Talk:Zicam/Archive 1

Archive 1

First thread (moved below TOC)

Needs criticism, as no individual preparation has been unambiguously demonstrated to be different from a placebo.—Preceding unsigned comment added by 96.238.31.247 (talk • contribs)

Claritin is just barely different from a placebo (more here). Allergy medications are sort of a grey area, IMHO.--Joel (talk) 20:03, 17 June 2009 (UTC)

Recall

It's a recall. The FDA's letter tells the manufacturer that selling the product is now prohibited unless and until they go through the whole "safe and effective" drug approval process. So it's being removed from store shelves now. --John Nagle (talk) 19:53, 16 June 2009 (UTC)

Sources are referring to it as an "advisory" or "warning". The FDA itself isn't using the term "recall", at least not here. Cosmic Latte (talk) 04:16, 17 June 2009 (UTC)

Or, for that matter, here, in their "Public Health Advisory". Cosmic Latte (talk) 04:20, 17 June 2009 (UTC)

The whitewashing has to stop. The product has been withdrawn from sale. The FDA has ordered the company to submit a "new drug application" if they want to try to sell the product again. A "new drug application" means the product has to be shown to be safe and effective in clinical testing. It's not up to the FDA to show it is dangerous; it's now up to the manufacturer to show that it is safe. --John Nagle (talk) 16:14, 17 June 2009 (UTC)

I would suggest that while "controversy" may be somewhat of an understatement, "Product withdrawn from sale after warning letter from Food and Drug Administration" is a rather unweildy name for a section header. Something short and to the point - say, "Product withdrawal", is concise and simple. Shereth 20:40, 17 June 2009 (UTC)

I just noticed the continuation of this thread. Indeed, my objection wasn't that the heading was incorrect, but rather that a section heading shouldn't take up half of the article. Perhaps this will work? Cosmic Latte (talk) 21:16, 17 June 2009 (UTC)

Quoted the actual FDA letter, which is now on line. The language of the letter is quite strong, stronger than the news reports. Basically, the FDA told them that, because a risk has been reported, the product has to be withdrawn and put through the entire New Drug Approval process, the usual clinical testing for "safe and effective". --John Nagle (talk) 21:47, 17 June 2009 (UTC)

This is fairly unprecedented. No manufacturer, to my knowledge, has ever failed to immediately initiate a recall after receiving a letter like this from the FDA.

I also want to point out that Zicam is at least partially homeopathic. It "contains" a few homopathic remedies in addition to having a level of zinc apparently large enough to sicken users. Skinwalker (talk) 23:05, 17 June 2009 (UTC)

It is also unclear whether the anosmia results from (or is correlated with) incorrect usage (e.g. sniffing the product deeply into the sinuses as you would fluticasone and similar steroid sprays which are used for allergic rhinitis) as opposed to usage per the instructions (applying the product exclusively to the anterior nares). —Preceding unsigned comment added by 98.231.54.228 (talk) 20:56, 5 July 2009 (UTC)

It's probably not the zinc, but the benzalkonium chloride. —Preceding unsigned comment added by 66.167.95.48 (talk) 23:27, 17 June 2009 (UTC)

I've noticed that the FDA is "recalling" just the cold medicines, but not the allergy medicines as well. What is different between the two formularies that only the former poses a risk? Askari Mark (Talk) 00:03, 18 June 2009 (UTC)

Zicam's so-called 'inactive' ingredients?

It strikes me that there might be a problem with the inactives rather than the active. Especially the first on the list, benzalkonium chloride. I'm not too fond of the idea of snorting Scrubbing Bubbles, but apparently thats what's been going on with this crap! There are *already* problems being looked into with benzalkonium, so why is all the doubt here being cast on zinc gluconate, which probably does exactly what the FDA says it does... absolutely nothing! Zaphraud (talk) 20:35, 17 June 2009 (UTC)

See WP:TALK for why this isn't appropriate. I'd suggest removing the section and focusing on the article itself. -- Ricky81682 (talk) 21:59, 17 June 2009 (UTC)

I think many people are confused (and rightfully so) about the "active ingredient" in Zicam. Zinc gluconate is the active ingredient in Zicam, the same active ingredient that can be found in "Neutorsol" which is a solution that veterinarians inject into the testicles of male dogs to render them sterile. It destroys the reproductive cells of these male dogs which have the basic animal genetic makeup as humans. It comes into question, why does Matrixx continue to claim that Zicam is safe when it's active ingredient kills reproductive tissue in animals?

