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Pseudoephedrine minimally effective, if at all

Pseudoephedrine + Claritin is essentially ineffective.  A less than 10% improvement of symptom is a failure—although the author calls this a success.  It means that 90% of those taking the combination for perennial allergic rhinitis did not benefit.  Moreover there was no control group or test of pseudoephedrine alone.  {Loratadine is Claratin}

 

1: Rev Alerg Mex. 2004 Jan-Feb;51(1):23-8

Hernandez Colin D, Gonzalez Diaz SN, Rodriguez Medina R, Aguilar Angeles D, Gonzalez Gamez J, Becerril Angeles M, Orea Solano M, Dominguez Henkel R, Segovia Ayala C.

Hospital Civil Juan I Menchaca, Guadalajara, Jal, Mexico.

BACKGROUND: Several drugs for the treatment of perennial allergic rhinitis and its symptoms have been investigated since some years ago. These drugs are: steroidal-type immunoregulators, immunotherapy and antihistamines. Because of first generation of the last ones originated several side effects, pharmacological research was oriented to the search of formulas with the same of higher efficacy, but with fewer effects on central nervous system. OBJECTIVE: To compare the efficacy and safety of epinastine 10 mg plus pseudoephedrine 120 mg vs loratadine 5 mg plus pseudoephedrine 120 mg, twice a day, in the treatment of perennial allergic rhinitis. MATERIAL AND METHODS: A comparative, random, open, prospective, longitudinal and multicenter study was made in 62 patients with an average age of 26.17 +/- 9.75 years (13-56 years) with diagnosis of perennial allergic rhinitis, who attended to external consultation of the different departments of allergy of the participant institutions. All patients were submitted to: complete clinical history, physical exploration, measurement of vital signs, nasal exploration, qualification of allergic symptoms and record of daily symptoms. Moreover, washout during a week and pharmacological treatment was given during two weeks. Symptoms referred by patient and findings of physical exploration during the different visits, as well as rhinoscopic findings, were assessed by a scale of five parameters of rhinitis. Tolerance grade of drugs was assessed based on frequency and severity of side effects. RESULTS: According to the basal clinical assessment symptoms qualification of patients of groups of epinastine and loratadine was of 9.12 +/- 2.78 and 7.90 +/- 2.7, respectively. Seven side effects appeared: three cases of somnolence, one of sickness and one of anxiety in patients of group of loratadine and one case of somnolence and one of dysmenorrhea in the subjects of group of epinestine. Although it did not have statistically significant difference, it is clinically important for patients. Frequency of side effects was higher in the loratadine group. CONCLUSION: Both drugs are efficient for the treatment of perennial allergic rhinitis.

 

 

 

Commentary by jk

 

One disconcerting limitation of the above study is its duration.  Nearly all the studies of allergy medication run for 2 or 3 weeks.  Most of these drugs are known to have a diminishing effectiveness through developed tolerance. The results cannot be extrapolated to longer periods of usage.  The hay fever season runs over 3 weeks, and many people have multiple allergies. 

 

 

Drug companies and periodical publishers keep doctors in the dark by keeping the articles off the internet.  It is a question of convenience and price.  Doctors spend most of their time in hospitals and private practice.  They seldom visit a medical school—unless they practice at one.  The typical article on line runs over $20.  One paragraph abstract are available for free. However, only about 15% of the abstracts have the statistical results—the above article is one of the 15%.  Medical schools provide internet access to most journal articles.  They must be accessed on campus.  The inconvenience effectively blocks the reading the latest research on the various treatments they us.  Moreover, nearly all of the latest research is designed to find more indications for existing medications rather than measure their effectiveness or risks.  The market-place motives of drug companies work counter to the public’s best interest.