Talk:Phenylephrine

Confirmed Placebo
http://www.forbes.com/sites/daviddisalvo/2015/10/26/the-popular-over-the-counter-cold-medicine-that-science-says-doesnt-work/ http://www.jaci-inpractice.org/article/S2213-2198(15)00318-9/abstract — Preceding unsigned comment added by 98.193.37.192 (talk) 22:31, 2 November 2015 (UTC)


 * Wow. The FDA just recently published similar findings. I'm sure somebody else has already made a talk page about it. But here's an article about it: https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-ineffective-fda-panel-says/index.html 2607:FEA8:99E0:61D0:F043:412:4A76:609A (talk) 23:35, 13 September 2023 (UTC)
 * Is no one aware that phenylephrine is active via nasal spray, but inactive taken orally? This explains much of the controversy. Yes, it can be effective, but yes, orally it is not. Stephenscholnick (talk) 23:19, 25 September 2023 (UTC)
 * Due to said specifics, can that be added in the opening paragraph to prevent misquotes and confusion in the general userbase? Currently, it does not mention that it's specifically the oral dosage that has been deemed ineffective. Mastercodex199 (talk) 00:05, 20 October 2023 (UTC)

Placebo Problems
There is a problem with the statement in the first paragraph. It tries to claim that phenylephrine hydrochloride as a decongestant is a nothing more than a placebo which is misleading and make lay people think that the drug is completely ineffective.
 * Actually, it basically *is* a placebo. It DOESN'T work! Actually, J&J came up with phenylephrine in the 70s, but nobody has bothered to use it until pseudoephedrine became restricted.

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. I have seen the wonder placebo can work; knees healing themselves after something that looks like knee surgery, cancer patients living years longer than normal when not told or refusing the end, older people dropping like flies when put into homes or as active as kids at 95 due to their mentality and so on. I routinely don't take painkillers or any other medicine like that and have actually stopped taking them when I was told to do so. But this does work. I have seen these structures many, many times before. But never bothered to read into the times to onset or durations for this specific set of over the counters; things like Ephedrine aren't OTC in the UK, which is why I can buy a kilo of iodine without an account or being bothered. I didn't even buy it, or get it given to me, I found it lying around and drank it. Just drinking the powder, I can feel there is a very specific period the strong symptoms disappear within. Since I don't know the timescales involved, I can't bias those subconsciously. The drug is doing it.

The claim that this drug is no more effective than a placebo is sheer idiocy. It wouldn't be on the market if it didn't really do anything. Somebody needs to fix this catastrophe of an article and do some proper research. Call this anecdotal if you want to, I don't care, but I've been taking this stuff for months and it WORKS. And I have suffered from sinusitis for decades. NO placebo could possibly remedy such a long term chronic condition. Somebody please do some decent research and fix this stupidity.

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)

Finally it must be said that the whole efforts are in no relation. The use of methamphetamine is a rarity and the regular users of methamphetamine are a very samll minority.

"The estimated number of semi-regular methamphetamine users in the U.S. (those who use once a month or more) equals less than one quarter of one percent of the population (0.2 percent). Almost 11 million Americans have tried methamphetamine at least once – far fewer than those who have tried inhalants (23 million), psychedelics (34 million), cocaine (34 million), or marijuana (100 million).

Of those 10.3 million, only 1.3 million used methamphetamine in the last year; and only 512,000 used it within the last 30 days." Drug Policy Alliance (2010)

And the studies show a continuing downward trend (in 2012, the number of past month methamphetamine users decreased to 440,000). Also the number of first time users is constantly decreasing. Fewer and fewer use actually methamphetamine.

Another question is why should 99,9% of people who uses pseudoephedrine as decongestant be affected by the actions of a small minority of app. less then 0,1% who uses to make methampehtamine out of it?

It makes no sense to me that such a small minority of people should have such big impact on a whole nation. That's ridiculous. The whole methamphetamine situation has been grossly overstated and exaggerated.

References:

Results from the 2009 National Survey on Drug Use and Health: National Findings http://samhsa.gov/data/NSDUH/2k9NSDUH/2k9Results.htm

Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings http://www.samhsa.gov/data/nsduh/2k10nsduh/2k10results.htm

Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings http://www.samhsa.gov/data/NSDUH/2011SummNatFindDetTables

Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/

Regards, --Stefan Bach7777 (talk) 08:05, 2 December 2013 (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)
 * I think it has more in common with snake oil. Jason Harvestdancer | Talk to me 16:45, 18 September 2023 (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 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).

