Published December 11, 2023
During the winter respiratory season, it may be tempting to run to the pharmacy and pick up any decongestant that you see. However, a common ingredient found in many over-the-counter cold and flu medications may not be as effective in treating your symptoms as you may think.
When someone is congested, blood vessels in their nose are dilating and phenylephrine is supposed to release some of that pressure. In September, a Food and Drug Administration (FDA) panel found it doesn’t get rid of nasal congestion.
Brittany Langdon, PharmD, Pharmacy Manager for the Apothecary & Wellness Center at Yale New Haven Hospital, and Richard Yik, Yale New Haven Health Pharmacy Intern both say they weren’t surprised by the FDA’s statement.
“The studies that were done on phenylephrine originally had to prove efficacy in some capacity. However, the weight of those studies was questionable, and I think that’s what was ultimately revisited,” said Langdon.
Many over-the-counter cold and flu medications include a mix of ingredients aimed at alleviating several symptoms, so it’s possible those products can provide some relief depending on your illness. When it comes to clearing up nasal congestion though, Langdon and Yik say the behind-the-counter decongestant, pseudoephedrine, is much more effective.
Pseudoephedrine, commonly known as Sudafed, was moved behind the counter due to the Combat Methamphetamine Act, after some people started using the drug for illicit reasons. When used appropriately to treat congestion in consultation with your pharmacist and/or clinician, pseudoephedrine is an effective medication.
Behind-the-counter medications may be harder to access, but patients benefit from interacting with their pharmacist before taking a drug like pseudoephedrine.
“When you speak to a pharmacist to get a medication, that’s when they can screen you to see if you’re an appropriate candidate to use it,” Yik said.
For example, pseudoephedrine is not recommended for those with high blood pressure, and even those without high blood pressure need to take the appropriate dose. Other options for congestion relief can include the use of a humidifier, decongestant nasal spray like Afrin or even a saline nasal spray.
A pharmacist can also make recommendations for when it’s time to speak with a clinician. A fever, any pain, shortness of breath or symptoms that linger for weeks are all possible scenarios when someone should see a doctor.
We all know the best way to deal with the respiratory season is to do your best to avoid getting sick in the first place. It’s not too late to get your flu shot or COVID booster, and those who are older may want to consider other shots, including for RSV, pneumonia and shingles.
If you have questions about any of those common vaccines or medications, ask your pharmacist for help. Yale New Haven Health Pharmacy at North Haven Medical Center offers all available vaccinations to patients 18 and older. Most insurances are accepted and walk-ins are welcome.
“No question is a bad question. No symptom is too small,” said Langdon. “Feel free to use your community resources, including your pharmacist, when you’re feeling sick.”
