Talk:Phenylephrine

message: http://www.forbes.com/sites/daviddisalvo/2015/10/26/the-popular-over-the-counter-cold-medicine-that-science-says-doesnt-work/
http://www.jaci-inpractice.org/article/S2213-2198(15)00318-9/abstract  — Preceding unsigned comment added by 98.193.37.192 (talk) 22:31, 2 November 2015 (UTC)
replies: text: Wow. The FDA just recently published similar findings. I'm sure somebody else has already made a talk page about it. But here's an article about it: https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-ineffective-fda-panel-says/index.html 2607:FEA8:99E0:61D0:F043:412:4A76:609A (talk) 23:35, 13 September 2023 (UTC)
replies: text: Is no one aware that phenylephrine is active via nasal spray, but inactive taken orally? This explains much of the controversy. Yes, it can be effective, but yes, orally it is not. Stephenscholnick (talk) 23:19, 25 September 2023 (UTC)
replies: text: Due to said specifics, can that be added in the opening paragraph to prevent misquotes and confusion in the general userbase? Currently, it does not mention that it's specifically the oral dosage that has been deemed ineffective. Mastercodex199 (talk) 00:05, 20 October 2023 (UTC)
thread_title: Confirmed Placebo

message: "Patients with congestion and hypertension are typically advised to avoid products containing phenylephrine". Surely this can't be right?62.244.182.162 (talk) 14:10, 1 October 2008 (UTC)
replies: text: I'm assuming that since phenylephrine has a side effect of hypertension, you wouldn't want a normally hypertensive person with slight congestion taking something that would raise their blood pressure even more. It's like the side-effect being worse than the actual treatment130.49.150.51 (talk) 18:18, 7 October 2008 (UTC)
thread_title: Under side effects

message: Article says:
Although pseudoephedrine is much more commonly used as a nasal decongestant in the United States, because of the possibility that pseudoephedrine can be used in the illegal manufacture of methamphetamine, it is expected that phenylephrine will become more common.
Based my my observations (in Indiana and in Massachusetts), in the last year, this prediction has come true -- many products which long contained pseudoephedrine have a small "New Formula!" tag on their packaging, and upon inspection, contain phenylephrine instead. Notably, Nyquil and Dayquil are completely switching: see http://vicks.com/pseudoephederine_faq.shtml.
Ancedotal note: no one seems to be suggesting that the "new" ingredient is _better_ in any way, which is odd given the general latch-onto-any-little-thing marketing we typically see from drug companies. This suggests to the conspiracy theorist in me that it's actually *less* effective. (This is supported by the way I first noticed this whole mess -- I took a little red pill, and noticed it didn't help with my congestion as I was accustomed, so then I read the fine print -- hey, different medicine!) I'd be very interested in seeing references to studies comparing the two medicines; from some quick research, the best I could find was this article http://www.msnbc.msn.com/id/8322753/ which states that "Few studies have been done to compare the effectiveness of phenylephrine versus pseudoephedrine as a cold medicine ingredient."
Here is a link to the Student Doctor Network bbs which indicates that phenylephrine is not as effective as pseudeoephedrine:
http://forums.studentdoctor.net/showthread.php?p=3302453#post3302453
68.42.67.38 19:55, 28 January 2006 (UTC)
replies: text: At least in the USA, the reason PPA was banned is not because of abuse (which was quite rare, doubtless because overconsumption of PPA typically results in headache, nausea and panic attacks), but because a statistical medical study published in 1999 demonstrated that PPA is linked to a very rare, but progressive and deadly form of heart disease. --Ryanaxp 17:39, 4 August 2006 (UTC)

text: Phenylephrine is most definitely far less effective than pseudoephedrine for any nasal congestion serious enough for someone to desire to take medication to treat.  Basically, phenylephrine doesn't hurt to toss into the mix of a multi-symptom cold formula if you're already taking it to treat other ailments.  If nasal congestion is your primary symptom, then I recommend you ask the pharmacist to give you something containing pseudoephedrine.  --Thoric (talk) 23:08, 5 January 2010 (UTC)
thread_title: Phenylephrine versus pseudoephedrine

message: We should keep a close eye on efficacy studies such as this one.  There aren't many studies available, so every new one would be helpful.  This particular study is in the recruitment phase.  It is in Phase III, so it should offer some real insights once it has concluded.  --W0lfie 15:34, 15 March 2006 (UTC)
thread_title:  New study underway 

message: Isn't the source of phenylephrine shark liver oil? -- Finlay McWalter | Talk 13:41, 3 April 2006 (UTC)
replies: text: I don't think shark liver oil is a source of phenylephrine, unless it is a very minor one.  Its synthetic manufacture should be easy enough that an exotic source such as shark liver oil wouldn't be necessary.  --Ed (Edgar181) 13:54, 3 April 2006 (UTC)

text: I think it has more in common with snake oil. Jason Harvestdancer | Talk to me  16:45, 18 September 2023 (UTC)
thread_title: Shark liver oil