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)

i wouldnt say it's a rip off. phenylephrine works for nasal congestion for me in as little as 5 mg. i dont like the side effects i get from it but i've recently been having problems with my sinuses and been taking phenylephrine before and during work. it works quite well for me. im surprised at all these studies saying it is ineffective. sudafed does work better for me for nasal congestion but i also don't like it's side effects either. i just got phenylephrine instead of pseudoephedrine because where i live you have to go to the pharmacy to get it now because of meth smurfs. i didnt feel like going thru the hassle. 68.188.200.62 (talk) 01:35, 15 April 2014 (UTC)sk!

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? -- noosph e re 22:16, 14 January 2007 (UTC)


 * Anecdotal evidence is generally not considered accurate. Human memory is very fallable. Especially over time, through second or third etc hand reports, and various cognitive biases we aren't even aware of most of the time. Such as negativity bias, or confirmation bias.
 * Courts in the US aren't even allowed to convinct on anecdotal evidence alone (ideally). And peer reviewed journals/scientific groups will just ignore or refute any such evidence for acientific claims, because it's just not worth entertaining because yoy don't know how much is true, lies, remembered wrong, embellished (even unknowingly) etc.
 * So, hopefully you understand why anecdotal evidence is considered so untrustworthy. Even in the best of cases. 2607:FEA8:99E0:61D0:F043:412:4A76:609A (talk) 23:45, 13 September 2023 (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


 * Well, an independent double-blind study has now reported that "PE HCl, at doses of up to 40 mg every 4 hours, is not significantly better than placebo at relieving nasal congestion in adults with [seasonal allergic rhinitis]". Of course this isn't useful here until some secondary coverage arrives. Over-the-Counter Oral Phenylephrine: A Placebo for Nasal CongestionThe Popular Over-The-Counter Cold Medicine That Science Says Doesn't Work LeadSongDog come howl!  16:44, 27 October 2015 (UTC)

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

Side effects
Don't know about that. In me it causes some stabbing chest pains, high blood pressure, and shortness of breath. It doesn't do much for my congestion and I can't take it before I go jog. If I stay away from everything containing it, I'm fine. I wonder if Heath Ledger had too much of it in his system? Anyway, high blood pressure could be responsible for your nose bleeds, and that's the principal effect of phenylephrine... that and dilating pupils. There's zero reason it should even be available over-the-counter, let alone indicated as a decongestant. It's never been shown in any peer-reviewed properly-blinded study to be effective as one. Essentially people are being sold snake oil for cold and allergy relief with this stuff. -Reticuli 66.178.144.76 (talk) 20:19, 30 November 2010 (UTC)

Comparing the Sympathomimetic and Adrenergic effects of Phenylephrine vs Pseudoephedrine
Sashkia1 (talk) 01:20, 27 January 2012 (UTC)With the limited research available on the comparisons between Phenylephrine (the new Sudafed) and Pseudoephedrine, I have found limited information on the differences between the adrenergic affects of the Sympathomimetic drugs. I am researching this because I currently take several medications that cause an increase in Central Nervous System activity and when combined with Sympathomimetic drugs, can potentiate the side effects of all drugs involved resulting in an increased heart rate, restlessness, hypertension, etc., with my main concern being an increased effect on the anxiety I am already suffering from. The ONLY information I could find was in an answer posted by a user regarding a question asked about the differences in side effects of the two drugs named above. This answer, though by an unknown, therefore, probably an un-licensed/credentialed person, stated that Phenylephrine has less or no side effects, and while Pseudoephedrine is likely to have adverse CNS side effects causing CNS stimulation. I have referred to the many, though some considered uncredible, sources available on the research and opinions regarding differences in drug effectiveness pertaining to its reason for use, which all have stated Phenylephrine is less, some state significantly so, effective in nasal decongestant purposes. However, that is not the concern in this topic, as other decongestants or relief measures can be combined, including my most recent use of a warm-moisture release humidifier. In people/patients like myself who are already prescriebd medications that are stimulants or can cause CNS stimulation, the concern is adding another medication that can potentiate the side effects of the medications already being taken, thus leading to adverse reactions. Therefore the question at hand is what is the best choice to try when one does not want to take anything that can result in increased side effects of Sympathomimetics, particularly, anxiety and increased heart rates for example? 0206

Proven Ineffective for congestion relief
https://journals.sagepub.com/doi/10.1177/10600280221081526 184.161.251.199 (talk) 22:38, 30 March 2022 (UTC)

Pushback on effectiveness in lead
For my last edit, see Phenylephrine oldid — 8 May 2022

The existing cite for effectiveness was drugs.com which already contained text that its effectiveness was debated (not actually a good cite in the first place).

