Phenylephrine doesn't work though. It never did. It was "pushed" as an alternative to pseudoephedrine which can be used to synthesize meth, but afaik every single study done on this shows that phenylephrine does absolutely nothing, it's a placebo drug. The faster it's phased out the better.
Strictly speaking, phenylphrine works when it’s injected. It is approved and used every day for this indication in the service of general anesthesia.
However, the oral bioavailability is zero.
This is an example of using something off label that’s approved for something else. Sometimes it’s fine. And sometimes, it’s dumb.
How it was approved in the first place should have been reviewed