message: As a non-native speaker, I'm doing quite ok with the chemical parts, however do not understand what this means: "It suffers some rebound congestion effects". Can someone clarify? Thanks
Rebound (anything) is a phenomenon where after the rated duration of the medicine, the symptoms reappear at least as bad and probably worse. Lidnariq 23:07, 6 October 2006 (UTC)
thread_title: Clarification

message: The original brand name pseudoephedrine was "Sudafed".  You took two little red pills.  When they switched to phenylephrine, the dose became one little red pill.  I purchesed the new box without noticing the new ingredient, and was still taking two for a while until I noticed the change.  I wonder how many others also did this.  
Even two of the new ones don't seem as effective as the old pseudoephedrine.  Anecdotal of course, but where is the study showing comparable effectiveness?  I am sure the maker would want to check and see if there was some improvement for advertising purposes, so the lack of info on this suggests to me that the study was done but not released because the results were not positive.
:Phenylephrine, as you must already know now, is labeled as Sudafed PE. Check  to confirm dosage. --Amit 20:43, 8 October 2006 (UTC)
replies: text: You are not alone in questioning its effectiveness. I think it sucks and is ineffective. I got switched in my Dayquil and didn't even noticed. If phenylephrine is so worthy, why is it the predecessor, why was pseudoephedrine used in the first place? I'd love to see this addressed by anyone who knows. —The preceding unsigned comment was added by 166.44.39.52 (talk • contribs).
ANOTHER QUESTION
it combats hyPOtension (as per my med school lecturer)... i don't know if it is used to raise blood pressure
Pseudophedrine raises BP and HR, but this is more of a thing to watch out for than a treatment plan (i.e. might be risky if you have high BP or HR or CHD history/risk). It would be detrimental to the patient to take long-term, and there are much simpler ways to raise BP (which you rarely want to do anyway). Most commonly used are salt pills, which can easily raise BP and have minimal side effects - why use a complex chemical that interacts with all sorts of things when salt will do the trick? Anyways, very few people need to RAISE their BP (generally just athletes, and very few anyway)
Lenrodman (talk) 20:34, 18 November 2007 (UTC)
thread_title:  Overdose danger? Effectiveness? 

message: Does anyone out there know where to get a 3D image of the phenylephrine molecule? If so we should add it to the article. Thoughts?--Metalhead94 (talk) 23:59, 4 September 2008 (UTC)
replies: text: 3D images of molecules are usually created by their contributors. I'll add one tomorrow. Dursty (talk) 05:12, 27 September 2008 (UTC)
thread_title:  3D Structure would be nice 

message: Phenylephrine HCI is the active ingredient in some over-the-counter  hemorrhoid creams in the United States and possible elsewhere. The article should mention that. 5Q5 (talk) 22:19, 25 September 2008 (UTC)
thread_title: No mention of use in hemorrhoid creams

message: I wonder if this could be used to treat Dopamine Beta-Hydroxylase Deficiency ... as the article says it is an  α1-adrenergic receptor agonist and is sometimes used to treat low blood pressure. Anyone know anything?  —Preceding unsigned comment added by Interestedperson (talk • contribs) 18:08, 4 October 2008 (UTC)
thread_title: Dopamine Beta-Hydroxylase Deficiency 

message: I am pretty sure that the effectiveness studies that the FDA expert panel used to give phenylephrine GRASE baci in the mid 70's were unpublished drug company studies without peer review.  Hardly suprising that a study by the makers of Dristan and Novahistine showed that their products were effective.  121.209.49.58 (talk) 09:33, 20 October 2009 (UTC)
replies: text: Well, an independent double-blind study has now reported that "PE HCl, at doses of up to 40 mg every 4 hours, is not significantly better than placebo at relieving nasal congestion in adults with [seasonal allergic rhinitis]". Of course this isn't useful here until some secondary coverage arrives. Over-the-Counter Oral Phenylephrine: A Placebo for Nasal CongestionThe Popular Over-The-Counter Cold Medicine That Science Says Doesn't Work LeadSongDog come howl! 16:44, 27 October 2015 (UTC)
thread_title:  Effectiveness Studies 

message: Can we get a photo of the actual chemical? Badagnani (talk) 02:17, 29 November 2009 (UTC)
thread_title: Photo

message: Don't know about that.  In me it causes some stabbing chest pains, high blood pressure, and shortness of breath.  It doesn't do much for my congestion and I can't take it before I go jog.  If I stay away from everything containing it, I'm fine.  I wonder if Heath Ledger had too much of it in his system?  Anyway, high blood pressure could be responsible for your nose bleeds, and that's the principal effect of phenylephrine... that and dilating pupils.  There's zero reason it should even be available over-the-counter, let alone indicated as a decongestant.  It's never been shown in any peer-reviewed properly-blinded study to be effective as one.  Essentially people are being sold snake oil for cold and allergy relief with this stuff.  -Reticuli 66.178.144.76 (talk) 20:19, 30 November 2010 (UTC)
thread_title: Side effects

message: Sashkia1 (talk) 01:20, 27 January 2012 (UTC)
thread_title:  Comparing the Sympathomimetic and Adrenergic effects of Phenylephrine vs Pseudoephedrine 

