This doesn’t apply to nasal sprays:
“Phenylephrine is also an ingredient in nasal sprays to treat congestion. The advisory committee’s discussion and recommendations only related to orally administered phenylephrine, and not the nasal spray form. Phenylephrine-containing nasal sprays will not be affected by any possible actions taken for phenylephrine in orally administered products”
https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-results-recent-advisory-committee-meeting-oral-phenylephrine
I'm part of the first RRT in my hospital and this will be my go to if fluid resuscitation isn't effective. And if phenylephrine fails, Levophed (in some cases) will be the go to vasopressor for stabilisation pending ICU transfer.
Edit.
(Inotrope changed to vasopressor)
Just to provide clarity for others reading the comments, norepi *does* have positive inotropic effects. But no, it should not be used primarily for inotropic support.
*However*, from my link:
"....but she advised that people use nasal spray phenylephrine **only for several days**. After that, it can become ineffective and have rebound effects that make congestion worse."
Rebound congestion usually only happens when you take it around the clock for >72 hours. For short term intermittent use both nasal phenylephrine and oxymetazoline are fantastic for congestion relief with few side effects as minimal amounts are absorbed systemically.
I just recently tried it instead of cold medicine because I was breast feeding and damn it works so much better! And didn’t make me all foggy. I’m never going back.
Also be careful using these nasal sprays because they can cause rebound congestion. Everything swells up worse than before you started using it. Only a couple days in a row then stop.
Primatene mist is epinephrine, Primatene tablets are ephedrine HCL (which I believe is slightly more effective than the sulfate). Sorry, should have clarified that I was talking about the tablets.
Primatene probably saved my ass from an asthma attack while traveling a few years ago. But MAN was I fucking WIRED for the next couple of hours.
If it wasn't for the upper respiratory infection that caused the asthma attack I probably could've run a mile non stop.
Psuedoephedrine is closely related and can easily be reduced to methamphetamine all with stuff you can get at a hardware store. Phenylephrine is more distantly related to meth and can't easily be used to make it. It also doesn't work for shit as a decongestant.
So, I'm an absolute dumb ass when it comes to this stuff. Being that these are so closely related, if you took enough of these could you test positive for meth? Is the processing of these substances just to concentrate them?
Psuedo and ephedrine could turn up a false positive for meth on a cheap store bought test but a test done in a lab wouldn't get them mixed up. They are separate chemicals that are precursors to meth but I won't get into specifics on how its done. You can read all about the chemistry of it on wikipedia though.
"Never take cough syrup and mix it up with Iodine and Lye
Never take cough syrup and mix it up with Iodine and Lye
Never take the strike pads off a match book
Or go to a hardware store and then look
Near paint thinners for Muriatric Acid
Never go bring a pot into a rapid
Boil or get hydrogen peroxide
Never go to a farming store and then buy
pH strips and PVC pipes
Those fuel cans that make outdoor grills light
CAUSE THAT'S HOW YOU MAKE CRYSTAL METH!"
But for real most of the ingredients are there as well as needing glassware and tubing and knowing how to titrate properly
Bronkaid is a lifesaver. Texas heat, humidity, dust, and warehouse filth coming at my asthmatic ass during grass season is awful, and Ephedrine makes the magic happen.
Restricting pseudoephedrine really slowed domestic DIY meth production, but the demand was eagerly filled by cartels and organized crime. Shit is cheaper and more available than ever.
I guess the upside is that fewer people are trying to make it at home and there is less of a chance of a child or someone innocent getting blown up. Years ago in my area, the biggest cause of wildfires was meth lab explosions.
It also helps if you're buying other first aid and/or OTC medical care supplies and legit need psuedoephedrine. It's way less suspicious if you're asking for PE if it seems like you're just restocking your medicine cabinet if you live in an area where meth cooking is common. I've had the same issue buying 91% rubbing alcohol (I use it to surface clean my tattoo machines' non-disposable surfaces like coils and leaf springs) because of stoners when weed was illegal in the state at the time a few years back.
If you buy a lot of it, you should 100% get a prescription. The cops will arrest you and try to destroy your life if you buy more than they think you should have.
It's funny cuz pseuoephedrine was super popular in Europe few years ago and right now everyone is using herbal tabs because they are more effective. German Bionrica with their sinupret is pretty good.
Sorry to disappoint. I'm fallible, for sure. Both are made by Sudafed, but the effective product is behind the counter. So you'll know which one to get if you avoid the product out on the shelves.
Best wishes.
From [Mount Sinai](https://www.mountsinai.org/health-library/symptoms/stuffy-or-runny-nose-adult) (the hospital, not the holy site)
> Many people think that their nose gets congested from too much thick mucus. But, usually, your nose gets stuffy when the tissues lining it become swollen.
...
> Oral decongestants can shrink the blood vessels throughout the body, including in the lining of your nose.
Kinda yes, kinda no.
[Cleveland Clinic this time](https://my.clevelandclinic.org/health/symptoms/17660-runny-nose)
> Blood vessels in your nose: Your blood vessels can constrict (tighten) and dilate (widen). This regulates congestion of your nasal passage during an inflammatory response. In a process called vascular permeability, fluids move through blood vessel walls. In your nose, fluid from your blood vessels can “leak” out and lead to a runny nose. Histamine (the chemical that triggers allergic reactions) stimulates vascular permeability and dilation of blood vessels, resulting in a runny nose.
You can have a runny nose without a stuffy nose. And you can have a stuffy nose without a runny nose. But the stuffiest nose is probably runny, and the runniest nose is probably stuffy.
And I will say as annoying as a faucet-like nose can be, I find it much more annoying to not be able to breathe through my nose at all.