Because dosages matter. Hydrogen sulfide is both a neurotransmitter and a powerfully deadly poison. Lots of safe and effective medications would sterilize you if injected directly into your balls. (This is not to imply Zicam is either safe or effective. Just that your argument is invalid.)TFGreg (talk) 05:55, 11 January 2011 (UTC)

Benzalkonium chloride, an "inactive" ingredient of Zicam, damages, and ultimately kills, cilia

Benzalkonium chloride damages, and ultimately kills, cilia. So perhaps benzalkonium chloride is the explanation for the ill-health effects of Zicam. The following from a search of the Zicam site for "benzalkonium chloride" on June 17, 2009 (when the news of Zicam's ill-health effects came out):

"Extreme Congestion Relief Nasal Gel ... are: Alkoxylated diester, Aloe barbadensis gel, Benzalkonium chloride, Benzyl alcohol, Disodium EDTA, Disodium phosphate, ... http://www.zicam.com/node/247

Intense Sinus Relief Nasal Gel ... are: Alkoxylated diester, Aloe barbadensis gel, Benzalkonium chloride, Benzyl alcohol, Disodium EDTA, Disodium phosphate, ... http://www.zicam.com/node/248

Elsewhere on the web, the ingredients are listed as:

Active Ingredients: Zincum Glucoincum* 2x Inactive Ingredients: Benzalkonium chloride, glycerine, hydroxyethlycellulose, purified water, sodium chloride, and sodium hydroxide.

"Benzalkonium chloride affected the nasal mucosa in the form of ciliary loss, epithelial spongiosis, mucosal swelling, hyperemic subepithelium with increased mononuclears in lamina propria. http://medind.nic.in/jae/t06/i1/jaet06i1p60.pdf http://74.125.47.132/search?q=cache:iRymEiMPd1IJ:medind.nic.in/jae/t06/i1/jaet06i1p60.pdf+Benzalkonium+chloride+cilia&cd=4&hl=en&ct=clnk&gl=us&client=firefox-a

Bernstein IL J Allergy Clin Immunol. 2000 Jan;105(1 Pt 1):39-44. Comment in: J Allergy Clin Immunol. 2000 Sep;106(3):595-6.

Is the use of benzalkonium chloride as a preservative for nasal formulations a safety concern? A cautionary note based on compromised mucociliary transport.

...

"CONCLUSION: Both animal and human in vitro data suggest that BKC promotes ciliostasis and reduction in mucociliary transport that may be partially masked by absorption and dilution effects occurring in respiratory mucus. These possible confounding factors may account for several disparate human in vivo results. ..." PMID 14726922

Rizzo JA, Medeiros D, Silva AR, Sarinho E. Benzalkonium chloride and nasal mucociliary clearance: a randomized, placebo-controlled, crossover, double-blind trial. Am J Rhinol. 2006 May-Jun;20(3):243-7. ...

"CONCLUSION: BKC in the concentration used in nasal preparations impaired mucociliary clearance in healthy individuals after 3 weeks of use. Presently, when preservative-free alternatives are available, BKC could be a risk without benefit." PMID 16871922

Rizzo JA, Medeiros D, Silva AR, Sarinho E. Benzalkonium chloride and nasal mucociliary clearance: a randomized, placebo-controlled, crossover, double-blind trial. Am J Rhinol. 2006 May-Jun;20(3):243-7. PMID 16871922

Bernstein IL. Is the use of benzalkonium chloride as a preservative for nasal formulations a safety concern? A cautionary note based on compromised mucociliary transport. J Allergy Clin Immunol. 2000 Jan;105(1 Pt 1):39-44. Review. PMID 10629450

Marple B, Roland P, Benninger M. Safety review of benzalkonium chloride used as a preservative in intranasal solutions: an overview of conflicting data and opinions. Otolaryngol Head Neck Surg. 2004 Jan;130(1):131-41. Review. PMID 14726922

Verret DJ, Marple BF. Effect of topical nasal steroid sprays on nasal mucosa and ciliary function. Curr Opin Otolaryngol Head Neck Surg. 2005 Feb;13(1):14-8. Review. PMID 15654209

Graf P. Benzalkonium chloride as a preservative in nasal solutions: re-examining the data. Respir Med. 2001 Sep;95(9):728-33. Review. PMID 11575893

Graf P. Rhinitis medicamentosa: aspects of pathophysiology and treatment.' Allergy. 1997;52(40 Suppl):28-34. Review. PMID 9353558

