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Anti-cold medications: not recommended by the authorities… but still sold by pharmacists
Anti-cold medications: not recommended by the authorities… but still sold by pharmacists
(SPECIAL SUBJECT / FRANCE 2)
Faced with rare but serious accidents, the Medicines Safety Agency has decided to advise against certain cold medications – without withdrawing them from the market. Do pharmacists take the necessary precautions before dispensing them? “Special Envoy” did the test.
Irritated throat, blocked nose, fever… faced with winter ailments, many consumers turn to products sold as self-medication, without a prescription, in most pharmacies. But in October 2023, the National Medicines Safety Agency launched an alert message on anti-cold products such as Actifed Rhume, Nurofen Rhume, Dolirhume or Humex Rhume: the ANMS advises against them, without prohibiting their use. sale.
In question, possible rare but extremely serious side effects, listed in small print in the instructions which accompany these pseudoephedrine-based drugs: in particular risks of heart attack and stroke, disproportionate to treating a simple cold.
Stroke, heart attack… the potential dangers of pseudoephedrine
To find out more about the dangers of this component, “Special Envoy” interviewed two pharmacologists specializing in drugs and their effects. Since they began working on anti-colds in 2001, Margaux Lafaurie and Pascale Olivier have presented six reports to the ANSM. Under the vasoconstrictor action of pseudoephedrine, explains Margaux Lafaurie, the vessels of the nasal mucosa contract, and air passes better through the nose – which relieves the feeling of a blocked nose. However, as pseudoephedrine absorbed orally passes into the blood, this action is not limited to the vessels of the nasal mucosa: “This vasoconstriction will take place in the other vessels, which explains the occurrence of undesirable effects such as heart attacks, strokes, and other associated undesirable effects.”
The two pharmacologists have identified numerous cases. They are the ones who are at the origin of the inclusion of adverse effects on the instructions (in the 2000s), then of the ban on advertising for these drugs (in 2017) and, finally, they also participated in the publication of brochures intended for pharmacists. They contain a questionnaire listing several points to check before dispensing an anti-cold: it is imperative to ask the patient if he suffers from cardiac pathologies or high blood pressure, check that he is not taking any other vasoconstrictor and, to women, that they are not breastfeeding.
The “Special Envoy” test in 9 pharmacies
Do pharmacists really ask these questions? How do they enforce the authorities’ warnings on products that are still on sale in their pharmacies? “Special Envoy” did the test in nine pharmacies, using a hidden camera.
The results are mixed. There is still some good news: when symptoms are announced, it is not pseudoephedrine-based medications that are offered first, but rather, for example, lozenges with pine sap.
On the other hand, if you ask the first pharmacist for a cold medicine, he sells it without asking any questions. The second very quickly dismisses the questionnaire, a third affirms that there are no side effects… Which makes one wonder if the information sheet has arrived in all the pharmacies! Four out of the nine pharmacies visited dispensed these medications without any verification. In the other five, questions relating to hypertension or heart problems were asked.
Excerpt from “Anti-cold: the impossible ban?”, a report to be seen in “Special Envoy” on March 7, 2024.
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