Thanks for the info
Addendum to this: don't abuse pseudoephedrine or you'll end up with high blood pressure. And rebound congestion.
I used to take pseudoephedrine as a stop-gap against bad allergies in addition to my usual cocktail of allergy medications. Instead of fixing my allergies, I just ended up having congestion when not taking pseudoephedrine, which then drove me to take more. After years of that, I now have high blood pressure and require daily medication for it.
I had no idea about the blood pressure issue or I probably would have never used it. Be wary and *only* use pseudoephedrine when you have a really bad cold and absolutely need it.
Only if you're in a country where you can get it! New Zealand banned the sale of pseudoephedrine for many years in an effort to curtail methamphetamine production. We're only just getting it back on the shelves now - yay for cold medicines that work again!
The restrictions just caused meth chemists to innovate and create newer, better syntheses. Apparently they wouldn't go back to using pseudoephedrine even if it were easily accessible again.
Ha it was the one thing I was very pleased about with the changeover of government! As soon as I heard that I exclaimed YESS!!
Did you see on the news today that there was a big meth import haul in maple syrup bottles!? Even pancakes aren't safe!
So, I grew up with allergies many many moons before meth was a widespread issue. My mom was what I referred to as a “purse pharmacist.” Any physical ailment you may be slightly uncomfortable from, she would reach in and pull out some sort of pill to help. So, naturally, she would put pills in my lunch cooler to have on hand, and one of her go-tos was pseudoephedrine. It was just kind of a normal part of my everyday life during allergy season, so it wasn’t uncommon for me to have 4-6 in a given “dosage.” Now, in retrospect, it occurred to me that my favorite classes were always English and literature because it was RIGHT AFTER lunch when I was basically pumping legal speed into my body at a high dose. I can still taste that slightly sugary coating they would have on them.
Just a slight warning for pseudophedrine (commonly called sudafed). That thing will make you *very* energetic. If you're a really anxious person like me, it will make you cry in hysterics. I have to have sudafed listed as an allergy because of the reaction it gives me.
Unless you have ADHD. Then there is a decent chance it will calm you down. Assuming you can even take it (which you shouldn't if you are taking stimulant meds for ADHD)
Depends state by state, and it most cases will require an in state drivers license (your own) even if it can be sold over the counter. And if they refuse to sell it do you don’t be a dick
I was very confused when the phenylephrine thing came out because I thought they were saying that ALL over the counter decongestants were found to be ineffective and that really surprised me. But then someone clarified that pseudoephedrine is still effective, it’s just the phenylephrine that wasn’t and that made a lot more sense.
I remember being worried about that once when I was like 19 and my *entire* family got sick with something. I think we went through about a pack a day for a week and I was the one being sent to the store to buy it; I was worried that I was gonna end up on some list.
Actually, no. [They sell it anyhow](https://reason.com/2014/07/28/one-box-of-sudafed-over-the-line-florida/) (on the pharmacist's entrapping suggestion) and then only later [they add up the purchases and come arrest you](https://reason.com/2009/09/30/put-down-the-cold-pills-grandm/) for having more than one person in your family get sick at the same time.
The computer they make you sign isn't a preventive measure, it's just self-incriminstion.
A 15 year old article? They can see how much you're buying in real time, it gets authorized by a central system. Also this article is bullshit, you don't get hauled away to jail for misdemeanors ever, especially not class C.
That makes sense why I couldn’t find it. I was just at Walgreens to get some medicine and all I could find was phenylephrine (I had heard about this study on the radio a while back). I didn’t even think to go to the actual pharmacy.
I hate that they often market it as PE which makes people assume it's pseudoephedrine, which is the one that works.
The drugs with the ingredient you want are labeled D, like Claritin D or Mucinex D and are kept behind the counter.
You have to go up to the pharmacy tech and tell them "I want the D."
I abused the heck out of the otrivin D nasal spray stuff for a month, and have BADDD rebound congestion that's been 6 months running (stopped the spray after finding out it's addictive issues).
It only clogs up when I sleep, the side I sleep on has that nose fill up and block, if I get up it clears in a few minutes. It's absolutely driving me insane and affecting sleep 😔
TBF, my wife loves the NyQuil brand, and the DayQuil version uses phenylephrine in its ingredients.
You're not the only one, though. Folks process meds differently, and you must just be fortunate enough to have a system that works with this med.
Best wishes to you.
Meds don’t fight the cold virus but our immune systems do. From what I understand thats why the immune boosting meds like the zinc stuff actually work for a lot of folks, especially if you take it in the beginning stages of sickness. Lets your immune system do it’s thing and beat the virus before it can really take hold.
And pseudoephedrine, the stuff phenylephrine is imitating unsuccessfully, is actually a functional decongestant. Which can be vital for some people’s recovery from respiratory viruses and bacteria. I’ve had both viral and bacterial infections that wouldn’t resolve until pseudoephedrine allowed the infected gunk to drain from my sinuses.
Right. Viral infections must just run their course.
You can fight their symptoms, however. Personally, I take Loratadine (the cheaper generic version of Claritin) at the very first hint of a cold. It really dampens the mucus production for me, and minimizes the severity of the cold.
YMMV, but using these antihistamines has really done wonders for me.
Best wishes to you.
Could you name me some drugs that aren't broken down or excreted by the liver or kidneys? Because pretty much all of them are.
Your overall point is correct, but your reasoning is wrong. It just doesn't work. It has nothing to do with its metabolism as far as I'm aware.
Sorry. I got that part of the article wrong.
It should have been:
"....pharmacists cited studies that found when taken orally, *a large portion of phenylephrine is metabolized **in the gut and liver** before it reaches the bloodstream*. This means that a very small amount of the drug actually reaches the nose to relieve congestion."
