain.

[ThTh5] I can’t vouch for the accuracy, but here is an amazing look at what the Aztec city of Tenochtitlan might have looked like.

[ThTh6] Color me extremely skeptical that we’ve found the remains of an alien spaceship in the ocean.

[ThTh7] I hate to say I told you so but … wait, a minute. I don’t hate saying that. I like saying I told you so (short version of that link: paper straws may be worse for the environment than plastic ones).

1. That’s a joke. Please do not sniff mouse anuses unless you are really aching to try out Hanta virus. Although, unlike phenylephrine, Hanta actually will unclog your nose. Along with all the rest of your orifices and internal organs.