An FDA advisory group confirmed some popular decongestants are ineffective. Now what do we do?

By Madeline Holcombe, CNN

(CNN) — Just in time for fall and winter sniffles, an advisory committee to the US Food and Drug Administration has decided that a popular ingredient in oral cold and allergy medications doesn’t work.

What do we do now?

“There’s so many options out there,” said Dr. David C. Brodner, an otolaryngologist in Boynton Beach, Florida.  “You’ll still have options if you want to go and try some home remedies or pharmacy remedies on your own before you see a doctor.”

Phenylephrine is the main ingredient used in many common over-the-counter congestion products. It is safe to use, but an independent advisory committee to the FDA agreed Tuesday that it is ineffective in pill form. Other forms like nasal sprays are still believed to be effective.

Pill forms of phenylephrine are still available to buy while the FDA seeks public comment and makes a final decision on whether companies will need to pull or reformulate the medication, according to the administration.

If a cold or viral upper respiratory infection lasts seven to 10 days without getting better — or if it gets worse — Brodner recommends seeing a doctor.

But before then, there are things you can do at home to help relieve your symptoms, he said.

What to get at the pharmacy

Even without phenylephrine, there are many things at the pharmacy that could help when you are feeling congested, Brodner said.

He recommends a three-step plan to attack the stuffed-up feeling.

First, he suggests trying a product like Mucinex — or something with guaifenesin — that helps thin out the mucus built up in your sinuses.

Then he would try a nose spray with steroids, like Flonase or Nasacort, Brodner said.

Lastly, he tells his patients to get some sort of saline irrigation device, like a neti pot, to help wash their sinuses out, he said.

Sinus irrigation

If you deal with chronic sinus pressure and headaches, you might have found a friend in the neti pot.

By sending water with a salt solution through your sinuses, neti pots and other saline nasal irrigation devices remove mucus and inflammatory products from your nose, explained Dr. Richard J. Harvey, a professor of rhinology at Macquarie University.

But a word of caution: Tap water may be safe to drink and cook with, but it isn’t sterile enough for neti pot use,  said Shanna Miko, an Epidemic Intelligence Service officer at the US Centers for Disease Control and Prevention.

The CDC recommends that people using at-home medical devices like CPAP machines, humidifiers and neti pots use only water that’s free from microbes, such as distilled or sterile water, which can be bought in stores. Boiled and cooled water may also be used.

Brodner recommends that his patients use irrigation twice a day while they are feeling sick.

Warm compresses, hot showers and hydration

Noses like to be hydrated and warm, Brodner said.

Hot showers, warm compresses and lots of fluids help make it easier for your nose to stay at the state it needs to keep things healthy.

Placing a warm compress on your head or face might help because it is soothing and comforting. But steam from a hot shower or a warm compress placed over your nose can also heat things up nicely.

“It would just help to warm up the nose and moisten the nose, which would then allow the nose and the sinus to get the mucus flowing,” he added.

Common advice when someone is sick is to be sure to hydrate, and that is because drinking water helps keep the lining of the nose and the sinuses moist, Brodner said.

“A dried-up sinus is really hard to drain,” he added.

Spicy food

Believe it or not, “spicy foods actually work” when it comes to congestion, Brodner said.

The burning sensation from spicy foods comes from a chemical called capsaicin, he said.

“As you know, if you eat something spicy, your nose runs,” he said.

That runny nose will help drain mucus from your sinuses — and hopefully flush out whatever is irritating it, Brodner said.

Getting good sleep

Getting sleep when you are congested is important, but can sometimes be harder to pull off.

“If you’re not getting adequate sleep — which we will call adequate sleep seven hours or more — then your body has reduced ability to fight infection,” Brodner said.

The problem is that you get better sleep when you breathe through your nose instead of your mouth, because your nose heats and moistens the air coming through, he said.

If you have to breathe through your mouth at night, using a humidifier in your room while you sleep can help keep the air warm and moist for you, Brodner added.

Sleeping with your head elevated might also be helpful, because you are using gravity to encourage the fluid to drain, he said. But that is only beneficial if you can comfortably sleep that way.

Chicken Soup

A big bowl of chicken soup may just be worth a try, according to a 2018 study.

There could be an anti-inflammatory property to chicken soup that reduces cold symptoms, the research showed, but those results were found in a lab, not in humans, according to study author Dr. Stephen Rennard, Larson Professor of Medicine at the University of Nebraska Medical Center in Omaha, in a 2018 story.

The spices and steam may be helpful to clearing the sinuses, according to another 2018 study.

And you can’t discount the tender loving care that goes along with someone making it for you, Rennard said.

“My wife (who prepared the soup for the study) makes the point that when you are feeling ill, if someone is taking care of you, that tender loving care is not a placebo effect,” he said. “There are clearly beneficial effects of that. So, if someone is sitting there and making you chicken soup, it may make you feel better … but whether it has to do with contents of the chicken soup may be irrelevant.”

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