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OTC medicines just as effective as expensive counterparts

University Of Chicago : 25 June, 2007  (Technical Article)
A study has found no difference in relieving seasonal hay fever symptoms between an over-the-counter decongestant and a prescription drug that costs more than three times as much.
Conducted during the ragweed allergy season in Chicago, researchers found daily doses of 240 mg of pseudoephedrine hydrochloride (Sudafed 24 Hour) were just as effective as 10 mg daily of montelukast sodium (Singulair) at relieving nasal congestion, runny nose, sneezing and itching.

Dr. Fuad Baroody, associate professor of surgery at the University of Chicago and director of the study, was unavailable for comment yesterday. But in a statement released Monday by the university he said the study results 'came as a genuine surprise':

'Our hypothesis was that montelukast would have additional benefits and pseudoephedrine would interfere with sleep, but when we compared them head-to-head we found that for treatment of allergic rhinitis, these drugs at these doses were virtually identical.'

The study involved 58 adults with ragweed allergy; 30 took montelukast and 28 took pseudoephedrine each morning for 14 days. 'There were two surprises,' Baroody said in the statement. 'We expected pseudoephedrine to be effective against congestion, but we underestimated its impact on sneezing, runny nose and itching.'

The study was funded by Merck and was expected to prove that its product, Singulair, was more effective.

Local doctors interviewed yesterday downplayed the importance of the study, saying they rarely prescribed either drug as a frontline defense.

Dr. Raymond Dattwyler, allergy chief at New York Medical College, said, 'The first line of defense would be an antihistamine. If that is not effective, you would use a steroid nasal spray as the second-line drug.'

Dr. Jonathan Field, allergy and asthma clinic director at NYU Medical Center/Bellevue Hospital Center, said the study was not long enough to gauge the three- or four-month hay fever cycle. 'Allergy sufferers should give the over-the-counter alternative a try. If it doesn't work, they should try traditional antihistamines,' Field said. 'But if they have both seasonal allergies and asthma, then montelukast is a better alternative.'

Meriam Gueziel, a seasonal allergy sufferer from Manhattan, said the cost difference was important.

'If it is equally effective, I would take the one over the counter,' said Gueziel, a patient of Field's and a former Singulair user. 'I don't need a prescription or authorization. With my plan I would pay only 15 percent, so the over-the-counter is still a good solution.'

The study appears in the Archives of Otolaryngology–Head and Neck Surgery.

While prices vary, a timed-release 240 mg capsule of Sudafed costs about 80 cents a day, compared with $3.20 a day for Singulair, according to the university statement.

About 40 million people in the United States suffer from seasonal allergies.
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