Over-the-Counter Medications: Are They Really Safe? (Issue #2)
Read: Issue #1 and issue #3 in this blog series
At Casco Bay Direct Primary Care, patient safety and education are two of our most important objectives. This blog series was started with that in mind.
We had intended to discuss the use of over-the-counter PPIs (proton pump inhibitors) like Prilosec and Nexium in this issue. However, with a recent FDA Advisory Panel statement regarding common cold medications, and cold and flu season around the corner, we felt compelled to discuss the use of over the counter cold and flu medications.
Have you ever felt crummy from a cold and gone to the pharmacy?
There are so many cold and flu medications that it’s hard to know what to take! Have you ever taken Sudafed Sinus Congestion, Tylenol Cold and Flu Severe, NyQuil Severe Cold & Flu, Theraflu Severe Cold Relief, or Mucinex Sinus Max (these are just a few examples - there are many others)? These medications all have one thing in common - the ingredient phenylephrine.
Phenylephrine, commonly found in many over-the-counter cold and flu medications, is reached for by millions of people each year.
This medication is a decongestant that works by narrowing blood vessels in the nasal passages, reducing swelling and congestion.
For many years pharmacists and physicians have been questioning if this medication really helps patients, and studies have now conclusively shown that it is no more effective than a placebo (sugar pill) in reducing symptoms.
For this reason, the FDA Advisory Panel officially made a statement that this medication is ineffective and there is no scientific evidence that oral phenylephrine is beneficial. (Please note there were NO safety concerns identified and this panel was advising on oral phenylephrine, not nasal sprays containing phenylephrine).
So what should patients use instead for managing the symptoms of the common cold?
One alternative is nasal saline spray. Saline sprays provide relief by moisturizing the nasal passages and loosening and thinning nasal mucus, which in turn alleviates congestion. Saline sprays also help keep the cilia in your nose healthy.
Cilia are small hair-like structures that help humidify air going to your lungs, trap bacteria to keep them from entering the cells, and aid your sense of smell. By keeping cilia healthy, saline sprays may help treat nasal and sinus infections, studies show. Another option is anti-histamines.
While they may not directly relieve congestion, they can help manage other common cold symptoms like runny nose and sneezing. Moreover, symptomatic relief can be achieved through non-pharmacological methods.
