Random Thoughts – Randocity!

Welcome to the new Randocity Fact Check Series. With all of today’s lies, deception with intentional and wilful misleading information, Randocity is beginning this series to combat these misleading and false articles. With that said, a recent Time article blanketly claims Phenylephrine is ineffective. Let’s explore.

Time Article

The Time article in question is entitled “With the Decongestant SNAFU, the FDA Tries Something New” written by Haley Weiss and published on September 14, 2023 4:30 PM EDT. Note, the link included points to the article’s contents located at the Wayback Machine at the Internet Archive to show this article’s snapshot as it was written at the time this article was published. I offer a link to the actual Time article later in this article, but I suspect this article will be corrected soon, thus the snapshot is required. Please click the Wayback Machine link to read this article in full.

Because Time and other large media outlets have tendencies to revise, correct and sometimes delete articles at later dates, the Wayback Machine is the only safe way to maintain a consistent link to such articles from the past. Let’s move on.

Misleading Information

The trouble even with sites like Time is that they hire writers who don’t always properly investigate or clarify the information about which they are writing. In this case, Haley Weiss doesn’t properly clarify her article’s own topic.

Here is Ms. Weiss’s relevant misleading statement in her article:

…the panel of experts assigned to evaluate over-the-counter allergy medications ruled that phenylephrine was effective.

Except phenylephrine has never worked. What’s puzzling, then, is how it stayed on those shelves for 50 years without a challenge.

Note: Highlighting and text formatting added by Randocity for fact checking and clarification purposes.

This unusual blanket statement regarding Phenylephrine is entirely misleading. The article opens by not outright stating the fact that the entire article’s premise involves discussion solely around oral administered versions of Phenylephrine. Simultaneously, this article makes no mention of nasal spray versions of this drug. It is, thus, left up to the reader to understand and discern (and not conflate) this fine point. Conflation is the problem at issue here.

The reality is, either Haley is intentionally trying to mislead readers into believing that all forms of Phenylephrine don’t work or Haley is naive and doesn’t understand (or didn’t research) that multiple administration forms of Phenylephrine exist. Being a health columnist for Time, I find the latter to be extremely unlikely and improbable.

In this article, Haley seems to be intentionally trying to conflate all forms of Phenylephrine under the same “doesn’t work” umbrella, when clearly this is not true.

Nasal Spray Administration

While oral pills and oral suspensions appear to be the sole focus of Haley’s Time article, this article also conveniently ignores the fact that the drug Phenylephrine is also available in a Nasal Spray format. In fact, several known brands utilize this drug ingredient including the brand Neo-Synephrine… and, yes, this brand has been on store shelves for years. The form of Phenylephrine used in a nasal spray is Phenylephrine HCL.

When Phenylephrine HCL is administered using a nasal spray, this drug is, contrary to Haley’s misleading assertion in her Time article, quite effective and fast acting at opening up nasal passages when applied directly to nasal mucosa tissues, thus shrinking (or constricting) them. This author has used Neo-Synephrine for years for this purpose. I can also attest personally that Phenylephrine HCL is not only QUITE effective, it’s also fast acting and usually starts working within 1-3 minutes.

The downside to Neo-Synephrine (Phenylephrine HCL) is that it is short acting and requires frequent re-application. The best duration I’ve been able to get out of this nasal spray is between 1 and 3 hours of relief.

How I use this specific nasal spray is for the near instant relief it offers (1-3 minutes), opening up nasal passages rapidly. I then couple Neo-Synephrine with a second spray from the longer acting Afrin. Afrin contains Oxymetazoline HCL, which this drug lasts between 6-12 hours in duration, depending on amount of nasal discharge. The more discharge, the faster it wears off. However, Afrin’s active ingredient (Oxymetazoline HCL) takes up to 15 minutes to begin working after being sprayed… which is why I couple up Afrin with Neo-Synephrine. Waiting 15 minutes for a nasal spray to begin working takes way too long.

Neo-Synephrine gives me short and immediately relief. Afrin gives me long continuous relief long after the Neo-Synephrine has worn off.

