Behind-the-counter drugs: who knew?

I spend a lot of time for my job inside of large metal tubes and plaster and glass boxes.  No, I’m not a lab rat.  I mean I spend a lot of time in airplanes and conference rooms.  Thus, I share the air in these confined spaces with other people, people who are often in various stages of ill-health.  As a consequence, I’m frequently exposed to all kinds of germs.

Hint: you know those airline in-flight magazines and SkyMall catalogs in the seat back in front of you?  Resist the urge to pick them up and read them.  Think about how many other passengers before you picked up those items after having coughed or sneezed into their hands.

And, oh yes, ignore the flight attendant when he or she tells you to pull out the aircraft’s safety instructions card and read along.  It’s too damn dangerous.

But I digress.  Whenever I return from one of my business trips, my wife insists that I ingest glassfuls of Airborne, an Alka-Seltzer-like tablet that fizzes in water and is intended to serve a cold preventative.  While I have found that Airborne tends to, um, give me the runs, I usually do as she suggests.  And yet I still occasionally end up catching a cold.  Then I run out to the closest Walgreen’s or CVS to pick up one of the over-the-counter (OTC) cold remedies.

Sudafed has typically been my cold medication of choice, and so, when I came down with a sudden, fast evolving cold last Wednesday, I looked inside our medicine drawer, found a box of Sudafed PE (one of the few remaining cold remedies in that drawer that wasn’t well beyond its expiration date), and began taking a tiny, red pill every four hours, along with a glass of Airborne (to make my wife happy).

Unfortunately, the Sudafed did little to alleviate my cold symptoms, and I continued to sneeze, cough, and suffer from a runny nose and severe head congestion.  By Friday, feeling no better, and knowing that I would be flying to San Francisco on Saturday evening, I went to the pharmacy to seek the counsel of the pharmacist.

“What do you recommend,” I asked the pharmacist behind the prescription counter, “that I take to quickly knock this cold out of me?”

I was surprised when, without hesitation, she said, “Sudafed.”

“I’m already taking Sudafed,” I said, “and it’s not helping.”

“Is it the Sudafed you got from the aisle in the store?” she asked.  I nodded affirmatively.  “Well, that’s not really Sudafed.  The Sudafed I’m talking about is back here.  If you want it, I’ll need to see your ID and you’ll need to sign for it.”

“Sign for it?” I asked.  “Why?”

It turns out that the active ingredient in the behind-the-counter Sudafed is pseudoephedrine, which happens to be a key ingredient in the illegal street drug methamphetamine.  Who knew?

The Sudafed PE that is on the shelves in the aisle contains a different active ingredient, phenylephrine, which is described as a close cousin of pseudoephedrine, but one that isn’t used to make meth.

And one more thing about phenylephrine.  It’s been determined that it’s only about 10% more effective than a placebo.  Sudafed PE is essentially a friggin placebo!

So I signed for the BTC Sudafed with pseudoephedrine, took it home, opened the box, and saw that the tiny red Sudafed pills looked identical to the tiny red pills of Sudafed PE.  The instructions for the BTC Sudafed, though, said to take two pills every 4-6 hours, versus one pill every 4 hours for the PE variety.

But even though the pills looked alike, the difference was remarkable.  The “real” Sudafed opened up my sinuses and dried out my runny nose and watery eyes within minutes of swallowing the tiny red pills.

Perhaps I just never paid attention, but I didn’t realized that there were different versions of the same non-prescription drugs, one version in the aisle and another, with essentially the same name but with different active ingredients, behind the pharmacy county.  But I do now.

The next time I a catch a cold after spending time in a long, metal tube or a plaster and glass box, I’m going right to pharmacy counter and asking for the good stuff.

I suggest you do the same.

Comments

[Tracy]

I wish I had read this post sooner - I discovered this during a business trip while working at Fidelity, around three years ago. And you're right - it's amazing how much better it works than the fake stuff.

Just be careful - soon you'll be crossing borders to buy it so you don't appear to be purchasing too much of it. You wouldn't want the government to think you're opening a meth lab!