People bought nearly three hundred million packages of over the counter oral decongestants in this country last year, according to the FDA.

It turns out that an ingredient found in more than 80% of them simply doesn’t work, according to a panel advising the drug regulator. As in, it’s basically as effective as taking a sugar pill.

Which means the agency could pull it from the market. 

At Mt Vernon Pharmacy in Baltimore, pharmacist Ellison Park was not surprised to hear the FDA panel found that phenylephrine is not effective as an oral decongestant

“You kidding me?” he said. “I never recommend that to anyone.”

Still, the FDA estimates that consumers spent $1.8 billion on phenylephrine decongestants last year. 

Stephen Schondelmeyer, a professor of Pharmaceutical Economics at the University of Minnesota, said if the ingredient can’t be used as an oral decongestants, drug developers will likely pivot.

“The companies will look to say can we reformulate the product and if we take phenylephrine out, is there something else we can put in?” he said.

One possibility is pseudoephedrine. It used to be the main ingredient in many decongestants, but it can also be used to make methamphetamine. So now, it’s available behind the counter. 

Pharmacist Ellison Park does recommend Sudafed (which contains pseudoephedrine) sometimes, along with sprays. And he always suggests water, sleep, and time. 

“I mean, people always think there’s some kind of special cure for the cold,” he said. “But there’s no cheat to this.”

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