Graf P. Rhinitis medicamentosa: a review of causes and treatment. Treat Respir Med. 2005;4(1):21-9. Review. PMID 15725047

Chiambaretta F, Pouliquen P, Rigal D. [Allergy and preservatives. Apropos of 3 cases of allergy to benzalkonium chloride] J Fr Ophtalmol. 1997;20(1):8-16. Review. French. PMID 9099278

Armengot M, Basterra J, Garcia-Bartual E. The influence of anesthetics and vasoconstrictors on nasal mucociliary transport. Acta Otorhinolaryngol Belg. 1989;43(2):149-56. Review. PMID 2481378

Illum L. Nasal clearance in health and disease. J Aerosol Med. 2006 Spring;19(1):92-9. Review. PMID 16551220

—Preceding unsigned comment added by 66.167.95.48 (talk) 23:45, 17 June 2009 (UTC)

Fascinating, and possibly meritorious of publication. However, not here; Wikipedia cannot publish original research or synthesis. Perhaps you can synthesize this into a review and publish it in a journal? Antelan 21:20, 19 June 2009 (UTC)

COI issue?

The defense of Zicam, after the FDA ordered it withdrawn from sale, has been rather strong. I've noted this at Wikipedia:Conflict of interest/Noticeboard#Zicam and Zinc gluconate. --John Nagle (talk) 21:29, 20 June 2009 (UTC)

[edit conflict; expanding previous post; see collapsed bit below for initial version] "The defense of Zicam" comes from Zicam, and would seem to be an appropriate thing to elucidate in an article about, well, Zicam. This is neither an article about the FDA, nor a daughter article about the controversy; it is not "whitewashing" anything by attending to its own subject. I'm not sure if the phrase, "after the FDA ordered it withdrawn from sale" is meant to indicate the chronology of events or to imply the authority of the FDA, but on account of this I'll assume that something of the latter is intended. I should note, then, that the FDA does not make itself an authority on Zicam (and by "authority" I mean intellectual authority, not executive authority) simply by deciding to create a stir about it. While the FDA undoubtedly has caused (or contributed to) a social event, it has done so in response to anecdotal reports, and not (or at least not as clearly) in response to randomized controlled trials or to meta-analyses thereof (in other words, it has not exactly been forthcoming with what we call "reliable sources for medicine-related articles"). If the FDA presents reliable information about Zicam-as-medicine (as opposed to, say, Zicam-as-American-medical-commodity), and if an editor cites this presentation as medical information, I would not object in the slightest. We are not the fire department; we aren't here to determine that Zicam is a true alarm or that 2012 is a false alarm. We aren't here to be anybody's saviors--except, that is, by letting facts speak for themselves so that they can engage listening ears and critical minds. In short, there is no COI--unless, perhaps, you consider my delusions of membership in the Anal-Retentive Encyclopedists' Association (AREA). Hey, not a bad acronym there. If only... Cosmic Latte (talk) 16:04, 21 June 2009 (UTC)

This edit [1], deleting a quote from the FDA warning notice, is a bit much. --John Nagle (talk) 16:50, 21 June 2009 (UTC)

See the edit summaries here and here, and the content of here (i.e., my preceding talk post). The quote is not summary-style (nor is it, like a good epigraph, so eloquent as to be diminished via paraphrasing); it already is summed up in the text and is available in full-form in the reflist; and it excessively quotes a primary source that isn't even derived from scientific control, thereby flying in the face of WP:MEDRS (and WP:MEDASSESS in particular). If anything is "a bit much", I would think, it's the quote itself. Cosmic Latte (talk) 17:15, 21 June 2009 (UTC)

The FDA is most certainly a reliable source in a self-reference which is what the paragraph is about, and what the FDA has to say is absolutely relevant here. It is qualified throughout as the opinion of the FDA and not presented as fact. I don't see the problem. Auntie E (talk) 17:50, 21 June 2009 (UTC)

I have no problems with Cosmic Latte’s edits. As for the addition of the quote from the FDA, I’m not sure what it adds that can’t be covered by a citation to the advisory itself. The whole section is about the recall, so the specific wording of the order itself is unnecessary. If it’s to be kept, I’d advise that it be shortened by the removal of the two sentences appended by ellipsis; they bring in too much legalese that is subsequently covered by the remainder of the text in that section.