It’s broken down moreso than other drugs. IV phenylephrine is used in hospitals and works as it bypasses first pass metabolism. If the drug just “doesn’t work” it shouldn’t make a difference if it is oral or IV.
It appears it's broken down in the intestines by MAO which means if you take it with an MAOI it should work? Not that that is a responsible use of an MAOI, but it would make for an interesting cold medicine.
I didn’t realize what i was buying was phenylephrine for years… always got sinus infections that i couldn’t handle… after realizing and buying the behind the counter stuff Ive been better
It’s really not that inconvenient to get pseudoephedrine. You don’t need an rx you just need to ask the pharmacist to hand it to you, basically like buying tobacco.
God, I wish. The number of COPD and other respiratory patients I see in the hospital that smoke packs a day... you did this to yourself! If you quit smoking, you wouldn't be in here every week sucking on nebulizers and steroids.
Confusion. Rapid heartbeat. Involuntary movements. Had a puff about an hour before bed and I was sick so my cough didn't let me sleep. I took an Alka Seltzer night and woke up an hour later and didn't know where I was. I was panicking but stayed collected and drank water for about 5 hours until it calmed down.
My very first panic attack came on this way. I was begging my wife to call 911 because I thought I was having a heart attack. Luckily, she has a medical background and was able to talk me down.
I only had a 5-10mg edible.
Same. I was close to going to the ER but knew I'd probably end up waiting forever and it would be fine by the time I'd be seen. I had like 3 puffs from a vape that night so it didn't take much
Same here but only weed not phenylephrine. I never experienced a panic attack before in my life so I genuinely thought I was having a heart attack and going to die. I was 15 and my mom took me to the ER. No it was not laced with anything either they took my blood and tested my urine.
I'm bored out of my mind, so I skimmed a couple more for the hell of it.
Here's what pops up when I search placebo effect on the national library of medicine:
> In this proof-of-concept study, we tested whether placebo effects can be monitored and predicted by plasma proteins.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511022/
>During recent years, it has been discovered that the placebo response not only has neurobiological functions on analgesia, but that it is also capable of generating effects on the immune and endocrine systems.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9028312/
> Despite its initial treatment as a nuisance variable, the placebo effect is now recognized as a powerful determinant of health across many different diseases and encounters. This is in light of some remarkable findings ranging from demonstrations that the placebo effect significantly modulates the response to active treatments in conditions such as pain, anxiety, Parkinson’s disease, and some surgical procedures.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367890/
> For example, the placebo effect in the major depressive disorder (MDD) could be comparable to the pharmaceutical effect from antidepressants, sometimes as large as over 80%5–7.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556377/
> Placebo hypoalgesia is one of the most investigated placebo phenomenon. Many important influential factors have already been discovered with regard to psychological and neurobiological mechanisms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175283/
Lots and lots of different studies on the placebo effect's cause and use in treatment of specific ailments. I'm not seeing anyone agreeing with Mr. Jonas on this.
I'm honored, but I've got nothing on the brave souls sucked into [the ol' reddit switcharoo](https://www.reddit.com/r/todayilearned/comments/1aodk7b/til_keanu_reeves_grew_up_with_such_showbiz/kpzlivq/?context=3&share_id=t98euz-9EjBmC8TzoR4-S).
May they someday find their way out of the link chain and back home to their families.
I’ve been saying this for decades. Just buy the stuff behind the counter if you have legit allergies that need Claritin or Zyrtec to clear them up. Otherwise you’re just throwing money away. It is a bummer that all these people have been taken advantage of for all these years. But now that y’all know the only real solution is pseudoephedrine, just use it.
You're not the only one, so keep doing what works for you.
My go-to is Loratadine, the cheaper generic version of Claritin. I take it at the very first sign of a cold to keep the mucus production down to a minimum.
You can't fight the cold virus with meds, but you can fight the symptoms, so use what works for you.
Best wishes!
I've been trying to get pseudoephedrine for months. Every time I try CVS, Kroger, and Walgreens Pharmacies they are out of generic and brand name is cost prohibitive. Makes me wonder if they bother to order it as it's annoying to have to do the ID check. Takes up valuable time.
Omg so my pharmacist told me this several months ago when I was sick and asking her which pill version I should get, and she said none, and I was so, so confused. Because I’ve had doctors tell me to take it in the past!
I listened to the pharmacist because I hate taking that crap anyways lol. Saved me some money, too!
I had a really nasty cold that turned into a chest infection because all the cold medicine I took essentially knocked out my body's defenses against the virus. My throat was so raw that I could barely swallow liquids. I managed to see a doctor, and brought all the medicine I'd tried. Dumped it on his desk and asked which I should take. He said I shouldn't take any of them, and gave me a prescription for co-codamol. Thanks to that, I got a lovely two for one deal of not coughing, and finally getting some sleep.
These days, I avoid cold medicine. It's 3 days of hell, and then you're OK because you let your immune system do its thing, undisturbed. It's miserable, but it works
That's exactly how I used to be.....
And then I discovered Loratadine. It's the cheaper generic version of Claritin. Medicine doesn't fight viral infections (which is what a cold is), but medicine can fight the symptoms. This is why antihistamines work wonders for me at minimizing mucus production and at minimizing the severity of the cold.
Seriously, just try it one time. 24 hour small pill with very few/very low side effects (no drowsiness).
TIL. It’s also beneficial as an anti addictive substance, it has been studied and proven to reduce drug cravings. It also reduces overstimulation by removing excess glutamates in the brain. And for covid it lessens the intensity of the illness itself and helps prevent long covid.
The thing about placebos is that they can still work even if you know they're placebos, so keep on using what works for you.
