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> 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.




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