alt Hacker NewsI’ve had two doctors and two NPs tell me to stop using sudafed. It dries out the mucus membranes and allows infections to start. If you’ve had sinus infections before, they suck and you don’t want them again. Give the Sudafed away.
(It also gives me horrible insomnia if I take it at night so it wasn’t a huge hardship).
Guaifenesin thins the mucus instead, makes it more watery so it drains down the throat with no further complications like sore throat and coughing. And the extra volume helps flush bacteria out of the sinuses.
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Everyone's body and ailments are different. For some people in some situations, the benefits of pseudoephedrine outweigh the side effects. For others, it doesn't. Drugs should be used on an individualized basis.
The insomnia effect is no joke! It’s an amphetamine.
I used to take 24-hour allergy medicine with pseudoephedrine, and it took me years to realize it was the thing that was giving me insomnia during allergy season—for years I thought I just had periodic bouts of intense insomnia.
I stopped taking pretty much any OTC meds about 10 years ago. My sinuses seem much healthier. I hardly ever get congestion or runny nose anymore. Not sure there's a correlation here but for me, they don't seem to have any benefit.
The two aren't mutually exclusive. I take pseudophedrine whenever I have a serious sinus infection or blocked eustachian tubes because it's the only thing that promotes drainage. I also take guaifenesin for its mucosal thinning effects as a matter of course. I supplement these with nasal irrigation, DXM (if the cough is impacting my sleep), and diphenhydramine in lieu of the pseudo (again for sleep).
These drugs all have different mechanisms of action and specialties and should be used only as needed, i.e. if a symptom abates then you should stop taking whatever it is that treats it. The problem is that people are too used to combination formulations or, even worse, treating all of these drugs interchangeably. A chest cold has a different OTC treatment regimen than a sinus infection.