"I want to tell the French: don't use them anymore!" were the words of French National Medicines Agency President Christelle Ratignier Carbonneil urging citizens not to use vasoconstrictors for colds in an interview with Le Parisien.
Specifically, Carbonneil targeted nasal tablets or sprays containing pseudoephedrine. Their use, she maintained, can cause heart attacks and strokes. Although she acknowledged that the risk is low, she maintained that harmful effects can occur "regardless of the dose and duration of treatment."
In France, this ingredient in used in brands such as Actifed Rhume, Dolirhume, Dolirhumepro, Humex Rhume, Nurofen Rhume, Rhinadvil Rhume Ibuprofène/ Pseudoéphédrine and Rhinadvilcaps Rhume Ibuprofène/ Pseudoéphédrine.
Several French health organizations have supported this warning, such as the College of General Medicine and the National Order of Pharmacists. With the northern hemisphere entering winter, these health institutions decided to anticipate the results of a reassessment of pseudoephedrine that the European Union began in February at the request of the French agency.
"Despite the measures that have been implemented, cases continue to occur," said Ratignier Carbonneil in relation to the campaign that her agency has been carrying out for some time to limit the use of these treatments. "Recent data continue to show serious effects, even though the common cold is a benign disease."
The United States is torn between phenylephrine and pseudoephedrine
In the United States, purchasing most products with pseudoephedrine is only possible with a prescription, as it can be used to make methamphetamine. "Some people still notice amphetamine-like effects of sleeplessness and jitters at those doses," says Dr. Derek Lowe. "At higher doses (not recommended!) pretty much everyone will."
Instead, oral decongestants that can be more easily purchased have phenylephrine. Its effectiveness, however, is widely questioned. Lowe maintains that there are several studies that show that in some cases it is no more successful than a placebo. "I have always told friends and family members to avoid these products if at all possible, and to go back to the pharmacy counter to get something that actually works."
A panel of independent experts from the Food and Drug Administration (FDA) took aim in September against over-the-counter allergy and cold medicines. Simply put, it concluded that they were ineffective.
The FDA has not yet made a definitive ruling on the matter. Laboratories—and all interested parties—will have the opportunity to intervene if the public agency decides to move forward with the process to withdraw phenylephrine medications. If it ultimately decides to act against these over-the-counter phenylephrine medications, Americans could have to get a prescription every time they need oral drugs to treat a cold, or resort to alternative treatments.
Alternatives to relieve a cold
As part of its campaign against vasoconstrictors with pseudoephedrine, the French agency proposes on its website a series of alternative treatments, but not before clarifying that the cold usually "heals spontaneously in 7 or 10 days."
Drinking liquids, sleeping with the head elevated and moistening the inside of the nose with solutions such as saline solution or sprays of thermal or sea water are some of the proposed treatments. Another is to ventilate one's living space regularly and keep the environment cool, between 64.4 and 68 degrees Fahrenheit.
