What is Phenylephrine ?
The combat Methamphetamine act removed an effective groups of products from the market place. Once again the powers that be forget about the needs of the many to punish the mis-behavior or a select few. Most of us could care less than drug makers can use a OTC allergy medicine to make a illegal drug that can be used by drug users. Guess what?, you are not going to solve their drug problem by punishing allergy and asthma suffers. These idiots will sniff paint, or do whatever to get high. YOU WILL NOT STOP THEM! I know the gov is trying to do something good and look to to voters but stop punishing the law abiding citizens who are the majority to try to stop the activities of a minority. Here is my theory, I have been around drugs and drug users my entire life. I do not use drugs or sell them. If you are a drug user you are not intelligent. If you are not intelligent enough to decide not to use drugs you may die. Then you can not pass on your non-intelligent genes to future drug users. I believe this is called “Natural Selection”.
So now the pharmaceutical companies try to fill the void that the removal of Ephedrine and Psuedoephedrine left with Phenylephrine . Phenylephrine is a a1-adrenergic receptor agonist used primarily as a decongestant, and to increase blood pressure. Phenylephrine is marketed as a substitute for the decongestant pseudoephedrine, though clinical studies differ regarding its effectiveness in this role.
Phenylephrine is used as a decongestant and sold as an oral medicine. It is now the most common over-the-counter decongestant in the United States. Oral phenylephrine is extensively metabolized by monoamine oxidase, an enzyme that is present in the intestinal wall and in the liver. Compared to pseudoephedrine or ephedrine, it has a reduced and variable bio-availability. Phenylephrine may cause side effects such as headache, reflex tachycardia, excitability, restlessness and cardiac arrhythmia.
Phenylephrine is used as a replacement for ephedrine and pseudoephedrine in decongestant medicines due to pseudoephedrine’s use in the illicit manufacture of methamphetamine. Its efficacy as an oral decongestant has been questioned, with multiple studies not being able to come to an agreement. Whereas pseudoephedrine and ephedrine cause both vasoconstriction and increase of mucociliary clearance through its nonspecific adrenergic activity, phenylephrine’s selective a-adrenergic agonism causes vasoconstriction alone, creating a difference in their methods of action.
The primary side effect of phenylephrine is hypertension. Patients with hypertension are typically advised to avoid products containing it. Prostatic hyperplasia can also be symptomatically worsened by use, and chronic use can lead to rebound hyperemia. Patients with a history of anxiety disease or panic disorder, or on epilepsy medication should not take this substance. The drug interaction might produce seizures. Some patients have been shown to have an upset stomach, severe abdominal cramping, and vomiting issues connected to taking this drug.
Because this medication is a sympathomimetic amine, it can also increase contractility force and increase output to the cardiac muscle. In other words, phenylephrine mimics norepinephrine binding to a-adrenoreceptors and can cause increased heart rate. Extended use may cause rhinitis medicamentosa, a condition of rebound nasal congestion.
Is Phenylephrine A Good Substitute for Pseudoephedrine or Ephedrine?
Pseudoephedrine, Ephedrine and phenylephrine are all decongestants; and, until recently, pseudoephedrine and ephedrine were commonly available in the United States. Thank goodness the gov allows a few retailers to still sell ephedrine and Psuedoephedrine. Because provisions of the Combat Methamphetamine Epidemic Act of 2005 placed restrictions on the sale of pseudoephedrine products to prevent the clandestine manufacture of methamphetamine. There is only 1 or 2 places left to buy and LiveLeanToday.com is one of the few left. They are DEA Certified and follow all restrictions to the letter of the law. This is to prevent drug makers from buying the product for illegal reasons but yet provinding those who really need it with the medicine they need. Since 2004, phenylephrine has been increasingly marketed as a substitute for pseudoephedrine; some manufacturers have changed the active ingredients of products to avoid the restrictions on sales. Phenylephrine has been off patent for some time, and many generic brands are available.
Questions about effectiveness.
Pharmacists in Florida suggested in 2006 that oral phenylephrine is ineffective as a decongestant at the 10-mg dose used, arguing that the studies used for the regulatory approval of the drug in the United States in 1976 were inadequate to prove effectiveness at the 10-mg dose, and safety at higher doses. Other pharmacists have expressed concerns over phenylephrine’s effectiveness as a nasal decongestant, and other clinicians have indicated concern for regulatory actions that reduced the availability of pseudoephedrine. A subsequent meta-analysis by the same researchers concluded that the evidence for its effectiveness is insufficient, though another meta-analysis published shortly thereafter by researchers from GlaxoSmithKline found the standard 10-mg dose to be significantly more effective than a placebo. Additionally, two studies published in 2009 examined the effects of phenylephrine on symptoms of allergic rhinitis by exposing sufferers to pollen in a controlled, indoor environment. Neither study was able to distinguish between the effects of phenylephrine or a placebo. Pseudoephedrine and loratadine-montelukast therapy were found to be significantly more effective than both phenylephrine and placebo.
