Phenylephrine, the primary ingredient in common over-the-counter allergy medication, is ineffective according to the FDA’s September 2023 pronouncement. This development has wide-ranging implications. What can you do, especially if you have a history of allergy or sinus problems? And what else is important to take into consideration at this time?
What you need to know, above all, is that there are ways to ameliorate allergy and sinus problems that do not require dependence on OTC drugs that apparently do not work. I think it is also a good idea to consider how we think about and use pharma drugs on a daily basis. Just because something is OTC does not mean it is benign.
Phenylephrine is an interesting drug. In 2006, OTC drugs that relied on pseudoephedrine were removed from store shelves and placed behind the counter because they could be processed to create illegal narcotics. Enter phenylephrine, which is used in Sudafed PE, Mucinex, Dayquil, Tyenol Sinus and Advil Sinus Congestion, and similar generic products. This is a common and widely-used drug, no doubt about it.
And yet, a 2006 letter to the editor of The Journal of Clinical Allergy and Immunology (“Oral phenylephrine: An ineffective replacement for pseudoephedrine?“) declared that phenylephrine when taken orally at the FDA-approved dosage was not effective and, in fact, no better than a placebo. A Citizen’s Petition was submitted to the FDA by University of Florida pharmacy professors Drs. Leslie Hendeles and Randy C. Hatton in 2015, wherein they requested that phenylephrine’s GRASE, or “generally accepted as safe and effective” designation be rescinded. In 2022, the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma & Immunology released a statement supporting Hendeles and Hatton’s petition. In other words, there have been rumblings since its introduction that OTC drugs relying on phenylephrine are not a valuable addition to consumer medicine cabinets.
Consumers spent $1.8 billion on these worthless products in 2022.
What do you think of this? You may decide that this is a bit of a wake-up call, or at the very least an invitation to reconsider how you spend your money when you plan for allergy season.
How the pharmaceutical industry spins this is going to be informative, too. Watching Google’s results as I followed the story was interesting, to say the least.
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It’s also pretty fascinating to see just how deeply OTC decongestants have penetrated cultural norms. I do not remember being loaded up with OTC drugs as a kid but it sure seems like things have changed. There is a lot of money riding on this proposition, as the article “OTC Pediatric Healthcare Market to Reach US$ 18 Billion” attests. Is it really any surprise that there are shelves of product for children?
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So what does this mean for you and your stuffy nose? You can always buy OTC meds that contain pseudoephrine directly from the pharmacist, true. But this might be a good opportunity to rethink your reliance on sinus and allergy medications. As I wrote in my 2020 blog post, “Allergy Forecast Austin: Some Common Sense And A Measure Of Calm,” an acupuncturist can be a valuable ally in your quest to stop sniffling. There are three main approaches that a practitioner of Chinese medicine can take to help you:
You don’t have to contribute to the billion-dollar industry that has given you a placebo. There are options.
Acupuncture: Whether you frame things in terms of histamine and antihistamines, acupuncturists can place needles in spots that calm allergic responses that include hives or other manifestations of allergy on your skin. We can also select point prescriptions that help to clear your sinuses, ameliorate headache pain, and stop your post-nasal drip. Acupuncture is fantastic for allergies and if you haven’t tried it yet, then (a) no, the needles don’t hurt and (b) now is a great time to venture into new territories. Trust!
Herbal medicine: Speaking for myself, I do not do well with pharma drugs. If there is a horrible side effect to be had, I’ll have it. That’s why I got into Chinese medicine, in fact. I got to a point where I had no other choice, really. Whether or not you have a litany of horror stories about your experience with pharma, it’s still worth trying herbal medicine for your allergies. We have some marvelous formulas for sinus problems, we have others that will help you to sleep, and still others that combine sinus clearing with headache relief.
Nutritional education: There are several reasons why a person might develop allergies. It is possible to make dietary shifts that can have a domino effect on other areas of health, including one’s sinuses. Dairy can be a culprit in cases of intractable allergy. Sensitivity to chemical in pre-packaged food can be another issue. A person whose blood sugar fluctuates constantly might also find that stable glucose levels support overall health and play a part in reducing inflammation. Not all acupuncturists are expert in hypersensitivity and some offer health coaching (I do); others might be less inclined to oversee your digestive health. But we place a high value on nutritional therapy and most of us are able to educate and support a mindful approach to food. If you’re looking for ways to reduce dependence on OTC drugs that do not work, ask your acupuncturist about nutritional strategies.
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It truly will be interesting to see how the pharmaceutical industry spins the FDA’s ruling. On a broader level, this latest development really does say a lot about how we go about our lives in a state of constant, low-grade inflammation. But there are ways to change and this is a great time to reassess and do something different.
Are you ready to try Chinese medicine? If so, you know what to do next…
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Paula Bruno, Ph.D., L.Ac., is a licensed acupuncturist and herbalist, an AOBTA-CP traditional Chinese bodywork therapist, and a wellness educator and health coach. She maintains an active and growing practice at her Austin, TX office. Dr. Bruno is also available for distance appointments for wellness consultation or coaching.
In her first career, she was a Spanish professor.
Dr. Bruno’s specialties as a traditional Chinese medicine practitioner include: • Musculoskeletal health (acute or chronic pain relief; Ehlers Danlos syndrome & hypermobility support) • Digestive support, gut health, and weight loss • Aesthetic treatment, including scar revision • Men’s health • General preventative care and immune support for all persons.
She is the author of Chinese Medicine and the Management of Hypermobile Ehlers Danlos Syndrome: A Practitioner’s Guide. Dr. Bruno also maintains a second website, holistichealthandheds.com, with resources and information curated specifically for people with hEDS and HSD.
When you are ready to discover what traditional medicine plus a vibrant and engaged approach to holistic health can do for you, either contact Dr. Bruno or book an appointment online.
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Note: Material on this web site site is not intended to diagnose, prevent, treat, or cure any disease, illness, or ailment. A Chinese medicine practitioner in Texas identifies syndrome patterns but does not diagnose illness. Material on this web site does not purport to identify syndrome patterns.
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