BOGUS DECONGESTANT?

You may start seeing more questions from patients about phenylephrine given its recent media coverage.

Click here for previous newsletters.

1. Counselling Conundrum: a real question from a patient

2. Concise Conclusion: a straight-forward patient-friendly answer 

3. Quick Wrap-up 

Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.

Counselling Conundrum: "I heard that decongestant pills don't work; is that true?"

Concise Conclusion: I think you've most likely heard about one specific decongestant, phenylephrine. That drug was approved before rules were strict about allowing drugs come to market that are proven to be safe and effective. Studies have shown this drug is no better than placebo (a sugar pill), and there are talks of removing it from the market. If you have nasal congestion, stick to nose sprays (saline, decongestant, or steroid) or pseudoephedrine pills, all of which have been shown to be effective.

Quick Wrap-up: The pharmaceutical reason, it appears, is the very poor bioavailability of oral phenylephrine. In contrary, the nasal route formulation seems to still be effective. Remind patients to avoid using nasal decongestants for more than 2-3 days to avoid rebound congestion, and to be weary of oral pseudoephedrine in terms of hypertension.

Dive Deeper

1) https://www.fda.gov/news-events/press-announcements/fda-proposes-ending-use-oral-phenylephrine-otc-monograph-nasal-decongestant-active-ingredient-after

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