Stuffy Nose? This OTC Decongestant Won’t Help

The cold medicine you buy at your local drugstore may not be effective. Find out why, here.

Stuffy Nose? This OTC Decongestant Won’t Help

A stuffy nose is enough to send you off to the drugstore, scouring the shelves for a decongestant. And while many nose decongestants market themselves as offering temporary relief, researchers say that one drug in particular-- oral phenylephrine -– offers no relief at all.

Scientists enlisted 539 adults for the 2015 study. Some participants received a 10 mg immediate-release tablet of oral phenylephrine in fixed dosages ranging from 10 mg to 40 mg, taken every four hours. Other study participants took a placebo. The researchers concluded that none of the Federal Drug Administration (FDA)-approved dosages were better than a placebo for clearing clogged nasal passages. 

This isn’t the first time the drug has come up short in studies. “Two trials in 2009 found that it’s no better than a placebo,” says Sharecare chief medical officer Keith Roach, MD. “It’s not a good drug.” 

Phenylephrine was added to oral OTC decongestants as a replacement for pseudoephedrine, a drug that became used for illegally producing methamphetamine. Because of the latest findings, some groups are asking the FDA to remove oral phenylephrine from the market. 

“The drug companies say taking this medicine will make you feel better,” says Dr. Roach. “But you can feel better taking a placebo without the risk of serious side effects. I can give you a sugar pill with nothing in it and for some people, it works.” 

Side effects include "acute urinary retention, meaning you can’t pee even though your bladder is full,” says Roach. This can especially be a problem for older men with enlarged prostates. “You could end up in the ER needing a tube in your bladder.” It can also raise your heart rate and blood pressure and make you jittery, says Roach. “In some people this can be quite pronounced.” 

Prevention is key to avoid congestion and other cold/flu symptoms. Your first line of defense?

  • Get your flu shot, says Roach.
  • Practice good hygiene. Wash your hands frequently.
  • Avoid touching your mouth, nose and eyes. These are a prime germ entry points.
  • Get enough sleep. Not getting enough sleep can weaken your immune system.
  • Manage stress. When you’re stressed-out, your body releases more of the hormone cortisol, which suppresses your immune system and makes it harder for your body to fend off infection.
  • Eat healthy foods and exercise.
  • If possible, avoid being around people who are sick.

If you do pick up a bug, read OTC medicine labels carefully. Roach recommends choosing products that contain the decongestant pseudoephedrine (you’ll need to buy it at the pharmacy counter and provide your contact information) and loratadine, an antihistamine. Another medication Roach recommends is montelukast. But you won’t find it on drugstore shelves. “You’ll need a prescription,” says Roach. Whichever you choose, all can be effective in helping you breathe easier. 

Your Parent Has Dementia: What to Talk to Their Doctor About

Make sure all their doctors are aware of all the medications she is taking.

Q: My mom is 94 and has dementia. She is taking a whole medicine cabinet-full of medications and I think they actually make her fuzzier. How should I talk to her various doctors about what she is taking and if she can get off some of the meds? — Gary R., Denver, Colorado

A: Many dementia patients are taking what docs call a "polypharmacy" — three or more medications that affect their central nervous system. And we really don't know how that mixture truly affects each individual person.

A new study in JAMA Network that looked at more than 1 million Medicare patients found almost 14% of them were taking a potentially harmful mix of antidepressants, antipsychotics, antiepileptics, benzodiazepines such as Valium and Ativan, nonbenzodiazepine benzodiazepine receptor agonist hypnotics such as Ambien or Sonata, and opioids. And almost a third of those folks were taking five or more such medications. The most common medication combination included an antidepressant, an antiepileptic, and an antipsychotic. Gabapentin was the most common medication — often for off-label uses, such as to ease chronic pain or treat psychiatric disorders, according to the researchers from the University of Michigan.

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