An FDA committee said 1 type of nasal decongestant doesn't work, but experts say here's what does

Experts say these tips can help fight off common cold symptoms this season.

September 27, 2023, 11:43 AM

Over-the-counter agents to treat upper respiratory symptoms like nasal congestion make up a multi-billion-dollar business. But recently, an FDA advisory committee ruled that oral phenylephrine, commonly found in some over-the-counter, or OTC, products like Dayquil, Mucinex, and Sudafed PE, does not work as a decongestant.

The decision has left many consumers confused when searching for relief among all the available products on store shelves.

"It really is stressful for a lot of consumers," board-certified pulmonary critical care and sleep medicine physician Dr. Raj Dasgupta, MD, chief medical advisor at Sleep Advisor, told ABC News.

The Food and Drug Administration said in a public statement that the product will stay on the market while they review the available evidence.

The Consumer Healthcare Products Association, which represents manufacturers of over-the-counter-drugs, called the decision "disappointing" and offered to work with the FDA on the matter.

"We encourage FDA, before making any regulatory determination, to be mindful of the totality of the evidence supporting this long-standing OTC ingredient, as well as the significantly negative unintended consequences associated with any potential change in oral PE's regulatory status," CHPA president and CEO Scott Melville said in the statement.

PHOTO: A stock photo shows a sick person with tablets, nasal spray and other medicines, along with a glass of water.
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Dasgupta says that taking oral phenylephrine isn't dangerous and some people may believe it works for them, so those products don't necessarily need to be thrown out due to a safety concern, but better options may be available.

For consumers buying new products, ABC News spoke to two experts to provide four tips to help find the right solution for sinus and cold symptoms this season.

Read the label, be intentional about purchase

Dasgupta explained that many people don't actually know what products they are buying and that many products contain different medications that each treat different symptoms.

"If you are going to the store to pick up over the counter medications, you have to ask the question, 'Why? Why are you going there,'" Dasgupta said.

Cold symptoms may include nasal congestion, but people may also have muscle and body aches or a cough they want to treat and there are specific medications that target these other symptoms like acetaminophen, ibuprofen, or dextromethorphan.

Greg Castelli, Pharm.D., director of academic and clinical pharmacy in the department of family medicine at the University of Pittsburgh School of Medicine, says that sometimes less is more and recommends that people buying new products should consider only buying the one indicated for their symptom.

"When you're walking down those aisles, you'll see that there are products that have three and four medications in combination with each other. And you just may not need to have all those individual medications," Castelli said.

Pseudoephedrine is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes used as a nasal/sinus decongestant, as a stimulant, or as a wakefulness-promoting agent.
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Castelli says that oral pseudoephedrine can be found behind the pharmacy counter without a prescription and nasal sprays that contain phenylephrine are both effective agents for nasal congestion.

Certain medications that can be used to treat common cold symptoms such as diphenhydramine or Benadryl, a type of antihistamine, may also provide an added benefit of helping people fall asleep in addition to treating nasal inflammation, but should not be abused or overused.

Experts warn that all of these medications do have risks and side effects so people who have underlying medical problems should talk to their doctor about which one is right for them, or which ones should be avoided.

Some remedies don't require medication to help

Experts say that rest, relaxation, and hydration are undervalued when combating colds, but they do help.

"I think that when you're feeling sick, it's always a good time to re-address some of those sleep hygiene things," Dasgupta said.

Dasgupta recommends putting technology away before bed and making sure the room is cool and dark where you sleep at night, and if congestion is a problem, sleeping with the head of the bed elevated or on pillows can help.

Soup is good for the soul and sinuses

Experts say steam can help the sinuses, which can come from a hot shower or even from some comfort foods like chicken-noodle soup.

PHOTO: A bowl of steaming chicken noodle soup.
Steaming chicken noodle soup.
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"If you're gonna smell something, why not some nice noodles and some chicken? … The steam going up your nose is gonna be wonderful," Dasgupta said. "That's one you could do like just really briefly like maybe in the morning or when you get home from work."

Antibiotics are almost never the answer for the common cold

"We know that a lot almost 90% of these infections are caused by a virus and so antibiotics just aren't what's going to help you here," Castelli said.

The Centers for Disease Control and Prevention says most colds are self-limiting viruses that do not require treatment.

"I cannot emphasize enough that we don't take antibiotics for viruses," Dasgupta said.

Dasgupta says there are circumstances when a cold-like illness does need to be treated with antibiotics if it's due to a bacterial infection, but antibiotics should only be taken if prescribed by a healthcare provider.

Bonus: A little bit of honey can help a cough

Honey is one household product that can relieve cough symptoms and is safe for anyone above age one, so this is a good option for some kids when cough suppressants aren't recommended for them.

"Anyone over the age of one honey can be a really helpful effective way to help treat that cough," ABC News medical correspondent Dr. Darien Sutton told "Good Morning America."

Dr. Jade A Cobern, M.D., M.P.H. is a licensed and practicing physician and a member of the medical unit.

Dr. Brian Chen, M.D., M.P.H., resident in occupational and environmental medicine at Johns Hopkins, is a member of the medical unit.