“You Shall Love Your Neighbor As Yourself” (Leviticus 19:18)

The Most Popular Oral Decongestants Are No Better Than Snake Oil

Who would have guessed that many popular oral decongestants are worse than snake oil?  Certainly not me. 

But, it turns out that the most popular over-the-counter cold medicines do not work, and may be harmful to your health.  

According to recent FDA panel findings, the most popular oral decongestants containing phenylephrine do not work

looking down a store isle at all the different products of health items

Popular brands that claim to help your stuffy nose but don’t include 

  • Sudafed PE, 
  • Tylenol Sinus & Headache, Tylenol Sinus Severe, Tylenol Cold & Flu, Tylenol Cold & Flu Severe, Tylenol Cold & Head Congestion Severe.
  • Theraflu Severe Cold Relief, Theraflu ExpressMax, Theraflu Multi-Symptom Severe Cold.
  • Mucinex FastMax, Mucinex NightShift, Mucinex SinusMax,
  • Alka-Seltzer Plus Cold and Flu (both Day and Night formulas), Alka-Seltzer Plus Severe Cold and Cough PowerFast Fizz, and 
  • DayQuil, NyQuil Severe Cold & Flu, Nyquil Severe Cold & Flu Honey, DayQuil Severe Cold & Flu Honey.  

What’s in a name?  In the case of Sudafed, a lot!!!

Sudafed vs. Sudafed PE

I bet you don’t know the difference between Sudafed and Sudafed PE. 

Until I started working on this email, I didn’t.  

picture of a box of sudafed sinus and another of sudafed sinus

Regular Sudafed contains pseudoephedrine, which is a good decongestant. (The brand name itself is a shortened version of the drug’s name.)

On the other hand, Sudafed PE uses a completely different ingredient, phenylephrine, which, according to the recent FDA panel, doesn’t work.

The only reason customers buy Sudafed PE is because they can’t find regular Sudafed and assume that Sudafed PE is the same as regular Sudafed. 

Consumers typically can’t find Sudafed because it isn’t openly displayed (it is only sold from behind the prescription counter). 

Sudafed Contains Ingredients That Drug Dealers Use

When crystal meth became popular, Sudafed and other drugs with phenylephrine were pulled from open store shelves and moved to behind the prescription counter. 

So, while you can still purchase Sudafed without a prescription, you won’t find it sold in the open.  If you want to purchase Sudafed, you need to specifically ask a pharmacist for the drug and show identification.  

The makers of Sudafed (Johnson & Johnson) realized that their sales were plummeting and didn’t like that.  So, they came up with Sudafed PE – a drug that has a similar name but is totally different from regular Sudafed.  By using a similar name and packaging, Johnson & Johnson tricked consumers into thinking Sudafed PE was the same product as Sudafed.  

Sudafed PE Doesn’t Work

Comparing retailers selling worthless cold medicines to Snake Oil Salesmen is insulting to Snake Oil Salesmen

a picture of a poster advertising 'snake oil' potion that cures all

In the 1800s America was overrun by Snake Oil Salesmen. 

These dishonest hucksters went around the country trying to convince gullible consumers that their phony elixirs “cured all” ailments. 

While Snake Oils are generally harmless, cold medicines that contain Phenylephrine can be dangerous.  They make high blood pressure (and a number of other chronic conditions) worse. 

So, the 2023 version of Snake Oil can actually harm you.  

Why does the FDA allow ineffective, and sometimes harmful, drugs to be sold? 

That’s a good question – I only wish I had a good answer.  

In a world where consumer health is supposed to be of the utmost importance, despite solid research indicating phenylephrine’s lack of efficacy, the US Food and Drug Administration (FDA) has failed to respond to public concerns.

And, it’s not as if the FDA hasn’t known about this problem for many years.    

For example, in 2015 the FDA failed to respond to a petition to remove these ineffective cold medicines from store shelves.  In fact, as early as 2007 the FDA knew that they had a problem.  

Further, in 2020, there was a prominent article published in the Annals of Pharmacotherapy titled Why Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant? 

The article summary states 

Ineffective over-the-counter (OTC) drugs should be removed from the US market. Despite solid research showing that oral phenylephrine is ineffective as a decongestant, the US Food and Drug Administration has failed to respond to a 2015 citizen’s petition to remove it from the OTC nasal decongestant monograph. Other examples of scientifically proven ineffective OTC medications include guaifenesin as an expectorant, dextromethorphan as a cough suppressant, and chlorpheniramine for cold symptoms.

What you need to know…

Do your research before taking over-the-counter drugs.  When you go to the store to purchase an over-the-counter drug, use your cell phone to look up the drug and confirm it works as advertised and is safe. 

It’s unfortunate, but you just can’t trust the FDA, the manufacturer, or the retailer to have your best interests at heart.

Mark Sunshine


  1. Carla Segal on October 20, 2023 at 1:17 am


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