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Commentary: Some decongestants have been found to be useless – they're just the tip of the iceberg

PROVIDENCE, Rhode Island: With cold and flu season ramping up, you may soon be heading to the pharmacy in search of relief. When you do, you might remember that Sudafed has long been considered an effective decongestant. So you grab a box of oral decongestant that says Sudafed. You may or may not notice that the brand name is now followed by two letters: PE.

But Sudafed PE is a completely different drug from the original Sudafed, which can only be purchased from behind the counter. Other oral decongestants on drugstore shelves are very likely to be made with the same ingredient as Sudafed PE – phenylephrine. And it’s not effective.

A few weeks ago, a United States Food and Drug Administration (FDA) advisory panel confirmed what some patients, pharmacists and doctors have long suspected: That oral decongestants based on phenylephrine don’t decongest.

Decongestant pills with phenylephrine are so ubiquitous and so cleverly packaged that they were worth about US$1.8 billion in sales last year. And they aren’t the only over-the-counter product that doesn’t work as advertised, said Leslie Hendeles, an emeritus pharmacy professor at the University of Florida.

Consumers scanning pharmacy shelves must sort through ineffective cough medicines, anti-itch creams and medications for gastrointestinal complaints. There are also an array of dubious homeopathic remedies, which can be sold despite the fact that none are FDA-approved.

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