Effectiveness of Popular Nasal Decongestant in Question: What It Means for the UK

 

Effectiveness of Popular Nasal Decongestant in Question: What It Means for the UK

In a recent development, an advisory panel of the US Food and Drug Administration (FDA) has raised concerns about the efficacy of a commonly used nasal decongestant found in various cold and flu products. The panel's verdict indicates that phenylephrine, available in tablet, capsule, and liquid forms, does not effectively relieve nasal congestion. However, it's important to note that, despite its ineffectiveness, there are no safety concerns associated with phenylephrine use.

These findings do not extend to the nasal spray version of the drug, which the panel deemed effective.

Phenylephrine, which first appeared in the UK market in the 1970s, works by constricting blood vessels in the nasal passages, improving airflow and making breathing easier.

Today, phenylephrine is a common ingredient in many popular UK cold and flu products, including Lemsip, Beechams, Sudafed, and Benylin. Its popularity surged when pseudoephedrine, another decongestant, faced restrictions on its sales in 2008 due to misuse concerns. As a result, phenylephrine became the primary decongestant in numerous products.

The question arises as to why phenylephrine is only now considered ineffective, given its long history of use since the 1970s. The answer lies in the evolution of how drug effectiveness is assessed. Concerns were first raised in 2007 when it was discovered that, when taken orally in tablet, capsule, or liquid form, less than 1% of phenylephrine remained effective after passing through the stomach. This meager percentage was deemed insufficient to alleviate nasal congestion.

It is crucial to understand that only the oral forms of phenylephrine are considered ineffective because they must traverse the stomach, where the drug's efficacy is substantially reduced. In contrast, the nasal spray version delivers the drug directly to where it's needed.

Furthermore, modern methods for evaluating improvements in nasal congestion are more precise than those available when phenylephrine was first introduced. Using these contemporary methodologies, oral phenylephrine failed to demonstrate any significant impact.

So, should we expect to see many beloved family medicines disappear from pharmacy shelves? In the United States, the FDA is reviewing the advisory panel's findings before taking any action. However, CVS Pharmacy, the largest pharmacy chain in the US, has announced plans to remove certain oral cough and cold products that rely solely on phenylephrine as an active ingredient.

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) has issued a statement. The agency's Chief Safety Officer, Alison Cave, reassured the public, saying, "There have been no new safety concerns identified with phenylephrine-containing products, and people can continue to use them as directed."

As colder temperatures approach and the cold and flu season looms, individuals may find themselves unsure about how to address their stuffy noses. It is crucial to emphasize that neither the US nor the UK drug regulators have recommended removing oral phenylephrine from pharmacy shelves.

For those seeking alternatives, the nasal spray version of phenylephrine is still considered effective. Pseudoephedrine tablets available from behind the pharmacy counter, as well as steroid nasal sprays, saline nasal sprays, and steam inhalation therapy with menthol vapor rubs, are viable options.

As always, your local pharmacist is the best resource for guidance on any drug-related queries and advice on the most suitable treatment options for the upcoming cold and flu season.