Spring is here, and if you're not careful, the Zicam you buy from a local pharmacy may not be the hay-fever medicine you expected.
The over-the-counter products Allergy Relief and Intense Sinus Relief are both made by Zicam, and both promise relief of hay-fever symptoms. But there's a big difference. Intense Sinus Relief contains oxymetazoline, a decongestant the Food and Drug Administration has found to be safe and effective. The other product is homeopathic; it hasn't been reviewed by the FDA and its active ingredients, including sulphur, have been diluted almost to the vanishing point. Yet we often found the two products in drugstores shelved alongside each other.
In fact, our 11 mystery shoppers, who visited 52 drugstores throughout the U.S., often found products labeled "homeopathic" alongside conventional over-the-counter drugs. Such product placements could lead consumers to buy a homeopathic remedy when they're really looking for a standard medicine. That not only wastes money but might also lead to inadequately treated health problems. Even people seeking homeopathic products might not get what they expected. Our check of labels found that many of the remedies might not meet the standards set by the industry's own oversight organization.
Homeopathy is a centuries-old form of medicine that takes a substance that might otherwise cause symptoms or harm and dilutes it until the substance becomes virtually undetectable. Yet homeopathy's supporters say the infinitesimal amount of active ingredients somehow improves health. Not surprisingly, there's little good evidence backing up that notion. The most comprehensive analysis of homeopathy we know of—a 2005 review published in The Lancet of 110 placebo-controlled homeopathy trials matched with 110 conventional-medicine trials—found that any benefit from homeopathic remedies was "compatible with" the placebo effect. An accompanying editorial, "The End of Homeopathy," said that the findings were less surprising than the fact that debate over homeopathy continues "despite 150 years of unfavorable findings."
While the FDA is officially required to regulate homeopathic remedies, a spokeswoman for the agency told us that in practice it doesn't review those products and thus doesn't approve them as safe and effective, partly because of "limited resources," and partly because the products are so diluted they're not thought to pose any risks.
Andy P. Bormeth, executive director of the Homeopathic Pharmacopoeia Convention of the United States, says that "official" homeopathic remedies should state "HPUS" on their labels, indicating that they conform with his organization's guidelines. But only 4 of the 12 products our mystery shoppers found included those initials on their labels.
Check whether over-the-counter products are labeled homeopathic. If they are, we think you should put them back on the shelf. There's not enough evidence to justify their use, and they may cause problems if they allow a treatable ailment to worsen. If you opt for one anyway, stick with a product labeled "HPUS." But be leery of those that include alcohol, especially for children, since the FDA does not limit how much alcohol homeopathic remedies can contain.
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This article first appeared in the April 2008 issue of Consumer Reports on Health.
—Doug Podolsky, senior health editor