Should DayQuil Be Legal? • Hacker News Board

Re: Should DayQuil Be Legal?

#111

Post by tristor » Mon, Jul 06, 2026, 6:16 PM UTC

kube-system wrote: post #87

rustcleaner wrote: post #62

Earlier quoted context omitted.

Please no. We need to be going the other way on that trend: converting things which won't easily outright kill/maim you (and dare I say, even potentially addictive ones) at normal doses from Rx to OTC! Acetaminophen is one of the few cheap, easy, and working products on the shelf!

A concern with OTC drugs is specifically that they won't be taken at normal doses. People confuse brand names and drug names, and don't realize they are taking more than the reccomended amount. This is especially problematic with combination drugs.

There are people who don't know that Tylenol and acetaminophen are the same thing. That is not a reason for us to make everyone's quality of life and access to healthcare worse because some people are ignorant.

The desire to nanny-state things to the lowest common denominator is ruining everything, and it's a major driver for various problems all the way to the housing crisis and the cost of healthcare in the first place.

Re: Should DayQuil Be Legal?

#112

Post by wowczarek » Mon, Jul 06, 2026, 6:22 PM UTC

I get that the discussion here focuses on doubtful decongestants, but just the mention of acetaminophen makes me think of pharmaceuticals and people's relationship with them in the US. It's a strange world to me, especially how deeply ingrained the brand names are in people's minds - years of evidently successful marketing.

What, to me, should be illegal, is building expensive branding around a group of very basic analgesics - well and other groups like antihistamines.

In the UK I can buy an own-brand 16-pack (8 g) of paracetamol in a supermarket for £0.35 / $0.45. At the same time, I can buy a packet of Panadol (GSK), same substance, same content, same amount, for £2.35, nearly 7 times the price of generics.

How is THAT legal, and how are people so unaware as to actually buy it? "Unaware" may be the key here.

Re: Should DayQuil Be Legal?

#113

Post by tptacek » Mon, Jul 06, 2026, 6:23 PM UTC

Melatonic wrote: post #93

tptacek wrote: post #74

Earlier quoted context omitted.

Are you sure you posted the right paper? That paper appears to present a clinically insignificant outcome for DXM in children. I think it's perfectly reasonable to contest the research summary this article is providing. All science-based articles on interesting topics are going to be like that. But you're writing your comment as if they took a flyer on DXM, and the research consensus is in fact that DXM is not effect…

Phenylephrine was the replacement that doesn't really work but is non (or less) stimulating right ? From what I remember it was actually quite effective topically but not through pill form. Could be wrong. Also makes me wonder if there's an alternative function to DXM for people with colds (maybe it makes them feel better in other ways). Or it's just good marketing and associated with NyQuil having other drugs and pe…

It's not that it's less stimulating, it's that pseudoephedrine basically is methamphetamine (the chemistry to reduce it to meth is truck-stop straightforward). But oral phenylephrine doesn't work at all.

The case against DXM is nowhere nearly as good as the case against phenylephrine; phenylephrine is a scam, and DXM is a drug everyone thought was the gold standard cough suppressant, but then serious studies knocked down its effectiveness.

Re: Should DayQuil Be Legal?

#114

Post by [deleted] » Mon, Jul 06, 2026, 6:24 PM UTC

ultrarunner wrote: post #33

ryandrake wrote: post #28

Earlier quoted context omitted.

"Caveat Emptor" and "Do your own research" is not a basis for a functional society. Providing reading material is not a sufficient substitute for regulation in a country like the USA where 54% of adults read below a sixth-grade level. And letting marketing decide what counts as "accurate information" is just letting the fox guard the henhouse.

Counterpoint: 54% of adults read below a sixth-grade level because a society has been created to facilitate (and encourage) just that. Encouraging a population to rely on the thought processes of others is exactly what leads to over reliance on marketing.

[deleted]

Re: Should DayQuil Be Legal?

#115

Post by drdexebtjl » Mon, Jul 06, 2026, 6:25 PM UTC

jmalicki wrote: post #48

deaton wrote: post #45

No it should not be, but not because of the dextromethorphan or the phenylephrine being ineffective. By far the biggest issue is the acetaminophen it contains, which it isn't super obvious about, and frequently leads to acetaminophen overdoses. The vast majority of acetaminophen overdoses occur because people combined different medicines containing it (like DayQuil and Tylenol) without realizing they were taking the…

Acetaminophen (Tylenol) is probably the OTC drug that is at the top of the list to be made RX-only due to its dangers.

