Talk:Phenylephrine

Placebo Problems

There is a problem with the statement in the first paragraph. It tries to claim that phenylephrine hydrochoride as a decongestant is a nothing more than a placebo which is misleading and make lay people think that the drug is completely innefective.

From the link "In 1976, the FDA deemed a 10 milligram oral dose of phenylephrine safe and effective at relieving congestion, making it possible for companies to use the ingredient without conducting studies." But in their letter, Hendeles and Hatton say phenylephrine does not effectively relieve nasal stuffiness at this dose."

But then in the very same article: (http://news.ufl.edu/2006/07/19/decongensant/)

"As new drugs flood the market, Hendeles recommends people seeking relief from a cold try a topical nose spray. Sprays with phenylephrine are safe and effective for the relief of nasal stuffiness due to a simple cold lasting less than a week, he said, but the treatments should not be used for stuffiness from allergies lasting longer because a “rebound effect” can actually worsen congestion."

So the drug works and the details of its supposed placebo decongestant effects should be rightly moved lower down to where it is more relevant and specific. Or alternatively if someone can list the effects of the drug and its uses and make a clear distinction as to where it is found to be placebo and where it works. —Preceding unsigned comment added by 80.229.83.223 (talk) 10:11, 13 October 2008 (UTC)

The Beechams I have with this in is CERTAINLY not placebo. Did they bias the test by telling the people they were getting a decongestant by any chance?

Under side effects

"Patients with congestion and hypertension are typically advised to avoid products containing phenylephrine". Surely this can't be right?62.244.182.162 (talk) 14:10, 1 October 2008 (UTC)

I'm assuming that since phenylephrine has a side effect of hypertension, you wouldn't want a normally hypertensive person with slight congestion taking something that would raise their blood pressure even more. It's like the side-effect being worse than the actual treatment130.49.150.51 (talk) 18:18, 7 October 2008 (UTC).

Hydroxyl group

According to the chemical literature, the hydroxyl group on the chain should be coming out of the plane. Could someone change this?

Tried reverting the image to the version with an H. Did not seem to work.--Fred 3 July 2005 06:30 (UTC)

Phenylephrine versus pseudoephedrine

Article says:

Although pseudoephedrine is much more commonly used as a nasal decongestant in the United States, because of the possibility that pseudoephedrine can be used in the illegal manufacture of methamphetamine, it is expected that phenylephrine will become more common.

Based my my observations (in Indiana and in Massachusetts), in the last year, this prediction has come true -- many products which long contained pseudoephedrine have a small "New Formula!" tag on their packaging, and upon inspection, contain phenylephrine instead. Notably, Nyquil and Dayquil are completely switching: see http://vicks.com/pseudoephederine_faq.shtml.

Ancedotal note: no one seems to be suggesting that the "new" ingredient is _better_ in any way, which is odd given the general latch-onto-any-little-thing marketing we typically see from drug companies. This suggests to the conspiracy theorist in me that it's actually *less* effective. (This is supported by the way I first noticed this whole mess -- I took a little red pill, and noticed it didn't help with my congestion as I was accustomed, so then I read the fine print -- hey, different medicine!) I'd be very interested in seeing references to studies comparing the two medicines; from some quick research, the best I could find was this article http://www.msnbc.msn.com/id/8322753/ which states that "Few studies have been done to compare the effectiveness of phenylephrine versus pseudoephedrine as a cold medicine ingredient."

Here is a link to the Student Doctor Network bbs which indicates that phenylephrine is not as effective as pseudeoephedrine:

http://forums.studentdoctor.net/showthread.php?p=3302453#post3302453

68.42.67.38 19:55, 28 January 2006 (UTC)arborlaw

I've not been able to find any facts about the effectiveness of the new drug phenylephrine either-- but from personal experience it isn't near as effective as the good old pseudoephedrine.

-- And (purely on the basis of my own experience as someone with near-constant stuff nose, phenylephrine is definitely less effective, and there aren't readily available time-release OTC versions. Then again PPA (phenylpropanolamine) disappeared due to a few people abusing it, so... sucks, but inevitable. Nate 00:08, 5 April 2006 (UTC)

At least in the USA, the reason PPA was banned is not because of abuse (which was quite rare, doubtless because overconsumption of PPA typically results in headache, nausea and panic attacks), but because a statistical medical study published in 1999 demonstrated that PPA is linked to a very rare, but progressive and deadly form of heart disease. --Ryanaxp 17:39, 4 August 2006 (UTC)