message: https://journals.sagepub.com/doi/10.1177/10600280221081526 184.161.251.199 (talk) 22:38, 30 March 2022 (UTC)
thread_title:  Proven Ineffective for congestion relief 

message: For my last edit, see Phenylephrine oldid — 8 May 2022
The existing cite for effectiveness was drugs.com which already contained text that its effectiveness was debated (not actually a good cite in the first place). 
I added new material from a blog post, but this is a blog post of the highest magnitude: an established research chemist with a long history of public visibility, including many extremely wonky and detailed posts, whose blog is hosted at the American Association for the Advancement of Science (AAAS) website science.org (this quasi-endorsement is not likely available to the common chum). 
Though lacking comparable super-elite status within his profession, he writes with similar verve and authority as Scott Aaronson, another guy who might be found writing on his personal blog, though it could just as easily be stone tablets handed down from on high. 
If someone comes along to argue from the interests of Big Pharma that this material is unbalanced or undue (or poorly sourced), I'd pretty much myself place Derek Lowe's blog at 100 and drugs.com at a 10. 
Note that I put both the academic cites into the new material (useful, but too direct) as well as Lowe's interpretation (appropriately 3rd party). Lowe is not just some guy out there banging on without a good editor. He's well established and he's competent enough not to really need an editor looking directly over his shoulder. AAAS would soon notice, however, if he started to fall shy of established standards and would likely dehost his blog entirely as a result. 
Don't fall for ruses about the bloginess of this citation. Absolutely not an issue in this case, if ever I've not seen one. If an argument does come to pass, argue the facts instead. Unless Lowe has steered me wrong, this pushback is not just a single recent paper, but long established and political. — MaxEnt 19:52, 8 May 2022 (UTC)
thread_title:  Pushback on effectiveness in lead 

message: I examined reference 5 as the subject caught my interest.  Unfortunately this link to the pdf file is broken and the title indicates it wasn't on the subject. The PDF file was an insert for the subject drug and not pseudoephedrine
In the last sentence of the third paragraph it states:  Unlike pseudoephedrine, abuse of phenylephrine is very uncommon. [ref] 
I was expecting a reference that mentioned pseudoephedrine somewhere in the article.  There certainly won't be a reference to an unrelated product in the Insert for the phenylephedrine.  I will attempt to find a reference but want to ask here first if anyone has facts for this theory? I added needs citation template TSpot-SF (talk) 11:50, 6 August 2022 (UTC)
thread_title:  A theory in search of facts 

message: https://thehill.com/homenews/4200317-decongestant-used-by-sudafed-benadryl-is-not-effective-fda-advisers-find/ Morton.Michael.NC (talk) 21:30, 12 September 2023 (UTC)
replies: text: Glad to see someone else has brought this up. It definitely needs to be in the article. Yesthatbruce (talk) 01:47, 14 September 2023 (UTC)
thread_title:  Confirmed oral route uselessness? 

message: There is the uncomfortable, to the fans of this drug, FACT that it is rapidly broken down in the (normal) human stomach. This means: 1. The actual oral dose is very much reduced (but of course that will depend on the entire stomach contents at the time of its ingestion) and is unlikely to be transported into the bloodstream in "effective" amounts (for most people). 2. This is irrelevant to other modes - such as nasal spray, anal suppository, or eye/nose(?) drops - for which there is no controversy (afaik). The article - as it exists on Sept 17, 2023 - is very, very wrong. The earlier (1970's) FDA approval was based on FLAWED and incorrect data from the drug's manufacturer as well as the inexplicable use of mostly irrelevant data. We knew long before the 1970s that route of entry was important in determining effectiveness. It took the U.S. FDA 6 decades to correct its blunder. First, this remarkable incompetence should have its own section, and second the lead needs to be changed to reflect the facts. The DRUG's effectiveness DEPENDS on its route of administration for those conditions it can be effective for. Few comments here seem to grasp that truth and the article repeatedly fails to discriminate between oral and other routes when describing its effects. It is also NOT the case that the claim is that the drug is "completely" ineffective orally. The claim is that it is not orally effective → meaning shouldn't be marketed as being an effective oral decongestant.98.17.44.45 (talk) 18:23, 17 September 2023 (UTC)
thread_title:  Facts anyone? 

message: In the third paragraph it's mentioned: "Its effectiveness as a nasal decongestant has been questioned." but actually all of the sources describe that it's not effective only when taken orally. This is also mentioned in the next sentence. Still, I think that this particular sentence is misleading. I am looking for opinions whether it should be changed. --Bsivanov (talk) 11:38, 29 November 2023 (UTC)
replies: text: Do you mean that you would like to clarify that when taken orally it is not an effective decongestant, but that it can be an effective decongestant when administered via other routes? If so, I'm not sure how useful that is: under what conditions would you (1) need a decongestant, (2) be willing to use a non-oral route (e.g., IV), and (3) still choose phenylephrine? Kimen8 (talk) 11:53, 29 November 2023 (UTC)
thread_title:  Effectiveness as nasal decongestant