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Sudafed is a brand name and registered trademark for a family of over-the-counter (OTC) decongestants manufactured by Johnson & Johnson for sale in the United States, the United Kingdom, Australia and Canada. It is used to treat symptoms of the common cold. Original Sudafed contains the active ingredient pseudoephedrine, though formulations without that ingredient are also being sold under the Sudafed brand. Before being acquired by Johnson & Johnson in 2006, Sudafed was owned by Pfizer.

Switch to phenylephrine

In late 2004, Pfizer publicly disclosed its plans to make available a new OTC product, Sudafed PE, which does not include pseudoephedrine. Sudafed PE contains a different decongestant called phenylephrine, in a formulation sold for years. Decongestants with other ingredients were completely converted to phenylephrine later in 2005, though original Sudafed is still offered.

The new product was prompted by existing and proposed restrictions on the availability of pseudoephedrine-based products. U.S. state laws imposing such restrictions were in response to pseudoephedrine's role as an ingredient used to produce the illegal and highly addictive stimulant methamphetamine, also known as crystal meth.

Pfizer and its predecessor Warner-Lambert had studied at least two alternatives to the pseudoephedrine-containing formula in anticipation of pressure from state regulators and the Food and Drug Administration:

  • In 1996, the company began testing a patented decongestant ingredient known as "minus" pseudoephedrine. The company claimed animal tests showed this altered version offered sinus relief comparable to the current "plus" pseudoephedrine. The difference was that it couldn't be converted to methamphetamine, an illegal drug used recreationally. Pfizer did not bring the new ingredient to market because of the cost and time involved in gaining regulatory approval.
  • Pfizer spent $12 million trying to develop additives for Sudafed that might make it harder to remove the pseudoephedrine it contains. They abandoned the project in 2003, seven years after announcing its existence.

A prior report from a single study has questioned phenylephrine's effectiveness, however, a recent meta-analysis has shown the efficacy of a single dose of phenylephrine 10 mg compared with placebo in adults with acute nasal congestion due to the common cold.[1]

In Australia, Sudafed with up to 60mg of pseudoephedrine is available by prescription or subject to a pharmacist matching the purchaser's driver's license to a database and determining if the purchase history is consistent with personal use. If a driver's license is not provided, the pharmacist can, at his or her discretion, still provide the medication.

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