If your favorite sinus and allergy medicine goes missing from store shelves, what do you do? Google it, of course, or somehow find a way to vent your frustrations online. That's what those faithful to the antihistamine/decongestant combination medication Drixoral did. The question "Why is Drixoral not available?" is one of the first items to pop up on search engine results when one queries the name of the medication. Drixoral has been used since its regulatory approval in 1963 to treat stuffy or runny noses, coughing, sneezing, and itchy, watery eyes.
Indeed, Web posts about people's inability to find Drixoral abound. Schering-Plough Corp., which makes Drixoral, says it also fielded numerous calls about the medicine until the company created a Web page to keep consumers updated.
Drixoral is unavailable right now but hasn't been permanently pulled from the market, according to Schering-Plough. "We are in the process of changing manufacturing locations," says Julie Lux, a company spokesperson. The company, which is to be acquired by Merck, stopped shipping Drixoral to pharmacies in April 2008 and doesn't expect to begin shipping the medication again until 2010 at the earliest.
Finding an alternative. Drixoral combines two generic active ingredients, an antihistamine called dexbrompheniramine and the decongestant pseudoephedrine. As an alternative to Drixoral, people can seek out medicines that combine one of two older antihistamines, chlorpheniramine or diphenhydramine, with a decongestant, says Richard Haydon, associate professor of surgery in the division of otolaryngology-head and neck surgery at the University of Kentucky and president of the American Academy of Otolaryngic Allergy.
Newer over-the-counter antihistamines, such as Claritin (loratadine) and Zyrtec (cetirizine), can be purchased in formulations that also contain a decongestant. These combo drugs, like Claritin-D and Zyrtec-D, may help those who once relied on Drixoral. If allergies are your problem, an antihistamine alone (such as Claritin or Zyrtec, without the "D" that stands for decongestant) might help with your symptoms. If you're stuffy, a decongestant alone may work instead.
Before making a trip to the drugstore, first consider why you need the medication. Sinusitis, for instance, may require an antibiotic, which means getting a prescription from a doctor. Structural problems, like a deviated septum, may require surgery. For persistent congestion, it's usually best to see your doctor.
Figuring out which over-the-counter alternative will work best for you is a matter of trial and error, Haydon says. For the closest match to Drixoral, look for products that combine an antihistamine with a decongestant, such as pseudoephedrine or phenylephrine. Some Drixoral fans may find that the older generation of antihistamines, such as chlorpheniramine (which comes in a variety of brand names, such as Chlor-Trimeton) or diphenhydramine (sold as Benadryl and other brand names), may work better than newer-generation allergy meds like Claritin-D and Zyrtec-D. Benadryl Allergy & Sinus, for instance, combines diphenhydramine with pseudoephedrine, and Chlor-Trimeton 12-Hour Allergy Decongestant contains chlorpheniramine and pseudoephedrine.
Still, it's entirely possible that nothing will make those loyal to Drixoral as happy as that medication once did. "Everything that you can't have is always better than what you can have," Haydon says.
Even when Drixoral returns to stores, you'll have to show ID and ask for it at the counter. A 2006 federal law requires anyone purchasing pseudoephedrine, which can be used to make methamphetamine, to show ID when purchasing it. Since then, doctors report hearing increasing complaints from patients, who say that they have trouble finding medications containing pseudoephedrine. Some say they don't think that phenylephrine, which has replaced pseudoephedrine in many over-the-counter products, does a good job of unclogging their noses.
But there are other options to unclog those nasal passages. (Here are 5 things you can do for a stuffy nose.) A saltwater nasal rinse may help, for instance. Nasal sprays may also ease congestion, though prescription steroid sprays such as Flonase or Nasonex require a visit to the doctor's office. Over-the-counter decongestant sprays also can bring quick relief, though they shouldn't be used for longer than three days because overuse can create a rebound effect of narrowing and constricting the blood vessels of your nose, according to the Mayo Clinic.