I feel like I'm living under a rock, how is everyone in these comments so intimately familiar with this subject? I've never heard the word "phenylephrine" in my life.
If you live in the US or several other places, you probably know that the "good" Sudafed is kept behind the counter, and you have to sign for it. You may have also noticed that there is another version, called "Sudafed PE", that you can just pick up off the shelf.
A lot of people have done that and concluded for themselves that the PE version didn't work. That's why there are so many people commenting that they already knew the thing the article is about.
So... a lot of people were familiar with "PE", and apparently a lot of them knew that it stood for "phenylephrine". And it all touches on a bunch of existing controversy about why the effective medication is locked up.
It wasn't always. People knew that Sudafed was an pretty effective drug. (It was even used, under a different brand, on Apollo missions -- there was a TV ad with an astronaut endorsing it.) A lot of people are grumpy that a well-known effective medicine was made hard to get, and something else sneakily substituted.
The point being, it's not entirely a surprise that people are aware of the phenylephrine -- especially if they're older than, say, 40, and live in the United States. They remember, sniffily, when cold medicine started to suck.
It’s like drinking 15 cups of espresso all at once for me. Jittery; quick tempered; but a clear head and nose. Good with the bad when you’re ill but holy fuck would it be brutal without the head cold + alcohol + caffeine.
In my state, that's not how it works. You have to have a doctor's prescription to get it, which means you have to have a doctor -- and getting a doctor is incredibly difficult.
There's really no reason this shouldn't be OTC.
For years, I had friends in other countries buy it and mail it to me, but that's no longer an option at all.
It was Drixoral, which is a combination of pseudoephedrine and dexbrompheniramine. You can get dexbrompheniramine OTC and combine it with pseudoephedrine and it's OK -- but not quite the same because Drixoral was a time release thing.
I usually pick these cough syrups with codeine when traveling overseas, and has worked extraordinary well, including for my then young children. They are recovering by the 2nd or 3rd day after sleeping though the night without coughing. Obviously children dosage. I think sleep was the medicine.
I've found with most medications looking for an active ingredient and an amount is helpful. You can search for effectiveness or side-effects. The brand I got last time isn't always available and they'll have 3-hour or 12-hour versions with warnings about exceeding recommended dosages (or mixing medications). Or company annoyingly package similarly-branded things that just aren't the same.
Is this not common practice? I would be uncomfortable taking an ambiguously labeled “cold medicine” pill, personally. I know which medicines are effective for me and which are a waste of time and money.
They buy a brand that promises to fix what they don’t like, and if it works, they buy more next time.
https://www.cvs.com/search?searchTerm=acetomeniphen https://www.cvs.com/search?searchTerm=ibuprofin
But there's also one bottle of pills labeled as Arthritis Pain Relief. And one labeled as Muscle Pain relief. Which both have exactly the same medicine and the same time release capsules.
There's a Migraine variant label, a Tension Headache variant label. Just "Headache" relief. There's Back and Body pain relief (though that one is Apsirin, it's just showing up in the acetomeniphen search).
Some years back, Reckitt (British-Dutch multinational) got in trouble with the ACCC (Australia's competition and consumer protection regulator) for doing this. Selling "Headache Pain", "Back Pain", "Period Pain", etc all next to each other, despite all having identical active ingredients. The ACCC took them to court for misleading consumers, and won.
https://www.accc.gov.au/media-release/full-federal-court-ord...
"We can charge twice as much if we put it in a pink packet and say it's for period pain".
Very deceptive.
You missed the step where cartel super-producers (that didn’t depend on small qtys of feedstock from pharmacies) just started producing 5% more to make up for it.
The organized producers appreciated the government shutting down their nibbling competitors.
Sucks for the public though, paying the price for an ineffective measure.
The policy doesn't have to cut off the meth supply to be successful on its own terms.
Moreover we already have the most draconian and well funded drug agency of any OECD democracy, surely they could cope with some trailer park meth labs without having to hassle everyone with allergies or a cold.
Here in Australia we had project STOP in Queensland which started about 20 years ago, and there's an analysis of the outcomes here - https://www.aic.gov.au/publications/tandi/tandi509
tl;dr it did stop pseudoephedrine going to meth labs BUT it has had no long term impact on the number of labs being detected nor seemingly on the availability of crystal meth.
To me that's an abject failure of a policy, but some people look at it like "we restricted a precursor successfully!" and count it as a win.
Zyrtec and Flonase together is probably the best normal combo and is generally accepted to be ok.
Disclaimers: I'm not a doctor. Combining a nose spray and a pill is generally accepted practice and studied in several peer review studies I've seen. Stacking claritin and zyrtec pills together is not generally accepted practice, so don't do it.
Direct decongestants like pseudoephedrine are of limited use because you quickly develop a tolerance and they become ineffective. With corticosteroid nasal sprays, they work best after consistent use over several days and keep working more or less forever.
If they did read the ingredient list, people would realize that all those products in the pharmacy are mostly remixes of the same handful of chemicals sold at different prices.
I guess I only buy decongestants like once a year at most though, I would probably pay more attention if I needed them more often.
This is one of the major problems with putting pseudoephedrine behind the counter. It had been an ingredient in many of these combination products -- after all, if you have a cold, you have the combination of symptoms that come with a cold and want to take the corresponding combination of drugs.
But the combination products are convenience products. You could just as well buy the ingredients individually and take them together. People buy the combination product to be saved the trouble, which isn't compatible with the trouble of getting something from behind the counter.
So there generally isn't a combination product available with the decongestant that actually works in them. And phenylephrine, in addition to not working, has more dangerous side effects (e.g. larger increase in blood pressure) than pseudoephedrine. But now it's the thing in the bottle grandma gets when she has a cold.
But in general for any HN topic the people who have something to say get attracted to the article.
So I have a sore spot about this whole issue. I get made to suffer in order for lawmakers to have an empty gesture toward addressing the meth problem.
I came to the conclusion about these drugs on my own years ago.
I've found that conservative and non-continuous use of Afrin is a better option for me.
Certain individuals are prolific bullshitters too. I’d read a questionable comment and notice it’s the same person.
(My observation is general, not specific to this topic)
I guess the generics could be using cheap corn starch…
Same with pesticides - the brand name products often include things like better surfactants that make them much more effective. At least based on the papers I’ve read.
Not always of course.