It should be replaced with Dipyrone, which is much safer and more effective, but was restricted in the 70s in the US and parts of Europe.

In fact, it’s so effective against pain and fever, it keeps doctors from having to resort to prescribing opioids. Countries that haven’t restricted its use do not have nearly the same problem with opioid abuse.

It makes me wonder if its continued restriction is motivated by profits off the opioid crisis, rather than patient safety.

Re: Should DayQuil Be Legal?

#116

Post by m_a_g » Mon, Jul 06, 2026, 6:28 PM UTC

nostrademons wrote: post #96

The article kinda glossed over it, but one fact under-appreciated by the general public is just how dangerous acetaminophen overdoses can be . Scientists often talk about the "therapeutic index" or "safety ratio" of a drug. It's the LD50 (dose at which 50% of recipients die) divided by the effective dose. Common hard drugs like heroin or methamphetamine have a safety ratio of about 6-10 [1]. "Soft" drugs like marijua…

In most countries 4g is the upper limit and it is considered perfectly safe within that limit. So 8 500mg pills in 24 hours.

Re: Should DayQuil Be Legal?

#117

Post by [deleted] » Mon, Jul 06, 2026, 6:29 PM UTC

robobro wrote: post #4

Dextromethorphan is definitely not a placebo. Take enough and you'll go to space and meet God. Smaller doses produce euphoria and dissociation, which, even if they don't make the cough go away, makes it easier to tolerate a cold -- same reason antitussives have historically contained alcohol, cannabis extract (which may incidentally work as bronchodilator but was not the reason I imagine it was in antitussives) Funny…

[deleted]

Re: Should DayQuil Be Legal?

#118

Post by MichaelDickens » Mon, Jul 06, 2026, 6:30 PM UTC

jollyllama wrote: post #73

They wouldn't be selling the placebos if the real stuff were accessible. That's the real answer. The article mentions this but just accepts the inaccessiblity of the real thing as a given. You used to be able to get Nyquil with real sudafed in it. That was the gold standard. It's not even available behind the counter anymore, presumably because they can make more money from morons buying the placebos. As an aside: >…

> It's not even available behind the counter anymore, presumably because they can make more money from morons buying the placebos.

What do you mean "morons"? Say I'm a normal person who doesn't habitually read magazine articles about drug effectiveness. How am I supposed to know that phenylephrine doesn't work? It's in the drug store and they're selling it as a decongestant; I have good reason to believe it will decongest my nose.

Re: Should DayQuil Be Legal?

#119

Post by maest » Mon, Jul 06, 2026, 6:30 PM UTC

Btw, the cosmetics industry functions similarly, but worse. Although I suppose the health dangers are lower (the monetary ones are not).

For anti aging stuff, the workhorse ingredient is retinol (with a few formulation variations).

However, it is very difficult to buy _just_ retinol - most beauty brands bundle up retinol with a bunch of other ingredients. This has a couple of issues:

1. You won't know your retinol dosage. These creams almost never tell you the retinol proportion and concentration.

2. You're overpaying by _a lot_. The luxury name brand cream will cost maybe 10x more than the similarly sized $9 bottle of retinol from the ordinary, but it will only contain some fraction of retinol.

Tbf this has been slowly changing and I see even La Roche Posay sells retinol bottles for $50. Insane markup, but smaller than what was the case 5 years ago.

This is all compounded with the fact that it's very difficult to tell if your anti aging cream is actually working from your own experience:

- its effect is slow acting

- it's difficult to compare the result with the counterfactual, unless e.g. you only use it on half your face

Re: Should DayQuil Be Legal?

#120

Post by alistairSH » Mon, Jul 06, 2026, 6:30 PM UTC

triceratops wrote: post #80

bityard wrote: post #39

I just can't get super upset about this. Sure, OTC companies are duping customers with marketing, but what's new about that? As the person holding the money, it's my job to look at what is effective and what the active ingredients are in any given product. Or ask my doctor/nurse/pharmacist what to do, if I can't be bothered to make the effort myself. When I want to get irrationally angry about something in a departme…

> As the person holding the money, it's my job to look at what is effective and what the active ingredients are in any given product That ignores over a century of law regarding drug safety and efficacy, and false advertising.

Not to mention it ignores reality. Most consumers have neither the time now knowledge to research everything they buy. That's one of the roles of government.