Leading ingredient in over-the-counter decongestants doesn't work, FDA panel rules

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Leading ingredient in over-the-counter decongestants doesn't work, FDA panel rules
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The Food and Drug Administration reviewed data on phenylephrine, an ingredient in many popular decongestants, and deemed it ineffective when taken orally.

The key ingredient in popular decongestants such as Sudafed PE, Benadryl Allergy Plus Congestion and Allegra-D doesn't relieve nasal congestion when taken orally, a Food and Drug Administration panel concluded in a meeting Tuesday .

That's because, when taken orally, less than 1% of the drug actually ends up in the bloodstream and thus reaches the tissues of the nose that it's supposed to help, the committee reported in a memo from the meeting. So, if they don't work, how did phenylephrine-based pills get approved in the first place?

Phenylephrine was first evaluated as an over-the-counter oral and intranasal decongestant back in 1976, according to the NDAC memo. But the ingredient gained popularity in 2005 as a substitute for pseudoephedrine, a different decongestant that had been moved behind the counter by a law intended to rein in the sale of drugs that can be used to make meth.

"These three trials represent by far the largest and most carefully constructed trials that have ever been performed to evaluate the decongestant effect of oral PE [phenylephrine]," the NDAC memo states. The trials showed that the drug had no more effect than a placebo, and additional data from the FDA's clinical pharmacology lab showed very little of it enters the bloodstream.

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