Why do I have to get an inferior medication because some dope-makers abuse the superior one? While the dope-makers continue to get their stock of pseudoephedrine, common people like me suffer. I went to three stores and either they didn't have plain pseudoephedrine, or it was with the prescription drugs. They all had the new inferior drug. Bleh. --Amit 01:18, 1 September 2006 (UTC)

I've been using sudafed for years due to chronic congestion, and phenylephrine does nothing for me...It's useless as far as I'm concerned. --User:BenCoJones

Pretty much every pharmacy in the US should still have pseudoephedrine available, but you have to ask for it and sign for it, and the government tracks how much you buy (to make sure you aren't a drug lab tech). I'd highly recommend it, as phenylephrine is pretty much worthless. I don't know a single doctor who uses or recommends it. Pulling pseudoephedrine was a good idea because of meth lab problems (the issue's gone way down), but pharmacies shouldn't stock PE, and a legit pharmacist should tell you to use the real deal.Lenrodman 06:24, 16 November 2007 (UTC)

Well, Lenrodman, I am with you in the position that phenylephrine is virtually useless at the common 10 mg dose, I think your claims that since pseudoephedrine was restricted, the meth lab situation has "gone way down", Sorry, but that is far from the truth, and is an unfounded claim. About every night on WKYT Newsfirst I hear about a meth lab explosion here and there, and everywhere. The restriction of psuedoephedrine has also done virtually nothing to reduce the availability of methamphetamine.--Metalhead94 (talk) 01:10, 5 September 2008 (UTC)

Phenylephrine is most definitely far less effective than pseudoephedrine for any nasal congestion serious enough for someone to desire to take medication to treat. Basically, phenylephrine doesn't hurt to toss into the mix of a multi-symptom cold formula if you're already taking it to treat other ailments. If nasal congestion is your primary symptom, then I recommend you ask the pharmacist to give you something containing pseudoephedrine. --Thoric (talk) 23:08, 5 January 2010 (UTC)

New study underway

We should keep a close eye on efficacy studies such as this one. There aren't many studies available, so every new one would be helpful. This particular study is in the recruitment phase. It is in Phase III, so it should offer some real insights once it has concluded. --W0lfie 15:34, 15 March 2006 (UTC)

Shark liver oil

Isn't the source of phenylephrine shark liver oil? -- Finlay McWalter | Talk 13:41, 3 April 2006 (UTC)

I don't think shark liver oil is a source of phenylephrine, unless it is a very minor one. Its synthetic manufacture should be easy enough that an exotic source such as shark liver oil wouldn't be necessary. --Ed (Edgar181) 13:54, 3 April 2006 (UTC)

Clarification

As a non-native speaker, I'm doing quite ok with the chemical parts, however do not understand what this means: "It suffers some rebound congestion effects". Can someone clarify? Thanks

Rebound (anything) is a phenomenon where after the rated duration of the medicine, the symptoms reappear at least as bad and probably worse. Lidnariq 23:07, 6 October 2006 (UTC)

The following sentence in the article is not well written -

"It causes some rebound congestion effects than oxymetazoline, although to a lesser degree." Does the author mean to say the rebound is, (a) more than, (b) equal to, (c) similar to, (d) less than, the rebound effect from oxymetazoline. What about a cite to the literature? Does rebound occur after only a few uses? Does the frequency of dosing effect rebound? Bippeeii (talk) 20:48, 15 May 2009 (UTC)

Overdose danger? Effectiveness?

The original brand name pseudoephedrine was "Sudafed". You took two little red pills. When they switched to phenylephrine, the dose became one little red pill. I purchesed the new box without noticing the new ingredient, and was still taking two for a while until I noticed the change. I wonder how many others also did this.

Even two of the new ones don't seem as effective as the old pseudoephedrine. Anecdotal of course, but where is the study showing comparable effectiveness? I am sure the maker would want to check and see if there was some improvement for advertising purposes, so the lack of info on this suggests to me that the study was done but not released because the results were not positive.

Phenylephrine, as you must already know now, is labeled as Sudafed PE. Check [1] to confirm dosage. --Amit 20:43, 8 October 2006 (UTC)

You are not alone in questioning its effectiveness. I think it sucks and is ineffective. I got switched in my Dayquil and didn't even noticed. If phenylephrine is so worthy, why is it the predecessor, why was pseudoephedrine used in the first place? I'd love to see this addressed by anyone who knows. —The preceding unsigned comment was added by 166.44.39.52 (talk • contribs) 10:51, 4 December 2006 (UTC).

