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This one[1] is more recent and it will affect otc cough syrup in its current form. But I was thinking about the impact removing DXM [2] from cough medicine.

edit: The net effect of those being that anything that actually works requires prescription.

[1] https://www.reuters.com/world/us/us-fda-seek-public-opinion-... [2] https://www.webmd.com/parenting/teens-cough-medicine-abuse




Phenylephrine should be banned as an oral decongestant in all cold medicines, prescription and OTC, because it is a scam and doesn't work.

It basically serves as a way to sell people OTC decongestants, since the one that actually works (pseudoephedrine) is BTC.


> Phenylephrine should be banned as an oral decongestant in all cold medicines, prescription and OTC, because it is a scam and doesn't work.

How do people keep buying it and using it if it genuinely doesn't do anything for them?


1. the placebo effect is strong

2. people believe the box and/or ads

3. it comes in combination drugs and people don't actually know what each drug does. many people simply "buy cold medicine" when they have a cold, with no thought to the mechanism of the components.

If you're in a place where it is legal you haven't tried it before, next time you have a stuffy nose, give it a try. It doesn't do anything at all, and studies prove it!


> If you're in a place where it is legal you haven't tried it before, next time you have a stuffy nose, give it a try. It doesn't do anything at all, and studies prove it!

The reason I asked is that I've tried the OTC decongestant sprays (which I believe have phenylephrine in them?) some years ago, and they've worked damn well. I don't really believe that the sprays don't work, if that's the claim. But I don't know enough to tell whether the phenylephrine in particular has any effect, and I didn't memorize the ingredient lists of the ones I've bought and tried.


> The reason I asked is that I've tried the OTC decongestant sprays (which I believe have phenylephrine in them?) some years ago, and they've worked damn well.

They're likely multi-medication sprays. Even if they were purely phenylephrine as an active (lol) ingredient, saline nasal spray (water!) helps with some stuffy noses, especially allergy-driven ones.

"A spray with phenylephrine in it worked" and "the phenyleprhine worked" are very different things.


But if they work without phenylephrine then why do companies put that in them? Why not just put everything except that? The story doesn't check out for me.


When pseudoephedrine became a behind-the-counter drug in 2005 (https://en.wikipedia.org/wiki/Combat_Methamphetamine_Epidemi...), they wanted a replacement chemical that looked similar enough on the box to avoid a drop in sales.

It is a legitimate vasoconstrictor, but not when taken orally. https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-...

> The agency approved phenylephrine for over-the-counter use in the 1970s, but it became even more common after 2005, when legislation restricted access to OTC drugs that use a similar decongestant ingredient called pseudoephedrine.

> Phenylephrine works by temporarily reducing the swelling of blood vessels in the nasal passages. A respiratory infection or allergies prompt the body to send white blood cells to the nose, throat and sinuses, leading to swelling in the nasal membranes and the creation of mucus. Decongestants constrict the blood vessels in the sinuses and nose, reducing the swelling and helping fluids drain.

> In pill form, some scientists say, phenylephrine gets absorbed by the gut and is metabolized so well that only a tiny bit makes it to the bloodstream, where it is needed to reach the nose, according to the citizen petition that asks the FDA to pull the drug from store shelves. A citizen petition is a way for industry, consumer groups or individuals to petition the FDA to change regulations or take other administrative action.


Because it currently allows them to put "nasal decongestant" on the box.


Iirc the research suggests that phenylephrine actually works ok in nasal sprays, it just doesn't work orally.


> OTC decongestant sprays

That is nasal not oral. The mechanism of delivery matters, and those aren't directly comparable to the oral medicines which are currently under scrutiny.


Thanks. Well that's confusing then. People keep saying phenylephrine doesn't work which seemed blatantly false to me. They're not trying to ban the use in nasal sprays are they?


From the article linked above:

> the agency said that its order would only be related to the oral drugs and not the spray form.


> How do people keep buying it and using it if it genuinely doesn't do anything for them?

"They wouldn't sell it if it didn't work!"

People buy homeopathy for the same reasons. "It cured my cold! I took it for a couple of days and the cold went away!" Forgetting, of course, that colds resolve on their own in that same timeframe.


> This one[1] is more recent and it will affect otc cough syrup in its current form.

Functionally, no, it won't. The ingredient doesn't do anything; it's a scam.




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