A more serious problem, IMO, is that the ‘Use and ingredients’ section – and to a lesser extent, the lede – tend to present the entire Zicam line as cold formula. Zicam is a trademark for a variety of products. Shorthanding “Zicam” for its three problematic formularies is an inaccurate and misleading approach. It would be helpful to describe the use and ingredients of the different Zicam product lines. Askari Mark (Talk) 20:47, 21 June 2009 (UTC)

Because this discussion sprawled so rapidly beyond this section/page (and because I still haven't gotten over my delusions of membership in "AREA"--see above), I'm copy-pasting and collapsing those comments of mine (feel free to add any of yours) that are relevant to this thread, but which don't need to gobble up space here, as they already are present elsewhere. Also, if I may humbly offer a suggestion, I'd advise hesitating to conclude, because an editor happens to be resisting a given current of thought or sentiment in an article, that the editor is trying to advance an opposing current. Instead, the editor might be trying to resist any current that discourages adherence to a neutral point of view or to other techniques and tones required of an encyclopedia. If this makes someone an "NPOV-pusher" (to borrow a term from ScienceApologist), then so be it. But when an editor is accused in one case of being partial to hard-core science at the expense of popular belief, and accused in another instance of having popular but unscientific allegiances, the editor's sympathies very well might lie, in actuality, with those who seek a common ground. Cosmic Latte (talk) 07:03, 23 June 2009 (UTC)

Consolidation of relevant but sprawling comments
The following discussion has been closed. Please do not modify it.
Initial response to [2]; revised response at [3]: "The defense of Zicam" comes from Zicam, and would seem to be an appropriate thing to elucidate in an article about, well, Zicam. There is no COI--unless, perhaps, you consider my delusions of membership in the Anal-Retentive Encyclopedists' Association (AREA). Hey, not a bad acronym there. If only... Cosmic Latte (talk) 16:04, 21 June 2009 (UTC) Response to [4]: My edits have invoked policies and guidelines, so I do not see why you are assuming that I might have a "connection" to anything other than Wikipedia. And, having assumed such a possibility, you could have simply asked me to confirm it or deny it. In that case I would have denied it, given that my interest in Zicam stems not from any corporate connections, but rather from the fact--surprising though it may be--that I have caught at least a cold or two in my lifetime. If you still are not satisfied, then perhaps you could provide some actual diffs to demonstrate how my edits have been unreasonable, or at least less reasonable than your repeated and largely unqualified accusations ([5], [6], [7], [8]) of "whitewashing"? Cosmic Latte (talk) 08:26, 21 June 2009 (UTC) Response to [9]: I'll take advantage of the parenthetical bit at the end. I stated that the FDA suspected additional cases because the FDA stated that the FDA suspected additional cases. What they said was, "the agency is aware that Matrixx appears to have more than 800 reports" ([10]). I could have noted that that the FDA "had an apparent awareness" (or, better still, "an awareness of an appearance"), but figured that "suspected" would suffice for a paraphrase. My version reflected my source, and your version (I'll take the edit summary in stride) reflects yours. Your source, being a secondary source, is preferable to mine. And by "mine" I mean someone else's, which I had removed once as overdependence upon primary material, but did not attempt to remove once it was accompanied by a secondary source. My intention is not to downplay the criticism, but to upgrade the writing. Because much of the writing lately has been critical, it follows that much of the revision will be of critical drafts. Were the writing more laudatory, it would be laudatory writing that would come under scrutiny in revision. Cosmic Latte (talk) 15:35, 21 June 2009 (UTC) Response to [11]: Please see the explanation on article talk and reconsider your reversion. The issue is not "notability" (which, as per WP:N, only "refers to whether or not a topic merits its own article"), but rather A) medical reliability as per WP:MEDRS; B) excessive prominence of selective information drawn from a primary source, contravening WP:PSTS; and C) sheer excess, as opposed to WP:SS. Cosmic Latte (talk) 17:42, 21 June 2009 (UTC)

Article from Medscape

Article from Medscape:

• Matrixx Starts Recall of Zicam Nasal Products

-- Brangifer (talk) 00:04, 27 June 2009 (UTC)

Dextromethorphan sprays

Why does this article not cover oral sprays and melts that contain dextromethorphan? Not all of Zicam's products are quackery. Sincerally, C6541 (T↔C) at 20:26, 29 June 2009 (UTC)

CBS is a reliable source

User:Skinwalker has disputed the following edit:

"More recently, Matrixx has expressed concern that the FDA has refused to provide the research and evidence that led them to request the withdrawl of Zicam swabs. The company's Freedom of Information Act requests for the FDA's research have not been approved or denied for over three months. The FDA has declined numerous opportunities to comment as to why they have not provided the FOIA information requests. "

Citing BNet as not a reliable source. BNet is a publishing service for CBS, and is part of CBS newswire. The RS standard is that blogs (like BNet) which are operated as/by standard news organizations (like CBS) can be considered reliable.