Compare all of this to saline spray. While saline sprays are effective at washing nasal tissues, it does nothing to actively open up the nasal passages. If the saline manages to dislodge and wash away an allergen irritant, it might help reduce nasal allergies. However, I’ve never had any congestion relief from using a saline nasal spray, other than to sooth irritation and dryness.

Nasal Sprays are Drying

The one thing that drugs like Oxymetazoline HCL and Phenylephrine HCL have in common is that they are extremely drying to nasal muscosa. They are so drying, in fact, that they can sometimes cause nose bleeds. The best way to avoid this drying problem is to occasionally apply a saline spray to keep the nasal tissues hydrated while using Phenylephrine HCL and/or Oxymetazoline HCL. You can also use a facial steamer to steam the nasal passages, help hydrate them and offer relief from the dryness.

Nasal Spray Rebound

All of the current drugs that are designed to shrink nasal mucosa (vasoconstriction) by direct spray application have the possibility of a rebound effect. Nasal spray rebound is when the drug wears off and the nasal passages stay congested for long periods thereafter… sometimes for hours. This then causes the person with congestion discomfort to want to spray again to open up the nasal passages. It becomes a vicious cycle.

I workaround rebound by cessation of spraying one side at a time. I cease using the nasal spray in one nostril and wait through the rebound cycle to complete for that one side, which could take up to 24 hours. Once the rebound is over and that nostril is back to its normal state, I then cease using nasal spray in the other nostril and, again, wait through the rebound cycle. Once both nostrils are clear, I’m off of the nasal spray.

This is the only method I have found to get out from under the nasal spray rebound cycle. I go through this process with each cold I’ve had at the very end of the cold. There’s no real way to avoid nasal spray rebound, unfortunately.

Rebound is the reason that so many people get addicted to using nasal spray.

Nasal Spray Effectiveness

The final aspect of the use of any vasoconstricting nasal sprays is that they’re actually too effective. What I mean by “too effective” is that these sprays artificially open the nasal passages wider than is otherwise normal. It forces the nasal muscosa to shrink more than is normal when the nasal passages are open under normal circumstances. For me, this being “open too wide” causes several problems.

The first problem of being too open is that it allows way more allergens in, which causes me to sneeze way more often. The second problem is that I can feel that the passages are open too wide, which actually causes a slight bit of discomfort. Third, because the passages are open quite wide, this encourages way more air flow in and out, which seems to cause more drying than is otherwise normal. Thus, the need for saline sprays or steam treatments to moisturize. While the drug formulations also seem to encourage dryness via the drug chemical itself, the being open too wide seems to exacerbate this drying issue.

However, if the choice is being fully congested or using a spray to open nasal passages, I’ll choose using the spray every time. My first spray choice is always Neo-Synephrine because of its fast acting nature, even though it doesn’t last nearly as long as Afrin.

Time Article, Circling Back

The point to all of the above is that Phenylephrine is indeed effective and useful when applied in the correct way. However, when taken in an oral form, its effectiveness may be in question as Haley’s Time article suggests.

I don’t have a problem with Haley’s article if seen solely through the lens the oral drug versions. However, her article is confused and appears to intentionally conflate all versions of Phenylephrine to be one-in-the-same. They aren’t. While the oral versions may be ineffective and have no efficacy, the same absolutely cannot be said of the nasal spray version.

Debunking Haley Weiss Time Article

Haley Weiss’s article in Time (this is the actual Time article link) is strongly misleading. It intentionally attempts to lump all forms of Phenylephrine into the same bucket, claiming the overall drug is ineffective and does not work.

===> This article’s claim is absolutely false! <====

Phenylephrine HCL in a nasal spray format is quite effective as a decongestant when applied directly in the nasal passages. Phenylephrine, when taken in an oral pill or suspension format, as her article suggests, may or may not be effective for the purposes for which it was intended, as an oral decongestant. This article intentionally fails to separate the effective uses of this drug from its ineffective uses, thus making overall blanket statements to confuse readers.

I guess that Time is no longer a trustworthy enough news source to properly research its articles… nor can it now avoid making such misleading statements.

↩︎