I added new material from a blog post, but this is a blog post of the highest magnitude: an established research chemist with a long history of public visibility, including many extremely wonky and detailed posts, whose blog is hosted at the American Association for the Advancement of Science (AAAS) website science.org (this quasi-endorsement is not likely available to the common chum).

Though lacking comparable super-elite status within his profession, he writes with similar verve and authority as Scott Aaronson, another guy who might be found writing on his personal blog, though it could just as easily be stone tablets handed down from on high.

If someone comes along to argue from the interests of Big Pharma that this material is unbalanced or undue (or poorly sourced), I'd pretty much myself place Derek Lowe's blog at 100 and drugs.com at a 10.

Note that I put both the academic cites into the new material (useful, but too direct) as well as Lowe's interpretation (appropriately 3rd party). Lowe is not just some guy out there banging on without a good editor. He's well established and he's competent enough not to really need an editor looking directly over his shoulder. AAAS would soon notice, however, if he started to fall shy of established standards and would likely dehost his blog entirely as a result.

Don't fall for ruses about the bloginess of this citation. Absolutely not an issue in this case, if ever I've not seen one. If an argument does come to pass, argue the facts instead. Unless Lowe has steered me wrong, this pushback is not just a single recent paper, but long established and political. &mdash; MaxEnt 19:52, 8 May 2022 (UTC)

A theory in search of facts
I examined reference 5 as the subject caught my interest. Unfortunately this link to the pdf file is broken and the title indicates it wasn't on the subject. The PDF file was an insert for the subject drug and not pseudoephedrine

In the last sentence of the third paragraph it states: Unlike pseudoephedrine, abuse of phenylephrine is very uncommon. [ref]

I was expecting a reference that mentioned pseudoephedrine somewhere in the article. There certainly won't be a reference to an unrelated product in the Insert for the phenylephedrine. I will attempt to find a reference but want to ask here first if anyone has facts for this theory? I added needs citation template TSpot-SF (talk) 11:50, 6 August 2022 (UTC)

Confirmed oral route uselessness?
https://thehill.com/homenews/4200317-decongestant-used-by-sudafed-benadryl-is-not-effective-fda-advisers-find/ Morton.Michael.NC (talk) 21:30, 12 September 2023 (UTC)


 * Glad to see someone else has brought this up. It definitely needs to be in the article. Yesthatbruce (talk) 01:47, 14 September 2023 (UTC)

Facts anyone?
There is the uncomfortable, to the fans of this drug, FACT that it is rapidly broken down in the (normal) human stomach. This means: 1. The actual oral dose is very much reduced (but of course that will depend on the entire stomach contents at the time of its ingestion) and is unlikely to be transported into the bloodstream in "effective" amounts (for most people). 2. This is irrelevant to other modes - such as nasal spray, anal suppository, or eye/nose(?) drops - for which there is no controversy (afaik). The article - as it exists on Sept 17, 2023 - is very, very wrong. The earlier (1970's) FDA approval was based on FLAWED and incorrect data from the drug's manufacturer as well as the inexplicable use of mostly irrelevant data. We knew long before the 1970s that route of entry was important in determining effectiveness. It took the U.S. FDA 6 decades to correct its blunder. First, this remarkable incompetence should have its own section, and second the lead needs to be changed to reflect the facts. The DRUG's effectiveness DEPENDS on its route of administration for those conditions it can be effective for. Few comments here seem to grasp that truth and the article repeatedly fails to discriminate between oral and other routes when describing its effects. It is also NOT the case that the claim is that the drug is "completely" ineffective orally. The claim is that it is not orally effective → meaning shouldn't be marketed as being an effective oral decongestant.98.17.44.45 (talk) 18:23, 17 September 2023 (UTC)

Effectiveness as nasal decongestant
In the third paragraph it's mentioned: "Its effectiveness as a nasal decongestant has been questioned." but actually all of the sources describe that it's not effective only when taken orally. This is also mentioned in the next sentence. Still, I think that this particular sentence is misleading. I am looking for opinions whether it should be changed. --Bsivanov (talk) 11:38, 29 November 2023 (UTC)


 * Do you mean that you would like to clarify that when taken orally it is not an effective decongestant, but that it can be an effective decongestant when administered via other routes? If so, I'm not sure how useful that is: under what conditions would you (1) need a decongestant, (2) be willing to use a non-oral route (e.g., IV), and (3) still choose phenylephrine? Kimen8 (talk) 11:53, 29 November 2023 (UTC)