Therefore you’re better off taking a direct nasal spray and a pain killer. Might as well dump Lemsip.
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It’s an interesting story, and one that shows the limitations of the FDA and similar agencies as well as pharma companies, who in this case all apparently went along with selling a useless drug because there wasn’t a good alternative after pseudoephedrine was removed from the market because it can be used to make methamphetamine etc.
I first read about it last year in the following chemistry blog, but it seems like there have been concerns about it being useless for a couple of decades already.
But be that as it may: the fact remains that its alleged replacement, phenylephrine, is of no real use and does not deserve its FDA listing. There’s no reason to think that it’s a safer compound than pseudoephedrine or one with fewer side effects - if you can get enough of it into your blood, you’ll probaby have a rather similar profile. The only reason it’s sold is to have some alternative to offer consumers, even if it’s a worthless one. There have been several attempts over the years to do something about this (here’s an earlier one from the authors of the current paper), but absolutely nothing has happened. Perhaps the agency does not wish to be put in the position of having nothing available than can be put out on the open shelves, and perhaps the pharmacies themselves prefer things as they are as well. It’s for sure that the companies producing phenylephrine-containing products like the current situation a lot better than the alternative. But for people who actually want to be able to breath for a while as we enter allergy season, wouldn’t it be better just to stop pretending and to stop wasting everyone’s time and money?
https://www.science.org/content/blog-post/uselessness-phenylephrine
Fortunately pseudoephedrine is still available OTC in Taiwan.
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I thought they had stopped that a few years ago. Maybe just ephedrine not pseudoephedrine which is its isomer. Generally to make meth you have to convert pseudoephedrine to ephedrine which is its isomer.
According to that blog post (and a paywalled article I can’t access), these synthetic routes might not be so relevant nowadays anyway:
There are a number of synthetic procedures for doing this, some of them quite alarming, and several of which can indeed be performed in the barn, garage, basement, or trailer park of your choice - if you can get enough pseudoephedrine. Thus the move to put medications containing this behind the pharmacy counter, with limits on their sale. No more walking in with a duffel bag and buying every single Sudafed package in the store.
But it’s quite possible that that era is gone anyway. The Mexican drug cartels have apparently been putting some real effort into process improvements and economies of scale, and I am told that the drug is (sadly) cheaper than it’s ever been and available in higher purity than all but the most dedicated basement lab would be able to provide. As that article details, this includes an interesting and concerning increase in the compound’s enantiomeric purity over the years. Whatever the current synthesis is - and you can be sure that the DEA knows the details, even if they are understandably not going into them in public - it is strongly skewed towards the more pharmacologically desirable D-methamphetamine. All this means that even if pseudoephedrine were more freely available, it might not be as much of an illegal article of commerce as it was twenty years ago.
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They have meth factoriesin the golden triangle on the myramar side. They can supply most of Asia and the Mexican ones supply the USA. It’s way more convenient to hide than large fields or whatever natural drug plant. Although natural drug plants are cheap to make just seeds , sunshine and pesticides. They can also get poorly paid peasants to grow drug plants but underground chemists have high salaries.
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Yep almost all the meth comes from the golden triangle even to this day and yes they are proper factories making it from chemicals imported from China. Crusher is unusually well informed 
. Much of it is coming out of Myanmar and the Shan state. There are UN publications that go into detail on this.
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I’m just a good Christian family guy 
I dunno man…haha.
Taiwan is on the transhipment route, the Asian drugs gangs are highly internationalized.
The drugs coming out of Myanmar even have brand names and stamps so their users recognize it. They tend to vacuum pack them into tea packages bizarrely enough.
There’s meth labs in Taiwan too of course . Drug use in Asia is quite different than the US and Europe still, fentanyls haven’t made mich in roads…yet. It seems it’s meth , ketamine ， opiates and cannabis and designer drugs and vastly less cocaine and fentanyls .
In Ireland cocaine is now so prevalent that many young people do that on a weekend instead of drinking a lot and they can even purchase it in country pubs with no bother. Very different.
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It’s an interesting story. A bit of emperor’s new clothes for all involved as long as the money keeps rolling in eh. CONSUMERS fooled because the name looks so similar. pharmacists still making money.
There’s some kind of marshmallow flower extract that has become popular for colds now in Europe as well and I doubt it does anything either.
Let’s face it a lot of OTC drugs are so weak as to be practically useless as well, that’s why those on the know go to the doc here when you have a cold and they prescribe you stuff that’ll keep you working 12 hours a day no bother.
