There should be criminal charges for this, but they never will cuz this was one of those wink-wink deals between government and pharmaceutical industry. I wanna know how and why phenylephrine was ever approved (how did they have the data previously if they are now declaring it ineffective?) Did the data ex post facto "change"? WTF?
this post was submitted on 20 Nov 2023
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Eh... I'd need to look into this specific one more, and it's a bit weirder than 'normal' given this is a drug for a common physiological symptom, but there was a lot of bad medical science done from roughly WWI to the turn of the millennium that nonetheless still underpins some of our commonly available medicines. Clinical psych has it especially bad, but the replication crisis is a problem everywhere.
Not like phenylephrine. It seems almost entirely a medico-political response to the methamphetamine issue. Which is not a valid justification for bad science and fraud on the part of the government and pharmaceutical industry. And (I mean this as politely as can be) we don't need you to look into it, its a fact and established that this was bullshit. No history necessary, it was bullshit and snake oil and the reason I always asked for the real Sudafed when I had congestion (which is a rather rare issue for me, not sure across the population).
But I also have the better shit as an actual chronic prescription so I can't credibly speak as much to this issue as those who use Suda more often for congestion.
Edit: does Adderall sort of cover the same benefit as pseudoephedrine in terms of congestion relief? I feel like that was one of its original (not sure about official) indications?
It feels like every time I go on the internet, I get reminded I need to be very explicit about what I'm saying. (Or develop a thicker skin. :P) Apologies if I sounded dismissive, I was just trying to say that I don't know exactly how it was approved as I haven't done the research to know, but that wasn't surprised it had been, given the overarching issue with medical studies from the last century failing to be replicated. I'm not trying to imply that I'll somehow dig up the absolute truth of the situation that was previously unknown, I just know I'm making a statement with incomplete information.
No worries, dawg :)
You unintentionally sounded like a relative of mine which humorously triggered my mildy-snarky "Well, ACKSHUALLY, no. BRB gotta defer to the FDA's recent findings and publicity regarding phenylephrine".
For context, this person sometimes fancies themself an expert when they don't know anything or enough about a subject but still try to speak authoritatively as if their buy-in is essential to continue or speaking definitively on a given matter 😂
You're good, just try not to caveat a strong or even controversial claim someone else makes if you don't know you can dispute it right there like that. Like say that in your head, just don't say the head part out loud cuz someone will rip you a new one if they're grumpy.
But I wanted to be a little sassy and give you some cheek while still caveating that I wanted to be nice about it :)
Peace! I love you guys, no worries!
My understanding is that it is somewhat effective in nasal sprays, but not in any format that passes through the digestive system. When the US government wanted to tighten controls on pseudoephedrine as part of the War On (Some) Drugs, the pharmaceutical companies needed a substitute to push on the public, so they picked something that worked if you ignored the administration route. And then didn't confine the idiocy to the US.
(Pseudoephedrine is both an effective nasal decongestent and a chemical precursor of home-brewed methamphetamine.)
Ya, I believe that is what was at issue (nasal spray = good, oral = ineffective. At that
Sounds like it does work, but not really when taken orally.
So perhaps a nasal spray - or even some form of injection- might be effective whereas the pills they were marketing for this purpose were barely effective (due to it not actually reaching the sinuses in any significant amount)
I dont think its honestly an effective enough medication per se let alone when compared against the gold standard (pseudoephedrine) to ever extend my line of inquiry that far.
Why get complicated? Sudafed is easier and orally active so I would always just do that if my Adderall didn't do it already (not 100% on that conjecture)
- not sure if pseudoephedrine is actually the "gold standard" but if you ask anyone, that's what usually comes to mind
one of those wink-wink deals between government and pharmaceutical industry
I love these conspiracy claims; it's as if there's a secret meeting and completely hushed agreement held among people who can't even keep a land deal secret or decide that gay people are still people and keep it that way.
Or like that the government looked the other way like they did with Celebrex and almost like they hav a parallel history of approving bullshit interspersed with the actual good shit
I feel like I need to see some supporting docs on the other end of the scale to balance out all these breathless accusations. It sounds like it's obvious to you, but i may not be able to discern it from the litany of whackadoo prepper conspiracies we've heard for the last few years.
Setting aside snake oil salesmen and conspiracy wonk sources, do you have some actual math on this one?
Eori, who has worked as a nurse for 33 years, purchased some of the drugs mentioned for herself and her family more than eight times per year under the impression that they would be sufficient to treat nasal congestion, the suit says.
What the hell?? Is it normal for people to be that congested that often?
I don't recall ever needing to buy decongestant for my family, ever.
For somebody with recurring allergies or some other chronic condition, yeah you can go through these a lot. You have to balance not taking them too often (which can make things worse) against potentially not being able to sleep properly at night
I'm not a doctor, but wouldn't someone with more than just a temporary need, get a prescription for something more long-term? Nasal decongestant is extremely effective.
