What ever happened to using pseudoephedrine for COVID?

Welcome to Connect @chrisfeerer. I don't think doctors have forgotten about pseudoephedrine (Sudafed) but I'm not sure it's a first line treatment for COVID. I'm not a doctor but I've had Covid twice after having the 2 Pfizer vaccines and the first booster. If I had some around I may have tried it to help alleviate the congestion symptoms the first time I had Covid but I didn't and went to a Mayo Covid Clinic for an IV treatment. The second time I got Covid a little over a year after the first time, I had a milder case and really didn't have congestion just a lot of fatigue. Mayo Clinic has some information on how it helps here:

"A stuffy or congested nose may present with a cold, flu or COVID-19. Common decongestants include pseudoephedrine or phenylephrine, often labeled as "PE." These decongestants work by narrowing blood vessels, which temporarily relieves nasal congestion. However, they also can increase blood pressure in people with high blood pressure. Therefore, patients with hypertension, ischemic heart disease or kidney disease should use these medications with caution. When comparing these two medications, pseudoephedrine is more effective than phenylephrine. Pseudoephedrine does not require a prescription. However, it is placed behind the counter at pharmacies and requires a photo ID to purchase it."
-- Options for relieving cold, flu and COVID-19 symptoms: https://communityhealth.mayoclinic.org/featured-stories/cold-flu-covid-symptom-relief

Here are some references that may help explain a little better:
-- Pseudoephedrine and its derivatives antagonize wild and mutated severe acute respiratory syndrome-CoV-2 viruses through blocking virus invasion and antiinflammatory effect: https://pubmed.ncbi.nlm.nih.gov/34472141/
-- How do I treat a mild case of COVID-19 at home?: https://www.drugs.com/insights/treating-mild-cases-covid-19-home-3571321/

chrisfeerer, Sudafed (a decongestant) was being abused by people "to get high" and to make methamphetamine. The last I heard, you could get it over the counter, but, you had to sign for it. That could have changed. I actually worked for the pharmaceutical company that manufactured Sudafed. Personally, I couldn't tolerate it for sinus pressure as it hiked up my blood pressure and heart rate too much and made me feel very anxious.

With that said, I remember it helped a lot of people with sinus pressure, sinus headache, ear pain, etc., if you could tolerate the side effects. It's an older drug and I think I think other medications have taken precedence over it such as Mucinex-D, Allegra-D, Claritin-D, etc.,

Blessings to you and yours...

Right phenylephrine doesn't really work at all and what you get over the counter is mostly Tylenol. You have to get it from the pharmacy and present an id. Im sure most people rather not deal with all that. If it was still over the counter I'm willing to bet COVID would be or would have been reduced by half. Im not a doctor just someone that pays attention and has common sense and knows what worked for me. When I had H1N1 , I was given a box of Sudafed with pseudoephedrine and that was it.

So save millions of lives or worry about a few that are abusing it, where do we put it on the scale to see which option is better ?

I don’t think it’s really a “ cure” it would just alleviate the symptoms.
I’m not against it, we just don’t use it , in fact I’ve forgotten about it.
My husband does work for a state narcotics dept and it was part of their jobs to check pharmacies signatures of people purchasing as part of the regulation process as it defiantly was a huge problem being turned into illegal narcotics a while back.

We also ended up in the ER as my husbands heart rate got to a dangerous level when he took a couple tablets for a sinus cold. We thought he was having a heart attack.
Luckily we figured out it got dangerously high from this medication.

chrisfeerer, I know it's frustrating. I just checked for you and you can buy it over the counter at the Pharmacy, but, you have to sign for it. People that don't abuse medications are the ones that have to go the "extra mile" to get them because of the few that do.

You could ask your doctor if he recommends you using if you get COVID again (I hope you don't!) or sinus pressure. You do have to be careful with decongestants if you have high blood pressure and perhaps other medical issues.

Blessings to you & yours....