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It’s pretty useful info. The nasal inhalers do help me , the ingested phenylephrine cold medicine just a little.
I think the danger of those nasal sprays is that it can leave you with nasal drip if used too long.
I think the next time I get a cold I’ll try a nasal spray, lozenges and coffee.
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I had some issues with mucus and nasal congestion and was given phenylephrine here in Italy.
After I got the medication, I remembered that a common decongestant is shown to be useless orally so I did a quick google to see if it’s what I got. It is indeed the same medication.
I honestly am so frustrated with medical professionals. I often feel like they know less than me and do not stay up to date. They treat symptoms by checking off SOP and rarely do I find a medical professional willing to engage with me as an individual and equal participant in my healthcare. The lack of care finding the root causes of the symptoms is the pitfall of modern medicine. It’s all about how to treat symptoms for patients comfort and in some ways it’s the patients fault for demanding such treatments.
For example it’s probably not a good thing to take a fever down unless it’s very high that it’s going to hurt you. Fever is your body’s way to fight and kill off the infection. Doctors used to do the opposite and keep you warm to reduce the period of recovery. But now modern medicine got people used to comfort over efficacy of treatment.
The worst is the snobbery some medical professionals get if you dare to even question the efficacy of their treatment plan and bring up other options.
How can these people be some of the most educated people still give me medicine that’s no better than placebo 
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Doctors are not “the most educated”. They learned very specific things so they could sit around and listen to people complain about their aches and pains and then give those people drugs so they would leave.
The decongestant thing was huge news a few months back, but “don’t go unnecessary taking antibiotics, as they breed superbugs” has been all over the news for years. I’ve lost track of how many times I’ve been presented with antibiotics for things that have nothing to do with needing antibiotics. And they only give out a three day course, so they also quite literally are doing their very best to breed superbugs.
I always do a quick “what was I prescribed this time?” Google search and I always wonder how the heck they saw the correlation between what they prescribed and what my symptoms were.
I’d love to say “they’re only human”, but I also think most doctors everywhere just don’t care. They know they shouldn’t recklessly prescribe medications that don’t work, but they just want you out of here.
Like everything in life, be your best advocate.
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We always had many unopened bottles of fever meds in our house because we hardly used the ones the doc gave. Many/most people in taiwan give their kids fever meds if they are 37 degrees.
We never give the kids fever meds unless they have a high temp and are suffering. If they are acting normal, we ride it out. 24 hours later and they are fine. Take the fever meds and prolong the sickness is my observation.
We had to tell docs to give us whole tablets and not crush them up into powders because we found that some would put antibiotics and fever meds in. Even after we asked that they put them seperately.
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I thought pseudo ephedrine is what works, but they are used by meth labs to make meth, so doctors treat them like it’s illegal drugs or something. I’ve never really found decongestants to work, and what works is to address the cause of the congestion which is often allergy. But you don’t take decongestants for fever, you take NSAID for this.
Depending on what the root cause is, you might want to try nasal irrigation. It’s straightforward (although there’s a small learning curve) and it’s incredibly helpful for colds, allergies, etc. All you need is some boiled+cooled water and (optionally) a small amount of dissolved salt to make an isotonic solution. Make sure to use very clean water because you’re flushing it through a space where it normally wouldn’t be introduced.
As mentioned, most doctors just want to get you out of the office, and they’ll do that by following the standard procedures, many of which are useless or worse. There are perverse incentives in place to ensure that they do so - it’s not really that they’re terrible people (usually!). They just become like that because it’s the system they work in.
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It’s an interesting one and I found a common issue for very old drugs and for treating diseases with no good (drug) treatment options . Docs will prescribe something to make it feel like they are doing something and yes there is a profit motive there too.
I looked up a bunch of pills I was prescribed and the last papers on it were from the 70s and 80s and completely inconclusive.
I second this. I also do that too. Same with throat mucus. One can gargle with salt water or mouth wash. For me it helps.
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I also did this.
But prevention is better than cure so I and the family take cetirizine and keep the place as dust and mite free as possible.
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I often suspect that the air conditioning is making the air in my apartment too dry or something like that. I don’t know exactly what the cause of this could be, but in the last few weeks I also had the feeling that there was a virus going around at work. You could hear a lot of people coughing, even on the bus.
It’s important that the mucous membranes in nose and throat stay wet. AC makes them very dry, I think.
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There’s a highly contagious ‘coughing’ virus doing the rounds with kids especially , can search about it.