Re-editing in a day or so unless challenged. This is a pretty clear-cut error in editing in my opinion. Toycars (talk) 06:49, 9 December 2009 (UTC)

A quick poke around GoogleNews indicates that coverage of Zicam-related FOIA requests by Matrixx is nonexistent in reliable sources. Nor does the request appear to be covered by the Zicam website. The closest I can find is their press release back in June indicating a plan to contest the FDA advisory. - 2/0 (cont.) 19:14, 9 December 2009 (UTC)

That's odd, as I found that story referenced on Google News. I would seriously doubt Zicam would post press releases about FOIA requests, as it would not look good in the consumer eye that there continues to be debates about Zicam. That would cause confusion about the product lines still for sale. Zicam probably won't release any new information on their site until the matter is fully resolved (since the affected products aren't for sale otherwise). That does not mean however that this isn't a credible news piece, or that it is nonexistent relevance. I don't see anyone contesting that CBS is reporting exclusively here, but exclusive reporting doesn't mean it is not relevant to Wikipedia. As to WP:Crystal that was cited in the revert... I don't see how it applies here. The FDA's refusal to answer a media inquiry for a reliable source as to why the product was pulled, something that Zicam confirms they too are struggling with, is a new development. It is historical, not forward looking. I could see it becoming non-relevant after the FDA releases said data, but until then, it is current developments that are relevant. Toycars (talk) 04:19, 10 December 2009 (UTC)

Just because something is indexed on Google News does not make it an appropriate, encyclopedic source. Google News indexes a lot of things that are well below our sourcing bar here. If the only coverage of this action is on a low-profile blog on bnet.com, then I don't think it reaches the bar for encyclopedic coverage. We're not a blog aggregator. If this is a notable development, then it will attract more significant attention. We don't have to rush to include it with poor sources, because there is no deadline here. MastCell ^Talk 06:27, 11 December 2009 (UTC)

The Google News topic was a false premise, but let's not point fingers there… I was merely responding that the article was indeed sourced from Google News, refuting the argument that the story wasn't being followed on said service. I will append a couple of additional articles that follow the request for additional sourced coverage. This has nothing to do with a deadline, the fact that the FDA has violated federally-mandated FOIA timelines (without a stated reason), is relevant to the recent developments. You could make the argument that once the FOIA requests are resolved, that it is no longer relevant, but that would be wp:crystal, as we don't know if the FDA ever will resolve the FOIA requests. Toycars (talk) 03:54, 12 December 2009 (UTC)

I'm not making any such argument. I'm asking for reliable sources. Let's talk once we have a few to discuss. MastCell ^Talk 05:49, 12 December 2009 (UTC)

I think the matter will resolve itself in when the FDA doesn't respond to the latest FOIA request (technically there were two sets, the maker's of Zicam made a formal FOIA request after the request for return-to-market was denied with a refusal to give the data as to why). Technically, they should have presented a reason for delay already since they're past the 30 day window. We have a few sources to discuss already, but I don't want to start an edit war... I'll just wait until the 45 day window has closed in a couple of weeks to note that the FDA hasn't responded as required by law. Toycars (talk) 06:53, 14 December 2009 (UTC)

Maybe you could also wait until the matter is the subject of independent, reliable secondary sources, as mandated by Wikipedia policy? MastCell ^Talk 18:39, 14 December 2009 (UTC)

Homeopathic "ingredients"

The article provides a list of homeopathic ingredients in a manner that may be misleading to those not familiar with homeopathy. To wit, homeopathic ingredients are compounds involved in the production of the solution, but not actually present in it. Anyone reading the article who didn't know this would think Zicam contains galphimia glauca, histamine dihydrochloride, and sulfur, which it does not. Some sort of clarification should be included. TFGreg (talk) 06:08, 11 January 2011 (UTC)

Fixed. I also added a wikilink to active ingredients. You'll see a short section I added there. -- Brangifer (talk) 17:29, 11 January 2011 (UTC)