ANOTHER QUESTION

it combats hyPOtension (as per my med school lecturer)... i don't know if it is used to raise blood pressure

Pseudophedrine raises BP and HR, but this is more of a thing to watch out for than a treatment plan (i.e. might be risky if you have high BP or HR or CHD history/risk). It would be detrimental to the patient to take long-term, and there are much simpler ways to raise BP (which you rarely want to do anyway). Most commonly used are salt pills, which can easily raise BP and have minimal side effects - why use a complex chemical that interacts with all sorts of things when salt will do the trick? Anyways, very few people need to RAISE their BP (generally just athletes, and very few anyway) Lenrodman (talk) 20:34, 18 November 2007 (UTC)

Phenylephrine is about as effective as a pile of crap, an utter rip off, an inert filler for psuedoephedrine, the latter of which is very effective. Since I had already purchased my monthly limit of psuedoephedrine from behind the counter, I was forced to resort to phenylephrine. I got some Benadryl-D (diphenhydramine, phenylephrine) and took 4 of them, to help congestion and as a sleep aid. The diphenhydramine did a nice job as a sleep aid, but the phenylephrine hadn't even scratched the surface of my nasal congestion. It is really sad about the restrictions on pseudoephedrine, forcing this ineffective filler on us. Just an inert rip off.--Metalhead94 (talk) 06:03, 15 August 2008 (UTC)

Topical use to stop bleeding?

"Surgeons have used neosynephrine to slow or stop bleeding. It constricts the blood vessels. When my wife had a C section the doctor had a 16 oz spray bottle and as he cut through the layers to he uterus he would spray it and wipe it away. I asked what was in the bottle and he said nasal spray. I about fell over. He explained and it made perfect sense."

Is there any truth to this? Could I just go to the local drug store, buy myself a bottle of Neo-Synephrine 12-Hour Spray and use it on an open wound to stop the bleeding? -- noosphere 22:16, 14 January 2007 (UTC)

--Topical use of vasoconstrictors It's use to aide/stop blood flow would depend on the practical reaction time involved. Other uses are possible as well: look at the label for Preparation H. The active ingredient is phenylephrine 3-4%. Hemiroids are a vascular problem, therefore a vasoconstrictor is effective through repeated applications. Could the same be true of other problems? Could topical application to gradually restrict local blood flow gradually help skin problems as well? Restricted blood flow might cause the eventual die off of a wart, mole, or other localized skin disease, without any scarring. —Preceding unsigned comment added by 208.119.81.17 (talk) 00:22, 28 December 2007 (UTC)

3D Structure would be nice

Does anyone out there know where to get a 3D image of the phenylephrine molecule? If so we should add it to the article. Thoughts?--Metalhead94 (talk) 23:59, 4 September 2008 (UTC)

3D images of molecules are usually created by their contributors. I'll add one tomorrow. Dursty (talk) 05:12, 27 September 2008 (UTC)

No mention of use in hemorrhoid creams

Phenylephrine HCI is the active ingredient in some over-the-counter hemorrhoid creams in the United States and possible elsewhere. The article should mention that. 5Q5 (talk) 22:19, 25 September 2008 (UTC)

Dopamine Beta-Hydroxylase Deficiency

I wonder if this could be used to treat Dopamine Beta-Hydroxylase Deficiency ... as the article says it is an α1-adrenergic receptor agonist and is sometimes used to treat low blood pressure. Anyone know anything? —Preceding unsigned comment added by Interestedperson (talk • contribs) 18:08, 4 October 2008 (UTC)

Synthesis or manufacturing

I came to this page looking for information on how this compound is manufactured, and what the synthesis path is. Adding that information would be an improvement.

Effectiveness Studies

I am pretty sure that the effectiveness studies that the FDA expert panel used to give phenylephrine GRASE baci in the mid 70's were unpublished drug company studies without peer review. Hardly suprising that a study by the makers of Dristan and Novahistine showed that their products were effective. 121.209.49.58 (talk) 09:33, 20 October 2009 (UTC) Jonathan

Photo

Can we get a photo of the actual chemical? Badagnani (talk) 02:17, 29 November 2009 (UTC)

A possible Side effect

i am currently taking something with 5mg of phenylephrine and i experienced two possibly related symptoms: the viscous mucus changed it's usual green color to white and came out much like a flash flood making a waste of tissues for the past 3 days and sudden nose bleeds that come after i plug my nose and it's short but it concerns me; if anyone can explain why these symptoms are happening please answer below: also the medicine i'm taking is Tylenol Cold Multi Symptom