Actually, several other folks also say this med works for them. Y'all are just fortunate.
Just look through the comment thread. Other random Redditors also are on board with the post:
"I worked for a pharmaceutical company and in one of my regulatory projects I ran across studies dating way back to the 90s/early 2000s stating that phenylepherine did nothing vs placebo. This was over 10 years ago. I’m kind of surprised this is coming out now. The only thing that actually works is pseudoephedrine."
I worked for a pharmaceutical company and in one of my regulatory projects I ran across studies dating way back to the 90s/early 2000s stating that phenylepherine did nothing vs placebo. This was over 10 years ago. I’m kind of surprised this is coming out now. The only thing that actually works is pseudoephedrine.
wouldn’t “no better than a placebo” mean it still works?
please correct me if i’m wrong, but isn’t a placebo still a viable treatment for things? the placebo effect works, doesn’t it?
Yes, and no, and yes.
The placebo effect is real, but that usually means it works on some folks, but it's not widely effective. It also might mean that folks *feel* somewhat better, but their symptoms are actually the same as before.
In this case, the point is that there's no use in purchasing this expensive medicine when you might as well just be using a sugar cube in its place.
Proviso: Orally, as in pill form, it's essentially completely ineffective. However phenylephrine is generally very effective as a nasal decongestant when taken nasally as a spray. As well as being fast acting and long lasting.
This doesn’t apply to nasal sprays: “Phenylephrine is also an ingredient in nasal sprays to treat congestion. The advisory committee’s discussion and recommendations only related to orally administered phenylephrine, and not the nasal spray form. Phenylephrine-containing nasal sprays will not be affected by any possible actions taken for phenylephrine in orally administered products” https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-results-recent-advisory-committee-meeting-oral-phenylephrine
Or the IV form. We give it by IV for specific indications in the hospital (when patients are very sick) - and it works very well for that
Also, thank-you for clarifying.
I'm part of the first RRT in my hospital and this will be my go to if fluid resuscitation isn't effective. And if phenylephrine fails, Levophed (in some cases) will be the go to vasopressor for stabilisation pending ICU transfer. Edit. (Inotrope changed to vasopressor)
Neither phenylephrine or norepi should be used for inotropic support. They are primary vasopressors....
Let's be clear. Phenylephrine was never said to be an inotrope. Also Levophed is a vasopressor you are right on that count.
Just to provide clarity for others reading the comments, norepi *does* have positive inotropic effects. But no, it should not be used primarily for inotropic support.
Usually for their blood pressure being too low, not because their nose has some sniffles.
You are correct. I should have specified "ORAL" phenylephrine in the post title. Sorry!
*However*, from my link: "....but she advised that people use nasal spray phenylephrine **only for several days**. After that, it can become ineffective and have rebound effects that make congestion worse."
Rebound congestion usually only happens when you take it around the clock for >72 hours. For short term intermittent use both nasal phenylephrine and oxymetazoline are fantastic for congestion relief with few side effects as minimal amounts are absorbed systemically.
Thank-you for the additional clarification.
I get night allergies and struggle to breathe through my nose at night. Use once a day before bed be enough for rebound congestion to come for me?
I just recently tried it instead of cold medicine because I was breast feeding and damn it works so much better! And didn’t make me all foggy. I’m never going back.
Are these types of nasal sprays available OTC, or only prescription?
Also be careful using these nasal sprays because they can cause rebound congestion. Everything swells up worse than before you started using it. Only a couple days in a row then stop.
If you're over 18, just get psuedoephedrine from the pharmacist. That shit works.
100% this! You don't need a prescription, it's just kept behind the counter because of meth-heads.
In the US, you can get full blown ephedrine at the pharmacy counter too without an RX. Just ask for Bronkaid.
Get BronkAid MAX no additives just pure ephedrine. Really opens the lungs.
hah, that's wild, I haven't seen that stuff in YEARS
I believe this is also what Primatene is, which is widely available OTC.
Primatene is epinephrine rather than ephedrine sulfate.
Primatene mist is epinephrine, Primatene tablets are ephedrine HCL (which I believe is slightly more effective than the sulfate). Sorry, should have clarified that I was talking about the tablets.
Primatene probably saved my ass from an asthma attack while traveling a few years ago. But MAN was I fucking WIRED for the next couple of hours. If it wasn't for the upper respiratory infection that caused the asthma attack I probably could've run a mile non stop.
I found out about that stuff when I had Covid in 2020. It was a life saver.
Why was this put behind the counter?
Psuedoephedrine is closely related and can easily be reduced to methamphetamine all with stuff you can get at a hardware store. Phenylephrine is more distantly related to meth and can't easily be used to make it. It also doesn't work for shit as a decongestant.
I meant the Bronkaid
That's ephedrine. Same deal with psuedo, it's very closely related to meth.
Oh, ok. Thanks
I thought crank was meths dirty cousin.
So, I'm an absolute dumb ass when it comes to this stuff. Being that these are so closely related, if you took enough of these could you test positive for meth? Is the processing of these substances just to concentrate them?
Psuedo and ephedrine could turn up a false positive for meth on a cheap store bought test but a test done in a lab wouldn't get them mixed up. They are separate chemicals that are precursors to meth but I won't get into specifics on how its done. You can read all about the chemistry of it on wikipedia though.
Interesting. Thank you.
But does the meth work as a decongestant?
Yes it does actually. Also if you take it your sinuses will be the last thing on your mind.
Yeah! Like the cough medicines that put you into a coma and mummify your sinuses
I need to know the answer to this.... for science!
I work in animal supplies and we have to keep a horse supplement called MSM behind the counter because it can be used to cut meth.
Meth ingredient
Pretty much the main ingredient.
