The Insane World Of Online Decongestant Commerce

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It's May 1st in New York. The composition of the air is roughly 50% pollen and 50% nitrogen, oxygen, etc. If you're lucky, you'll be able to stop sneezing long enough to swallow a decongestant. If you're even luckier, you might take the right decongestant. And if you're luckier still, you might know a chemist who will decipher the ingredients in the various products that are marketed to temporarily interrupt sneezing and minimize the gallons of stuff running out of your nose. 

Fortunately, your friendly neighborhood allergic chemist is here to do it for you! It's ugly out there, much of it due to sleazy marketing techniques and stupid laws. Much of where the (intentional) confusion centers, is around the letters and words that follow the drug name. 

But first, the inspiration for this article - my kitchen table (you may want to look away):

J. Bloom Workspace Inspirational (2019). Channeling my inner slob.

The coupon is for Claritin-D, which works pretty well but is a bit pricey. I was initially going to write how absurd it is that you can't buy the stuff online, but five seconds of research turned up products that make you think that you can — very clever marketing, but not such good medicine. 

A quick trip to Amazon and "decongestant" yielded over 1,000 products. You will go out of your mind if you try to figure this out. Here are a few and their active ingredients. The Allegra marketers sure have it going on (Figure 1).

Figure 1. "Different" types of Allegra. (Left) Fexofenadine (the generic name for Allegra) plus phenylephrine - a lousy decongestant. (Center) Fexofenadine without phenylephrine. (Right) The same as Allegra-D, but in a time-release formulation. Do we really need all of these?

But the Sudafed marketers put the Allegra marketers to shame. Look at this madness (Figure 2). 

Figure 2. Sudafed Soup.

Let's look at the top line. There are three "different" Sudafed products. Sudafed PE Congestion contains phenylephrine (PE) - an essentially useless decongestant. You can buy this over the counter (OTC) or online because it does not contain pseudoephedrine - the drug that can be converted to methamphetamine (phenylephrine cannot). Sudafed was taken off pharmacy shelves in 2006 to stop "cooking meth" only to have illicit drug labs switch over to another (and better) method for making meth. The purity and supply of the "P2P" methamphetamine were improved, meth became easier to make, and more people have subsequently died.. (See Why Sudafed Is Behind The Counter: A Meth Chemistry Lesson). I'll share a bit of it with you.

"A Comprehensive Pharmacological Evaluation Of Two Decongestant Drugs." Bloom, 2017.

In the middle is Sudafed PE Night, which contains phenylephrine, Tylenol and Benadryl, a sleep aid. There is no need for drug makers to combine multiple ingredients just to crank out another product. (See Combining Pain, Cold, Cough, And Sleep Meds - Great For Drug Companies, But Unethical).

On the right is Sudafed Blocked Nose. It is identical to Sudafed PE Congestion. Possibly the company is trying to capture both the "nose" and "non-nose" markets. 

The bottom line is much of the same, but with one exception. On the left is Sudafed Pressure and Pain, which is phenylephrine plus Tylenol (as if you couldn't take each separately as needed). It is a "non-drowsy" version of Sudafed PE Night because they didn't add the Benadryl. In the middle, we have some beautiful alchemy as Sudafed Pressure and Pain gets an expectorant and a cough suppressant to become Sudafed Congestion, Cold, and Flu. On the right is the only decongestant that actually works - original Sudafed, for which you now need to provide an ID, DNA sample, and four character witnesses to get it from the pharmacist behind the counter. And you will sniffle your way onto a DEA list in the process.

Can it be long before we see this?

Finally, there's this:

Genexa Allergy-D. What does the "D" mean here? That's a good question. Genexa wants you to think that it means "decongestant." Is this true? Nope. 

"D" must stand for "DUH," because this garbage is HOMEOPATHIC. Those 12X's refer to dilution factors. A 12X solution is so dilute that will contain none of whatever useless junk was put in there, to begin with. The only way this stuff could clear your nose if is you painted it onto a 3/8" drill bit, attached that to a Hitachi DS18DSAL 18V 1/2in Drill Driver and BSL1815X 18V Battery ($99.50 on Amazon) and drilled holes in your sinus passages. Not recommended. 

So, let's sum up.

  • You can buy 1000+ decongestant drugs online. 
  • Virtually all of them will contain phenylephrine, which sucks.
  • None of them will contain pseudoephedrine, which doesn't suck. But you can't buy it online because it was previously used to make meth.
  • The restrictions on Sudafed resulted in more and better meth, more deaths, and more runny noses - nice going.
  • But it's OK to sell Genexa's Bottle Of Water-D, even though it is a fraudulent product.

Have a nice day. And keep the Kleenex handy.