The Medicines Agency advises against the use of vasoconstrictor medications for colds containing pseudoephedrine, due to a risk of heart attack and stroke. Is Fervex affected? Dangerous ?
In October 2023, theMedicines Agency (ANSM) advises against using non-prescription cold medications containing pseudoephedrinea vasoconstrictor, due to a potential risk ofheart attacks and cerebrovascular accidents (CVA). “The risk is very low but these events can occur regardless of the dose and duration of treatment.“, specifies the ANSM. The general public knows them in particular under the names ofActifed Cold, Dolirhume, Humex Cold, Rhinadvil Cold… Is the Fervex® who is also an over-the-counter cold medicine is affected by this warning?
Is Fervex a vasoconstrictor?
In a press release sent on October 23, 2023, the UPSA laboratory recalls that “the FERVEX range is not affected by these recommendations, since it does not contain any vasoconstrictor.” In other words, to date, no medication in the Fervex® range available in France contains vasoconstrictorr (a vasoconstrictor is a medication whose action aims to unblock the nose). “The only reference that contained a vasoconstrictor was the famous Fervex Day and Night® but he is not more commercialized (since September 2017) because it contained pseudoephedrinea decongestant vasoconstrictive molecule exposing to stroke risks among others in certain people at risk“, tells us Dr Nelly Le Grand, doctor of Pharmacy, micronutritionist and phyto-aromatherapist.
What is Fervex?
Fervex® is a “range name” marketed by laboratories UPSA which brings together several self-medication specialties: Fervex® Adults (in bag)Fervex® Children (in bag) and Fervex cold® (in tablets). These medicines, used in case of cold or flu For relieve runny nose, sneezing, watery eyes, headache and fever contain an antihistamine (Pheniramine ) – whose effectiveness is debated – and which exposes to risks of drowsiness notably. They also contain paracetamol which should be taken into account and not combined with other specialties containing them at the risk of exposing the liver to toxic doses.
What are the dangers of Fervex?
“These are specialties that I do not recommend as there are numerous precautions for use/contraindications and drug interactions”
“In my practice, the Fervex range of medications® are specialties that I do not recommend as the precautions for use/contraindications and drug interactions are numerousour interlocutor immediately indicates. Pheniramine and chlorphenamine are antihistamines of 1time generation (anti-allergic). They have been incorporated into products like Fervex for reduce runny nose and sneezing. These two molecules are antagonists of cholinergic receptors (they have an anticholinergic effect) but they have no effect on blocked noses“. The main side effects are:
- Sleepiness and a decrease in alertness.
- Dizzinesswith a potential drop in blood pressure when moving to a standing position.
- Visual disturbances.
- A dry mouth.
- Urinary problems (significant decrease in urine, difficulty urinating).
We avoid recommending them to the elderly, particularly because of the risk of falling.. “Also pay attention to the cumulative effects in people who have treatments that already have effects on alertness (painkillers, antihistamines, etc.). Finally, and we don’t always think about it, pheniramine or chlorphenamine, through their anticholinergic action can increase the side effects of certain treatments : antidepressants, neuroleptics (with dry mouth, constipation) or reduce the effect of certain medications such as certain medications used in Alzheimer’s disease“specifies Dr Le Grand.
Does Fervex make you sleep?
The presence of pheniramine in the medicine may cause a drowsiness, more marked at the start of treatment. As this drowsiness is increased by alcohol, it is preferable to start treatment in the evening and of abstain from alcoholic beverages during the duration of treatment
Can you drive after taking Fervex?
Fervex is linked to a risk of drowsiness, driving is not recommended if you have taken this medication. Attention is drawn, particularly among vehicle drivers and machine users, to the possibility of drowsiness or reduced alertness associated with the use of this medication, we can read on the notice. This phenomenon is accentuated by taking alcoholic beverages, medications containing alcohol or sedative medications.
What are the contraindications of Fervex medications?
There are formal contraindications to these products:
- Severe liver failure (due to the presence of paracetamol).
- Glaucoma at a closed angle.
- Prostatic adenoma because there is a risk of urinary retention (due to the presence of pheniramine and/or chlorophenamine).
Is it dangerous for pregnant women?
“First generation H1 antihistamines are neither teratogenic nor abortifacient, however their effects in the fetus and pregnant women are relatively poorly understood. As a precaution, they should therefore be avoided in case of pregnancy and during breastfeeding“, reports our expert.
Is it risky in children?
When it comes to children, it’s all a question of dosage. “It exists a “child” form of Fervex for those over 6 years old (Paracetamol 280 mg / Ascorbic acid 100 mg / Pheniramine maleate 10 mg), but for my part, I never recommend it because children seem less impacted or “disturbed” on a daily basis by cold symptoms (runny nose and sneezing) and are able to stay at home for a few days to rest. Paracetamol, alone, can be administered in case of fever or body aches“, says Dr Le Grand.
What medication should you avoid with Fervex?
“In practice, I always draw the patient’s attention to the fact that Medications in the Fervex range contain paracetamol, a molecule found in Doliprane®, Efferalgan®, Dafalgan®… It is often the first medication that we have on hand and that we will take as soon as the symptoms begin (headache, fever, body aches)“, reminds our pharmacist. It is therefore appropriate to do not associate Fervex with these specialties and wait at least 4 hours between dosesunder penalty of exposing oneself to an overdose of paracetamol the consequences of which may be fatal for our liver.
What are the alternatives to Fervex?
► In case of fever, body aches or headache: it is possible to take paracetamol (1 g per dose, 4 g per day maximum for an adult) spacing out the doses by at least 4 hours.
► Regarding nasal discharge“THE nose washes with physiological serum or sea water and frequent blowing of the nose remain, in my opinion, the preferred solution. For a child, we will make sure to use a specialty with a soft jet adapted to their age.“, advises Dr. Le Grand.
► If your nose is blocked“prefer a “hypertonic” nose wash“, inhalations or a handheld inhaler (ask your pharmacist for advice as there may also be certain contraindications). And above all, adopt good reflexes: ventilate living rooms and offices, diffuse antiseptic essential oils (also pay attention to contraindications), drink regularly (water or herbal tea), stock up on vitamins (fruits/vegetables organic) and give yourself a little rest“.