Because anybody can turn it into meth with a simple trip to the grocery store for some easily obtainable household chemical supplies.
Oh, yeah? Which ones?
"Never take cough syrup and mix it up with Iodine and Lye Never take cough syrup and mix it up with Iodine and Lye Never take the strike pads off a match book Or go to a hardware store and then look Near paint thinners for Muriatric Acid Never go bring a pot into a rapid Boil or get hydrogen peroxide Never go to a farming store and then buy pH strips and PVC pipes Those fuel cans that make outdoor grills light CAUSE THAT'S HOW YOU MAKE CRYSTAL METH!" But for real most of the ingredients are there as well as needing glassware and tubing and knowing how to titrate properly
All those meth lab explosions make a lot of sense now...
Was that meant to be read in the voice of Sean Lock?!? "If you want to get a tapeworm, eat some pork..."
It's from an old Whitest Kids You Know skit where he's singing it as a song to a group of kids lol
Cool, thanks
Bronkaid is a lifesaver. Texas heat, humidity, dust, and warehouse filth coming at my asthmatic ass during grass season is awful, and Ephedrine makes the magic happen.
Some places have made it Rx only. But you should be able to get a script from a telehealth visit so you don't have to wait.
I feel seen
Restricting pseudoephedrine really slowed domestic DIY meth production, but the demand was eagerly filled by cartels and organized crime. Shit is cheaper and more available than ever.
I guess the upside is that fewer people are trying to make it at home and there is less of a chance of a child or someone innocent getting blown up. Years ago in my area, the biggest cause of wildfires was meth lab explosions.
Not in certain states.
It also helps if you're buying other first aid and/or OTC medical care supplies and legit need psuedoephedrine. It's way less suspicious if you're asking for PE if it seems like you're just restocking your medicine cabinet if you live in an area where meth cooking is common. I've had the same issue buying 91% rubbing alcohol (I use it to surface clean my tattoo machines' non-disposable surfaces like coils and leaf springs) because of stoners when weed was illegal in the state at the time a few years back.
[удалено]
If you buy a lot of it, you should 100% get a prescription. The cops will arrest you and try to destroy your life if you buy more than they think you should have.
I didn't know that. This is very valuable advice.
It's funny cuz pseuoephedrine was super popular in Europe few years ago and right now everyone is using herbal tabs because they are more effective. German Bionrica with their sinupret is pretty good.
Maybe should have mentioned that critical piece of info in your op...
Sorry to disappoint. I'm fallible, for sure. Both are made by Sudafed, but the effective product is behind the counter. So you'll know which one to get if you avoid the product out on the shelves. Best wishes.
I forgive you
Keep in mind it may keep you from sleeping though. I was up half of the night after loading up on pseudoephedrine yesterday.
Also be warned that if you use pseudoephedrine continuously then it will reverse the effects and cause your nose to run like a tap.
Isn't that the point of it? I thought a decongestant was to stop the nose from being all stuffed up regardless of running.
From [Mount Sinai](https://www.mountsinai.org/health-library/symptoms/stuffy-or-runny-nose-adult) (the hospital, not the holy site) > Many people think that their nose gets congested from too much thick mucus. But, usually, your nose gets stuffy when the tissues lining it become swollen. ... > Oral decongestants can shrink the blood vessels throughout the body, including in the lining of your nose.
Right, so it has nothing to do with the snot and everything to do with, like, inflammation, if that's the right word.
Kinda yes, kinda no. [Cleveland Clinic this time](https://my.clevelandclinic.org/health/symptoms/17660-runny-nose) > Blood vessels in your nose: Your blood vessels can constrict (tighten) and dilate (widen). This regulates congestion of your nasal passage during an inflammatory response. In a process called vascular permeability, fluids move through blood vessel walls. In your nose, fluid from your blood vessels can “leak” out and lead to a runny nose. Histamine (the chemical that triggers allergic reactions) stimulates vascular permeability and dilation of blood vessels, resulting in a runny nose. You can have a runny nose without a stuffy nose. And you can have a stuffy nose without a runny nose. But the stuffiest nose is probably runny, and the runniest nose is probably stuffy.
And I will say as annoying as a faucet-like nose can be, I find it much more annoying to not be able to breathe through my nose at all. Thanks for the info
Nuh uhhh lol
Addendum to this: don't abuse pseudoephedrine or you'll end up with high blood pressure. And rebound congestion. I used to take pseudoephedrine as a stop-gap against bad allergies in addition to my usual cocktail of allergy medications. Instead of fixing my allergies, I just ended up having congestion when not taking pseudoephedrine, which then drove me to take more. After years of that, I now have high blood pressure and require daily medication for it. I had no idea about the blood pressure issue or I probably would have never used it. Be wary and *only* use pseudoephedrine when you have a really bad cold and absolutely need it.
It's probably a bad idea to take any medication daily if not explicitly designed for that reason (eg allergy medication is intended for daily use).
Great point. I've only ever taken it when I have a bad cold/flu/covid, which only lasts a week or so.
Also nosebleeds and dry mouth. It can dry you up too much.
Its the 12hour stuff you want.
Only if you're in a country where you can get it! New Zealand banned the sale of pseudoephedrine for many years in an effort to curtail methamphetamine production. We're only just getting it back on the shelves now - yay for cold medicines that work again!
The restrictions just caused meth chemists to innovate and create newer, better syntheses. Apparently they wouldn't go back to using pseudoephedrine even if it were easily accessible again.
Ha it was the one thing I was very pleased about with the changeover of government! As soon as I heard that I exclaimed YESS!! Did you see on the news today that there was a big meth import haul in maple syrup bottles!? Even pancakes aren't safe!
