Cold remedy alternatives have their drawbacks.

Byline: The Register-Guard

SALEM - If the Legislature requires a doctor's prescription before Oregonians can acquire their most relied-upon cold remedies, consumers may end up turning to a decades-old alternative.

A provision in House Bill 2485 would require a prescription for all medications containing pseudoephedrine. The doctor could call it in to a pharmacy without seeing the patient, and could allow for up to five refills within a six-month period.

Backers and foes alike acknowledge that the prescrip- tion-only policy could inconvenience thousands of people who lack health insurance and thus don't have a doctor.

For such cold sufferers, the alternative could be decongestant medicines containing phenylephrine. It's been used since the 1960s in over-the-counter remedies, such as Dristan. For those leading the war on methamphetamine, the critical difference between phenylephrine and pseudoephedrine is that the latter is used to make meth.

For others, the question is: Which remedy works better?

Phenylephrine has had its drawbacks: Most versions on the U.S. market are effective for four hours at a time, compared with timed release versions of pseudoephedrine that can relieve congestion for up to 24 hours. Also, pseudoephedrine is used in remedies that combine other medications, such as antihistamines, while phenylephrine products in the United States typically do not include other active ingredients.

Jim Anderson, a lobbyist for the drug company Schering-Plough, which makes such pseudoephedrine products as Claritin-D and Drixoral, said requiring a prescription would lead consumers to mix over-the-counter remedies to treat various conditions, such as allergy symptoms and nasal congestion. He said it's too much to ask consumers to wake up in the middle of the night because they no longer have easy access to longer-acting medicines.

The cold season may be months away, but Anderson said policy-makers should be mindful of the public outcry last winter, when flu shots initially were in short supply in Oregon.

He said consumers will react the same way if their choices are limited to a less effective alternative to the cold remedies they previously counted on.

However, Blake Rice, a former president of the Oregon Board of Pharmacy, said drug companies are rushing expanded product lines to market in response to anti-pseudoephedrine legislation nationwide.

By the fall, Pfizer and Bristol-Myers Squibb plan to have on drug-store shelves phenylephrine-based remedies that are as long acting as many pseudoephedrine products and that are combined with other active ingredients, he said.

- David Steves