Eight+ packs a year, assuming everyone in her family is using them, is still likely in excess of what's considered safe for long-term use. Many of those products are incredibly hard on the liver.
Nasal decongestant is generally only supposed to be used for a few days in a row otherwise it can also start to cause damage (and one can have some type of dependency as well)
Brutal 😟
I doubt she was buying for the same person eight times a year—more likely for a half-dozen people once or twice a year, which might include her kids, parents, siblings, or other people who are part of her family but not of her household. One person getting two colds a year is certainly not impossible, especially if they're living with school-aged children, who tend to bring home a sample or two of every virus circulating in the region. Plus, some people are more susceptible to this stuff than others.
But one package isn't a single dose. And chronic use can cause liver damage.
Seems excessive, even assuming she's buying it for people outside of her home (which would also seem strange).
Pretty sure liver damage isn't a side effect of phenylephrine—it's a side effect of Tylenol/acetaminophen/paracetamol, which is often but not always included with it in combination cold medicines (some include ibuprofen instead, or no painkiller at all). Tylenol might have been present in what this nurse was buying, but it's also possible that it wasn't. Phenylephrine's main side effect is high blood pressure, I think—my father's forbidden from taking it for that reason.
We have no reason to believe the nurse's family were taking all of each package. Someone in the family could be pitching out half-empty boxes as "no longer needed", or just forgetting where they put the stuff and then discovering it's past its best-before date when they find it later.
Equally, they might have four kids and all of them plus the parents getting the same cold sequentially as they pass it from one to the other. 7 days per cold x 3 doses per day x 6 people = 126 pills. Two colds per year would then require 8 boxes of around 30 pills, but no one will have taken them for more than a week at a time, or more than two weeks in the year. That isn't chronic use.
As for buying it for relatives outside her own household, it isn't hard to sketch out a scenario: "Ugh, I'm (achoo!) dying here, sis—can you stop off on the way home from work and get me something for this? You're a nurse, so you'd know better than I do which ones work."
(Yeah, I'm playing devil's advocate a bit here—I have no more real information than you do. My point is that while the media may have cherry-picked their example, this person isn't necessarily lying or doing anything dangerous.)
I know we're trying to rationalize all this, but it's leading to more questions! LOL
"Eori, who has worked as a nurse for 33 years, purchased some of the drugs mentioned for herself and her family..."
Considering that it seems pretty well known that pseudoephedrine is pretty ineffective for many years now, was she purchasing this decades ago and is now pissed off about it? Or has she continued to purchase it after knowing for years that it's ineffective?
Really, either way, as a healthcare professional, you'd think that chronic congestion would be addressed through prescription meds and not OTC drugs. Right? 🫠
She may have done what you just did, and confused pseudoephedrine (which works) with phenylephrine (the one that doesn't). 😜
(In all fairness, they're both multisyllable weird Greekish words that have the same first letter and the same ending, and I've come close to mixing them up a couple of times myself.)
As a nurse (not nurse-practitioner) I don't think she has any power to prescribe. All she can do is offer over-the-counter meds and advise the person to see a doctor if she thinks that's warranted.
There was one amusing article which I seem unable to find again that suggested American cold sufferers should get their hands on pseudoephedrine by obtaining crystal meth (which is more widely available and more stably supplied) and running the reaction the FDA was so afraid of in reverse to get the decongestant. Maybe we should have tried doing that up here too. 🤔
She may have done what you just did, and confused pseudoephedrine (which works) with phenylephrine (the one that doesn’t). 😜
LOL. Oops. I wrote the wrong active ingredient in the link, but the article talks about how phenylephrine, which replaced pseudoephedrine, is ineffective. The former isn't even available, so I'd hope she didn't confuse the two all these years!
There was one amusing article which I seem unable to find again that suggested American cold sufferers should get their hands on pseudoephedrine by obtaining crystal meth
LOL. That's the most American pharmaceutical story I've ever heard! 😂
This is the best summary I could come up with:
A Winnipeg nurse is seeking class-action status for her lawsuit against several top drug companies, accusing them of profiting for decades by marketing non-prescription oral decongestant medications containing an active ingredient that several studies have found ineffective.
In September, a panel of 16 external advisers to the U.S. Food and Drug Administration voted unanimously that phenylephrine is ineffective as a decongestant when taken in pill form.
The FDA's expert advisers came to that conclusion after finding that only trace levels of the drug reach nasal passages to relieve congestion when taken orally.
"While the losses by individual consumers may be relatively modest, the scale of this case is large, given the popularity of the products and the amount of time that they were sold for," Sokolov said in a statement.
But the suit says through prominent claims displayed on packaging and public websites, the companies knowingly or recklessly led consumers, wholesalers, retailers and distributors to believe phenylephrine works as an oral decongestant.
Representatives from Pfizer and GlaxoSmithKline told CBC News that they have not sold the mentioned products since 2019, as both of their consumer health-care businesses demerged into Haleon.
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