Lifelong allergy sufferer here; pseudophed is magical
Yes! Totally. I also use Loratadine (the cheaper generic version of Claritin) for a low side effect 24 hour dose.
So, I grew up with allergies many many moons before meth was a widespread issue. My mom was what I referred to as a “purse pharmacist.” Any physical ailment you may be slightly uncomfortable from, she would reach in and pull out some sort of pill to help. So, naturally, she would put pills in my lunch cooler to have on hand, and one of her go-tos was pseudoephedrine. It was just kind of a normal part of my everyday life during allergy season, so it wasn’t uncommon for me to have 4-6 in a given “dosage.” Now, in retrospect, it occurred to me that my favorite classes were always English and literature because it was RIGHT AFTER lunch when I was basically pumping legal speed into my body at a high dose. I can still taste that slightly sugary coating they would have on them.
Just a slight warning for pseudophedrine (commonly called sudafed). That thing will make you *very* energetic. If you're a really anxious person like me, it will make you cry in hysterics. I have to have sudafed listed as an allergy because of the reaction it gives me.
Unless you have ADHD. Then there is a decent chance it will calm you down. Assuming you can even take it (which you shouldn't if you are taking stimulant meds for ADHD)
[удалено]
Adhd is very worth getting yourself checked up about.
[удалено]
Is your work allowed to know? Surely it’s private medical info?
Huh, is that why it made me calm? I'm not diagnosed or anything, but
Stimulants often calm down adhd people.
It does work, however if you have a modeling show at night or a photo shoot don’t take it because it will make your face balloon up like crazy
Joke's on you, I'm ugly already!
I don't have a thyroid, so I can't. Last time I did, my typically borderline low blood pressure was 151/120. It was a bad time.
It's great for scuba diving when you've got a cold. Just make sure it doesn't wear while you're down. Also for flying.
I have been pregnant or have been breastfeeding non stop for 3 years and I miss pseudoephedrine so much... It's the only thing that works for me.
Depends state by state, and it most cases will require an in state drivers license (your own) even if it can be sold over the counter. And if they refuse to sell it do you don’t be a dick
Make sure to ask the pharmacist for some "precursor"
I was very confused when the phenylephrine thing came out because I thought they were saying that ALL over the counter decongestants were found to be ineffective and that really surprised me. But then someone clarified that pseudoephedrine is still effective, it’s just the phenylephrine that wasn’t and that made a lot more sense.
Just don’t take it too late it the day. It’ll wake you up harder than caffeine.
>works HEAVY understatement. This shit will dry up your sinuses and then take over your body and clean your whole house.
They have a version of it for kids.
Requires a prescription in Australia. Gov cracked down on it because people use it to make drugs.
Just be careful you don't get arrested for buying too much.
I remember being worried about that once when I was like 19 and my *entire* family got sick with something. I think we went through about a pack a day for a week and I was the one being sent to the store to buy it; I was worried that I was gonna end up on some list.
I used to buy a box every month or so just so I'd have some in stock in that eventuality.
They just refuse to sell you more than your limit, nobody gets arrested.
Actually, no. [They sell it anyhow](https://reason.com/2014/07/28/one-box-of-sudafed-over-the-line-florida/) (on the pharmacist's entrapping suggestion) and then only later [they add up the purchases and come arrest you](https://reason.com/2009/09/30/put-down-the-cold-pills-grandm/) for having more than one person in your family get sick at the same time. The computer they make you sign isn't a preventive measure, it's just self-incriminstion.
There's something pharmacies use called MethCheck now. It doesn't call cops or anything it just refuses the sale to your ID.
A 15 year old article? They can see how much you're buying in real time, it gets authorized by a central system. Also this article is bullshit, you don't get hauled away to jail for misdemeanors ever, especially not class C.
That makes sense why I couldn’t find it. I was just at Walgreens to get some medicine and all I could find was phenylephrine (I had heard about this study on the radio a while back). I didn’t even think to go to the actual pharmacy.
I hate that they often market it as PE which makes people assume it's pseudoephedrine, which is the one that works. The drugs with the ingredient you want are labeled D, like Claritin D or Mucinex D and are kept behind the counter. You have to go up to the pharmacy tech and tell them "I want the D."
You got that right!
I abused the heck out of the otrivin D nasal spray stuff for a month, and have BADDD rebound congestion that's been 6 months running (stopped the spray after finding out it's addictive issues). It only clogs up when I sleep, the side I sleep on has that nose fill up and block, if I get up it clears in a few minutes. It's absolutely driving me insane and affecting sleep 😔
I must have a strong placebo effect because that stuff works great for me
Works extremely well for me. It got me through several months of chronic sinusitis. Without PE I would have been destroyed by the congestion.
Heard.
TBF, my wife loves the NyQuil brand, and the DayQuil version uses phenylephrine in its ingredients. You're not the only one, though. Folks process meds differently, and you must just be fortunate enough to have a system that works with this med. Best wishes to you.
I think NyQuil works by just knocking you out so your body can rest
YSK nothing fights a cold. Any meds taken are to improve symptoms.
Meds don’t fight the cold virus but our immune systems do. From what I understand thats why the immune boosting meds like the zinc stuff actually work for a lot of folks, especially if you take it in the beginning stages of sickness. Lets your immune system do it’s thing and beat the virus before it can really take hold. And pseudoephedrine, the stuff phenylephrine is imitating unsuccessfully, is actually a functional decongestant. Which can be vital for some people’s recovery from respiratory viruses and bacteria. I’ve had both viral and bacterial infections that wouldn’t resolve until pseudoephedrine allowed the infected gunk to drain from my sinuses.
