C-Force: Some Cold Remedies Now Taking Heat
If you read my offering from last week, then you know I was addressing the fact that, despite modern medicine's many breakthrough cures and treatments, there remains no cure for the common cold. While a cure continues to allude us, there is no shortage of proposed treatments. According to a Statista report, "in 2024, the revenue in the Cold & Cough Remedies market in the United States amounts to $11.19 (billion)." It represents most of the global revenue spent on such products.
I wasn't planning on saying any more on the subject, but then this item hit the news: The Food and Drug Administration has "proposed removing a common ingredient in over-the-counter cold medicines that was found to have no effect on nasal congestion, despite its widespread use," according to a New York Times report by Christina Jewett.
What I hope is not lost in all the hubbub surrounding this announcement is that, as pointed out by Jewett, a petition with the FDA asking them to remove the ingredient dates to 2007. This has been going on for 17 years.
Reuters News Agency reports that "companies such as Procter & Gamble and GSK were among several accused in lawsuits of deceiving consumers about cold medicines containing the ingredient." The ingredient in question is phenylephrine. As described by Wikipedia, phenylephrine is "sold under the brand names Neosynephrine and Sudafed PE among others" and has long been used as a decongestant. Reuters says that while the FDA starts the process of "seeking public comments on its proposal to axe the ingredient ... companies may continue to market drug products containing oral phenylephrine as a nasal decongestant."
According to Jewett, "medical experts have said that patients who discover the ingredient in items in their medicine cabinet need not be concerned. They can safely take the rest of a combination product that includes phenylephrine if it contains other ingredients that are effective. Or they could throw out items that contain only phenylephrine."
As consumers, we should take no comfort in the fact that getting medication off shelves has required a decades-long effort. Reports Jewett, "concerns about the efficacy of the ingredient" date back to the 1990s. Phenylephrine "was added to cold and flu treatments as a stand-in for a more effective decongestant, pseudoephedrine, which was moved behind the (pharmacy) counter after its use was noted in homegrown methamphetamine labs manufacturing illicit drugs."
Says Sara Berg, news editor for the American Medical Association, "demand for effective cold remedies is understandable. But does cold medicine help relieve symptoms of the common cold? It depends."
When it comes to cold and flu season, Berg and her colleagues believe "prevention is the gold standard." Because respiratory droplets from coughs and sneezes can be spread indirectly by touch, they advise often washing your hands well and with soap and water. Additionally, "avoid touching your face a lot -- rubbing your nose, rubbing your eyes. That's how the germs get in," Dr. Brittany Chan says. "Disinfecting high-touch surfaces is not a bad idea."
Chan is a pediatrician at Texas Children's Pediatrics in Spring, Texas. "In pediatrics, we don't really recommend cold medicines," she says. "Certainly not for kids under 6. (That's) because they're younger and they're more susceptible to side effects. ... Nasal saline is effective and safe for all ages, and you can find this over the counter.
"For cough -- which is a big complaint of parents because no one likes to see their kid coughing all night -- for children older than 1 year old you can use honey. Honey actually has been shown to be as effective as some over-the-counter cough medications. ... It's natural. It's safe."
Combined with "lots of rest so that your body can do its work fighting the cold, lots of hydration" is needed, says Chan. "The more fluids you drink, the more the mucus is thinned out and you're able to get that out of the body quicker."
Chan also stresses that antihistamines "have not been shown to work for cold symptoms in children, and some of them can be sedating or have other side effects. ... In a small percentage of children, antihistamines like diphenhydramine can actually have a paradoxical effect and cause agitation or hyperactivity, which is the last thing we want in a sick kid."
Dr. Robert Weber, former director of Ohio State University's graduate program in health-system pharmacy administration and leadership, writes in a post on the university's Wexner Medical Center website about how, throughout his pharmacist career, he has been fascinated by "the evolution of medicines we use to treat people, and how so many 'old-fashioned' medicines are still in use -- and very useful -- today.
"In the 1800s, it was common to find people taking cough syrup containing opium to treat coughs and cocaine for toothaches or any mouth pain."
Weber also notes that aspirin, which has been marketed for pain relief since 1899, "has often been referred to as a 'wonder drug' for its abilities to be used in a variety of situations. Aspirin has an effect on inflammation, and also the aggregation or stickiness of blood platelets. This makes it a great agent for thinning blood in various situations where blood clotting is a problem, such as heart attacks or blood clots in legs.
"However, using this medicine in children was shown to be a problem and caused a variety of adverse effects, which is why we see Tylenol used commonly in children for some of the same uses as aspirin."
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