By Caitlin Tilley, Health Reporter For Dailymail.Com Published: 15:37 EST, 5 February 2024 | Updated: 16:14 EST, 5 February 2024
A pharmacist has cautioned people with colds and flu against taking a popular remedy before going to bed due to the risk of insomnia. In a video shared with his 300,000 TikTok followers, Dr. Ethan Melillo, a pharmacist from Rhode Island, mentioned that the decongestant pseudoephedrine can lead to difficulty sleeping. This is because the ingredient can impact the brain cells responsible for the jittery feeling associated with the ‘fight or flight’ response that keeps us safe when we’re under threat. Dr. Melillo issued the warning while holding up a packet of Sudafed – as pseudoephedrine is the main ingredient. ‘Pseudoephedrine can cause insomnia,’ he said. ‘The best way to avoid insomnia is to try to take it at least two hours prior to bedtime.’ Additionally, he recommended using a saline nasal spray at night. Saline nasal sprays are a well-proven decongestant known to have few side effects as they do not contain any active medicine. Another popular decongestant faced criticism last year after health authorities at the FDA declared it ineffective in relieving nasal congestion. The drug, phenylephrine, is found in medications including Sudafed PE, Vicks Nyquil Sinex Nighttime Sinus Relief, and Benadryl Allergy Plus Congestion. 
Sudafed is known to cause insomnia due to the decongestant pseudoephedrine, which causes jitters. The drug is believed to relieve congestion by reducing the swelling of blood vessels in the nasal passages. However, after reviewing a significant amount of evidence, an expert panel concluded that when taken orally, only a very small amount of the drug reaches the nose to relieve congestion. As a result, in September last year, major pharmacies in the country began to remove products from shelves, including CVS and Walgreens. Despite this ruling, the FDA still considers the ingredient safe and has not removed it from the list of over-the-counter ingredients.
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