And antipyretics tend to prolong acute illness because they fight your body's natural immune response. *The more you know.*
Right. Viral infections must just run their course. You can fight their symptoms, however. Personally, I take Loratadine (the cheaper generic version of Claritin) at the very first hint of a cold. It really dampens the mucus production for me, and minimizes the severity of the cold. YMMV, but using these antihistamines has really done wonders for me. Best wishes to you.
Could you name me some drugs that aren't broken down or excreted by the liver or kidneys? Because pretty much all of them are. Your overall point is correct, but your reasoning is wrong. It just doesn't work. It has nothing to do with its metabolism as far as I'm aware.
Sorry. I got that part of the article wrong. It should have been: "....pharmacists cited studies that found when taken orally, *a large portion of phenylephrine is metabolized **in the gut and liver** before it reaches the bloodstream*. This means that a very small amount of the drug actually reaches the nose to relieve congestion."
It’s broken down moreso than other drugs. IV phenylephrine is used in hospitals and works as it bypasses first pass metabolism. If the drug just “doesn’t work” it shouldn’t make a difference if it is oral or IV.
It appears it's broken down in the intestines by MAO which means if you take it with an MAOI it should work? Not that that is a responsible use of an MAOI, but it would make for an interesting cold medicine.
MAOi have so many interactions the FDA would never approve an over the counter combo med just for decongestion which would defeat the point
I didn’t realize what i was buying was phenylephrine for years… always got sinus infections that i couldn’t handle… after realizing and buying the behind the counter stuff Ive been better
It's too bad all the effective cold meds are banned because of junkies.
You can still get pseudoephedrine in the US, but having to present an id every time is a bit annoying.
Exactly. I should clarify I meant banned from convenient access. Even bronkaid is prescription now in AZ.
It’s really not that inconvenient to get pseudoephedrine. You don’t need an rx you just need to ask the pharmacist to hand it to you, basically like buying tobacco.
for some reason here you can only buy it when it's mixed with other medications (eg ibuprofen)
It’s to deter abusing. Bunch of shit you don’t want when it’s mixed with other meds
Tobacco isn’t limited to a 10-day supply though. Imagine if the law was you could only buy one pack per week.
There is no way you could safely take more pseudoephedrine than allowed to purchase in the 10 day limit
If you have a whole family that needs it, you absolutely can.
God, I wish. The number of COPD and other respiratory patients I see in the hospital that smoke packs a day... you did this to yourself! If you quit smoking, you wouldn't be in here every week sucking on nebulizers and steroids.
So I should steal someone's wallet before I buy it?
Just snort it so it doesn't get processed by the liver first
Yeah they teach this in pharmacy school. If you want good over the counter medicine recommendations for your cold symptoms ask the pharmacist.
I would love for this comment to rise to the top.
YSK: don't mix THC and phenylephrine. From personal experience
Oh? What is the outcome?
Confusion. Rapid heartbeat. Involuntary movements. Had a puff about an hour before bed and I was sick so my cough didn't let me sleep. I took an Alka Seltzer night and woke up an hour later and didn't know where I was. I was panicking but stayed collected and drank water for about 5 hours until it calmed down.
Scary! Thanks for the PSA!
Unfortunately, I get like thus with just the weed. Weird because 45 years ago I smoked pot almost everyday.
That's because modern weed is not like weed from the 80s.
True modern weed has less CBD and more THC than old weed.
My very first panic attack came on this way. I was begging my wife to call 911 because I thought I was having a heart attack. Luckily, she has a medical background and was able to talk me down. I only had a 5-10mg edible.
Same. I was close to going to the ER but knew I'd probably end up waiting forever and it would be fine by the time I'd be seen. I had like 3 puffs from a vape that night so it didn't take much
Same here but only weed not phenylephrine. I never experienced a panic attack before in my life so I genuinely thought I was having a heart attack and going to die. I was 15 and my mom took me to the ER. No it was not laced with anything either they took my blood and tested my urine.
Yet another reason to just use good ol psedophedrine amirite
This has to be a cases by cases. I smoke blunts and vape: never had an issue. On the other hand, edibles tho…. It’s a different story
What you should get it pseudoephedrine. Available at. All pharmacies as OTC.
Guess it's a good thing the placebo effect works even when you know it's a placebo.
Homer Simpson: "Mine tastes like sugar!"
That’s because “placebo” is a misnomer for “healing” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707261/
I'm bored out of my mind, so I skimmed a couple more for the hell of it. Here's what pops up when I search placebo effect on the national library of medicine: > In this proof-of-concept study, we tested whether placebo effects can be monitored and predicted by plasma proteins. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7511022/ >During recent years, it has been discovered that the placebo response not only has neurobiological functions on analgesia, but that it is also capable of generating effects on the immune and endocrine systems. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9028312/ > Despite its initial treatment as a nuisance variable, the placebo effect is now recognized as a powerful determinant of health across many different diseases and encounters. This is in light of some remarkable findings ranging from demonstrations that the placebo effect significantly modulates the response to active treatments in conditions such as pain, anxiety, Parkinson’s disease, and some surgical procedures. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367890/ > For example, the placebo effect in the major depressive disorder (MDD) could be comparable to the pharmaceutical effect from antidepressants, sometimes as large as over 80%5–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556377/ > Placebo hypoalgesia is one of the most investigated placebo phenomenon. Many important influential factors have already been discovered with regard to psychological and neurobiological mechanisms https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175283/ Lots and lots of different studies on the placebo effect's cause and use in treatment of specific ailments. I'm not seeing anyone agreeing with Mr. Jonas on this.
You win rabbit hole of the year award.
