Actifed, Humex, Rhinadvil … A vasoconstrictor or “nasal decongestant” is a medicine for the common cold, aimed at unblocking the nose. Available without a prescription, these treatments are associated with a risk of rare but serious side effects, recalls the Medicines Agency. List and precautions.
[Mis à jour le 17 décembre 2021 à 15h35] Actifed Rhume®, Humex Rhume®, Rhinadvil Rhume® … Vasoconstrictors are drugs often used to relieve cold symptoms. They are used to decongest the nose. Some, as oral tablets, are available without medical prescription like Actifed Rhume®, Dolirhume®, Humex Rhume® Where Nurofen Cold®. Yet they “are associated with a risk of adverse effects rare but serious, such as myocardial infarctions or cerebrovascular accidents “, would like to remind the National Medicines Agency (ANSM) in a press release published on December 17, 2021. To limit the risk, each person who decides to use a vasoconstrictor drug to treat their cold is given by the pharmacist an information sheet on the risk of side effects associated with these treatments and the precautions to be observed during their use, announced the Medicines Agency in a press release dated October 27, 2020. This sheet, drawn up at the end of 2019, has been updated with the latest safety data available on the subject. Thanks to the series of actions implemented by the ANSM, a significant decrease in sales of these drugs has been observed in recent years. Between winter 2016-2017 and winter 2019-2020, sales of specialties indicated for oral colds with vasoconstrictor increased dropped by 46%, going from 7.5 million boxes sold to 4 million. This decrease should however be put into perspective due to the health context which greatly limited the spread of winter viruses during this period.
Definition: what is a vasoconstrictor?
A vasoconstrictor is a drug that aims to decongest the nose. It is often associated with an analgesic (paracetamol, ibuprofen) or an antihistamine (cetirizine). It is able to narrow the blood vessels. The molecules it contains (for example pseudoephedrine, often associated with paracetamol or ibuprofen) therefore have a decongestant effect which reduces the feeling of a blocked nose in the event of a cold, for example.
What are the dangers and side effects?
Since January 2020, the National Medicines Agency reminds that vasoconstrictors expose to the risks:
- stroke,
- heart problems such as myocardial infarction,
- increased blood pressure,
- convulsions
- gastrointestinal bleeding,
- severe skin reactions (redness all over the body, pustules with fever).
Effects that may occur “regardless of the dose and duration of treatment” insists the ANSM. Also it is advisable to stop the treatment and to contact the doctor without delay when these symptoms are observed.
List: which vasoconstrictor drugs are concerned?
- Actifed Rhume®, tablet
- Actifed Cold Day and Night®, tablet
- Actifed LP Allergic Rhinitis®, prolonged-release film-coated tablet
- Dolirhume® Paracetamol and Pseudoephedrine, 500 mg / 30 mg tablet
- Dolirhumepro® Paracetamol, Pseudoephedrine and Doxylamine, tablet
- Humex Rhume®, tablet and capsule
- Nurofen Rhume®, film-coated tablet
- Rhinadvil Rhume® Ibuprofen and Pseudoephedrine, coated tablet
- Rhinadvilcaps Cold® Ibuprofen and Pseudoephedrine, 200 mg / 30 mg, soft capsule
- Rhinureflex®, film-coated tablet
- Rhumagrip®, tablet
What are the recommendations?
Since 2011, the National Medicines Agency has closely monitored vasoconstrictors and regularly recalls the recommendations for use concerning these drugs administered orally and nasally:
- Inform the pharmacist of his medical history: he will be able to tell you if you can take this treatment.
- Respect the maximum daily dosage (dose and frequency of intake) recommended by your pharmacist, as well as the maximum treatment duration of 5 days.
- Do not use them in children of under 15.
- Do not use them in cases of severe arterial hypertension, a history of stroke or even coronary heart disease.
- Do not combine these drugs with another vasoconstrictor taken orally or nasally or another drug containing paracetamol, ibuprofen or an antihistamine. The composition of the drug is indicated on the main side of the box.
- Vasoconstrictors are strongly discouraged throughout pregnancy and should never be used from the end of the 5th month of pregnancy when they contain ibuprofen. Always seek the advice of a doctor or pharmacist before taking these medicines if you are pregnant.
- In case of breastfeeding, vasoconstrictors are strictly prohibited.
Best for a cold: moisten the inside of your nose with suitable washing solutions (physiological serum, sprays of thermal water or sea water, etc.), drink enough (water, herbal tea), sleep with your head elevated, maintain a temperature of 18- 20 ° c in the house, ventilate regularly and try natural anti-cold remedies (homeopathy …). If symptoms persist and are associated with fever, it is best to see a doctor. The ANSM document recalls “than a cold heals naturally in 7-10 days without treatment but also the simple hygiene measures to follow in first intention if you have a cold“
What to do if you have taken a vasoconstrictor?
It is best to watch out for symptoms that may indicate the onset of a stroke or myocardial infarction (to find out, see the patient information document). If any of these symptoms appear, you should stop taking this medication immediately and consult your doctor immediately. Be careful, these side effects can occur regardless of the dose and duration of exposure to these drugs.