10years ago, a person could have purchased Vasopro, Primatene, Bronkaid and ephedra, the traditional Chinese herb containing the compound with little or no hassle. Now you have to show a driver’s license, and fill out a form to buy it. Vasopro itself is now viewed as a harsh drug– not as an effective medicine. Today, almost all Americans turn to its hassle-free cousin, phenylephrine, as an alternative. Almost all decongestants sold today contain phenylephrine as a substitute for pseudoephedrine. But there’s one major problem with this now popular alternative: it doesn’t work well. You can still buy ephedrine in psuedoephedrine in small amounts at LiveLeanToday.com
The End of Ephedrine and Psuedoephedrine’s Reign
For over a decade, phenylephrine has been gradually gaining pace as the world’s dominant over-the-counter decongestant. If you scan the shelves of your local pharmacy, you’ll notice that nearly every single product marketed with the word “decongestant” contains phenylephrine as its sole or primary ingredient. Just a few short years ago, pseudoephedrine dominated the market as a method for reducing nasal and sinus congestion.
Pseudoephedrine is a naturally occurring compound found most notably in the leaves of the ma huang, or ephedra, plant. In traditional Chinese medicine, ma huang was used to treat asthma, colds, coughs, pneumonia, and sinusitis. It worked splendidly due to its high concentration of pseudoephedrine and its chemical cousin ephedrine–both of which were eventually synthesized and sold as pharmaceutical drugs. Synthetic ephedrine and pseudoephedrine have also been widely abused, by dieters and by people using them to manufacture methamphetamine.
Phenylephrine Takes Over
U.S. Food and Drug Administration first approved phenylephrine in 1976, although only weak science supported its use. The FDA still stands by the product’s efficacy as a nasal and sinus decongestant, but its efficacy remains a point of much debate.
Phenylephrine was not a particularly popular medication until the the early 2000’s. In the late 90s and early 2000s, a few manufacturers began offering new “PE,” or phenylephrine, versions of products that formerly contained pseudoephedrine. This gave customers the idea that they were purchasing a novel product that would be better than ephedrine or pseudoephedrine.
In 2004, drug manufacturers were informed of impending legislation, the Combat Methamphetamine Epidemic Act of 2005. This ordered strict restrictions on the sale of products containing pseudoephedrine. Although it may have helped to slow the production of methamphetamine, pharmaceutical companies were terrified that it might affect sales of their products. Almost all manufacturers responded to the restrictions by replacing pseudoephedrine with phenylephrine as the “active” ingredient in their products.
There is no compelling evidence that phenylephrine actually works at the dose recommended on over-the-counter product labels. According to a press release by the University of Florida, the FDA based its approval of phenylephrine on only four limited tests. Half of these trials were not peer-reviewed, and they were paid for by the manufacturers of the drugs.
By contrast, six very well-designed studies have found that phenylephrine works no better than a placebo at relieving nasal stuffiness from colds, flu, allergies or sinusitis. If we stick with unbiased science, we see two studies supporting phenylephrine and six studies disproving it. So far, the evidence is pretty clear that phenylephrine is ineffective.
Many phenylephrine users will anecdotally report success using the product. I myself had taken it and believed that it worked, at one point. But, as we all know, correlation does not imply causation. As far as science shows us, the odds of finding congestion relief from phenylephrine are the same as finding relief from an inert sugar pill– except that the placebo isn’t likely to cause serious side effects.
Is Phenylephrine Dangerous?
Phenylephrine users can pay a deadly price without gaining any real benefits from it. Several people, including young children, have died after using phenylephrine products that we presume to be safe. The risks are not worth the benefits, considering that there is no convincing evidence that it offers any real benefits to speak of.
The National Institutes of Health notes that phenylephrine’s most common symptoms are anxiety, insomnia and dizziness– similar, perhaps, to having a few too many cups of coffee. For high-risk individuals such as those with hypertension, it can cause a serious cardiovascular problem, up to and including a heart attack.
Phenylephrine’s dangers are most serious for young children–in fact, USA Today reported that at least 54 American children have died from the use of phenylephrine.The American Academy of Pediatrics strongly warns against the use of cold medicines containing phenylephrine, asking parents to give them only to children over the age of six, and only with a physician’s approval.