Does ORAL phenylephrine work for congestion?

Not really.

Pharmacists generally see that oral phenylephrine (Sudafed PE, etc) doesn't work as well as pseudoephedrine (Sudafed, etc).

Now new evidence reinforces that oral phenylephrine isn't better than placebo...likely because it's poorly absorbed.

Recommend alternatives for congestion due to the common cold.

Encourage nondrug measures first...fluids, saline nasal products, bulb syringes to remove nasal mucus in young children, etc.

Explain that humidifiers or vaporizers SOMETIMES help.

Lean toward a cool-mist humidifier...the heated steam from some vaporizers and warm-mist humidifiers could pose a burn risk.

Recommend oral pseudoephedrine next...for more severe congestion.

Feel comfortable suggesting pseudoephedrine for a few days in patients with CONTROLLED hypertension. Encourage monitoring BP.

Suggest a TOPICAL decongestant, including phenylephrine, for some patients...such as those with uncontrolled hypertension or BPH. Advise using for a max of 3 days...to avoid rebound congestion.

Discourage inhaled camphor and menthol (Vicks VapoRub, etc). Just small ingested amounts can be toxic in small children...and applying beneath the nostrils can cause irritation and actually worsen congestion.

Also discourage intranasal steroids...intranasal cromolyn sodium (NasalCrom)...or oral OR topical antihistamines (Astepro, etc). These aren't effective for congestion due to the common cold.