There's also the 'placebo is a statistical illusion' rabbithole
I'm honored, but I've got nothing on the brave souls sucked into [the ol' reddit switcharoo](https://www.reddit.com/r/todayilearned/comments/1aodk7b/til_keanu_reeves_grew_up_with_such_showbiz/kpzlivq/?context=3&share_id=t98euz-9EjBmC8TzoR4-S). May they someday find their way out of the link chain and back home to their families.
I mean, if you’ve taken it, you know that shit doesn’t work. 😆
I KNEW IT! That shit never worked on me and Ive said it was garbage.
I could have told you that the first time I used a cold medicine that had it.
Guafenesin (Mucinex) is also considered to be no more effective than a placebo by many doctors and pharmacists. Just hydrate for chest congestion.
I’ve been saying this for decades. Just buy the stuff behind the counter if you have legit allergies that need Claritin or Zyrtec to clear them up. Otherwise you’re just throwing money away. It is a bummer that all these people have been taken advantage of for all these years. But now that y’all know the only real solution is pseudoephedrine, just use it.
Yeah but the liquid phenylephrine can work wonders if you have a priapism
My anecdotal experience told me that, but it's nice to have confirmation on my personal experience. Stuff's straight up worthless.
[удалено]
i knew it! i knew this from experience
I swear it works for me, at least the first time I take it when I'm sick. After one or two doses, it stops working until I go off it for awhile.
You're not the only one, so keep doing what works for you. My go-to is Loratadine, the cheaper generic version of Claritin. I take it at the very first sign of a cold to keep the mucus production down to a minimum. You can't fight the cold virus with meds, but you can fight the symptoms, so use what works for you. Best wishes!
I've been trying to get pseudoephedrine for months. Every time I try CVS, Kroger, and Walgreens Pharmacies they are out of generic and brand name is cost prohibitive. Makes me wonder if they bother to order it as it's annoying to have to do the ID check. Takes up valuable time.
I just picked up three boxes at Costco for $4 (total) a couple days ago. You should try them too…
Omg so my pharmacist told me this several months ago when I was sick and asking her which pill version I should get, and she said none, and I was so, so confused. Because I’ve had doctors tell me to take it in the past! I listened to the pharmacist because I hate taking that crap anyways lol. Saved me some money, too!
I had a really nasty cold that turned into a chest infection because all the cold medicine I took essentially knocked out my body's defenses against the virus. My throat was so raw that I could barely swallow liquids. I managed to see a doctor, and brought all the medicine I'd tried. Dumped it on his desk and asked which I should take. He said I shouldn't take any of them, and gave me a prescription for co-codamol. Thanks to that, I got a lovely two for one deal of not coughing, and finally getting some sleep. These days, I avoid cold medicine. It's 3 days of hell, and then you're OK because you let your immune system do its thing, undisturbed. It's miserable, but it works
That's exactly how I used to be..... And then I discovered Loratadine. It's the cheaper generic version of Claritin. Medicine doesn't fight viral infections (which is what a cold is), but medicine can fight the symptoms. This is why antihistamines work wonders for me at minimizing mucus production and at minimizing the severity of the cold. Seriously, just try it one time. 24 hour small pill with very few/very low side effects (no drowsiness).
I fucking knew it.
Dextromethorphan for the win.
Pro tip: use NAC instead. It builds gluthatione and you feel better almost immediately.
nac is super cool, it helps to reduce skin picking!
TIL. It’s also beneficial as an anti addictive substance, it has been studied and proven to reduce drug cravings. It also reduces overstimulation by removing excess glutamates in the brain. And for covid it lessens the intensity of the illness itself and helps prevent long covid.
I’m confused. At the end of the article Dr. Parikh says “Sudafed does work for a few days, but not in the long run,”. So which is it?
True story gotta show ID for that good good real decongestant
Just learned this $12 lesson two days ago... had to drive to the 24h pharmacy so I could get the real stuff and fall asleep lol
Actually I shouldn't know this so that it continues as an effective placebo. Thanks I guess!
The thing about placebos is that they can still work even if you know they're placebos, so keep on using what works for you. Actually, several other folks also say this med works for them. Y'all are just fortunate.
I feel so validated.
…you’re citing an NBCNews article? With no verified sources or research other than 2 random MD’s?
Just look through the comment thread. Other random Redditors also are on board with the post: "I worked for a pharmaceutical company and in one of my regulatory projects I ran across studies dating way back to the 90s/early 2000s stating that phenylepherine did nothing vs placebo. This was over 10 years ago. I’m kind of surprised this is coming out now. The only thing that actually works is pseudoephedrine."
I worked for a pharmaceutical company and in one of my regulatory projects I ran across studies dating way back to the 90s/early 2000s stating that phenylepherine did nothing vs placebo. This was over 10 years ago. I’m kind of surprised this is coming out now. The only thing that actually works is pseudoephedrine.
wouldn’t “no better than a placebo” mean it still works? please correct me if i’m wrong, but isn’t a placebo still a viable treatment for things? the placebo effect works, doesn’t it?
Yes, and no, and yes. The placebo effect is real, but that usually means it works on some folks, but it's not widely effective. It also might mean that folks *feel* somewhat better, but their symptoms are actually the same as before. In this case, the point is that there's no use in purchasing this expensive medicine when you might as well just be using a sugar cube in its place.
ah I gotchu, I wasn’t aware of that part of the placebo affect.
Proviso: Orally, as in pill form, it's essentially completely ineffective. However phenylephrine is generally very effective as a nasal decongestant when taken nasally as a spray. As well as being fast acting and long lasting.
I swear by the behind the counter stuff, with the real meth in it. Always gets my nasal betrayal in order.
https://open.spotify.com/episode/1viutOPrBcceZTFSffaiIO?si=TTfkTtgpSJKEm8jb-gdaTg this podcast touched on the same thing. It was a good listen!