I am not sure that that gets it quite right, though - by my recollection, there really is Zn in the product, but the pre-market approvals were done through the Homeopathic Pharmacopœia Convention instead of the usual safety and efficacy trials. The stated reasoning for adding zinc is based on homeopathic philosophy and it is potentized through homeopathic principles, but the end product still has a meaningful concentration (homeopathic overdose stunts not recommended). BR (or TFG or anyone) - can you tell me if I am walking on smoke here before I start digging in the sources? - 2/0 (cont.) 22:40, 11 January 2011 (UTC)

I was under the impression that it was a mixture of homeopathic medicine (water) and real (well, not water, at any rate) medicine. That is, water with zinc gluconate dissolved in it, and the homeopathic ingredients are just gravy. Also, see my edit about zinc gluconate actually being present.TFGreg (talk) 22:49, 11 January 2011 (UTC)

Thanks, that should be sufficiently clear. I added that zinc gluconate is the only active ingredient present, so that it's clear this is not a homeopathic ingredient. I entertained the idea of adding that even in biologically active amounts, the homeopathic ingredients would not be expected to treat cold symptoms (due to "like treats like") but I think it would be too confusing to include that much tangential detail. TFGreg (talk) 22:45, 11 January 2011 (UTC)

LOL! Now you're using logic, and we all know that doesn't work with homeopathy! Yet, there is a certain form of internal logic in the homeopathetic woo woo world, it just doesn't fit with external logic as applied in the real world. -- Brangifer (talk) 05:04, 12 January 2011 (UTC)

With the current wording it is still unclear to me whether zinc gluconate was included at potent doses or homeopathic ones. The confusion comes from saying it has a full-strength ingredient in one sentence and then saying it is marketed as a homeopathic remedy in the next. This seems contradictory to me. Perhaps it could be reworded to to say something like "The only active ingredient in Zicam Cold Remedy is zinc gluconate. In addition it contains homeopathic dilutions which means ...". Or "Zicam Cold Remedy is marketed as a homeopathic remedy which means .... However the concentration of zinc gluconate is high enough to be considered a true active ingredient. Also should this whole paragraph be in past tense, since Zicam Cold Allergy it has been recalled? It might help to avoid confusion with current products that are purely homeopathic. Pavon (talk) 00:58, 15 January 2011 (UTC)

You have a point and I'll fix that now. -- Brangifer (talk) 19:19, 15 January 2011 (UTC)

Done, plus adding sources, numerous copy edits to improve headings, format refs, etc.. -- Brangifer (talk) 20:43, 15 January 2011 (UTC)

I think that adding the dilution factors adequately covers the point I was trying to get at earlier - good work. - 2/0 (cont.) 22:06, 15 January 2011 (UTC)

When I called a customer representative for Zicam, they said the rapid melts has 11mg of elemental zinc and the rapid melts ultra has 14.5mg of elemental zinc. I wonder if they labeled it as a homeopathic remedy to capture a market of those that believe in homeopathy or rather to avoid FDA regulation. Anyways, the sentence about dilution is misleading, because there is a significant quantity of the active ingredient. 76.94.171.80 (talk) 15:55, 30 December 2013 (UTC)

Zicam HAS long-lasting adverse effects

What's going on? Zicam has long lasting adverse effects. The evidence is out there, not from RCTs or SRs, but other very STRONG evidence: why isn't it mentioned here in oh so authoritative Wikipedia? Just asking? I dunno - just puzzled. Actually the association between use of Zicam and anosmia has been demonstrated to be causative, using the Bradford Hill criteria to establish causality. Why is this not mentioned in the article? If Cochrane doesn't mention it, they must have just missed it. Sleuth21 (talk) 07:17, 13 January 2012 (UTC)

Is this a joke? The lede mentions anosmia (“a risk of damage to the sense of smell”), and then there's the section called "safety concerns" that is about 1/2 of the article. Six words (talk) 09:04, 13 January 2012 (UTC)

No. The latest two pieces of evidence by Lim et al. aren't mentioned explicitely in the article (there are others, I would guess). Wikipedia fails its readers. Sleuth21 (talk) 09:49, 13 January 2012 (UTC)

If you find new/better sources to include you can just add them. Had you called this section "Source XY on zinc and anosmia" I might have understood your point, but asking why it isn't mentioned that Zicam (or rather zinc gluconate, which, by the way, isn't in nasal Zicam remedies anymore) has long-lasting adverse effects will only raise my eyebrows as almost half of the article is about this very subject. The answer to your question as I now understand it is: because nobody added it yet - we're all volunteers and usually aren't online 24/7 to guard “our” articles. If I stumble upon some new information, I check the article it is relevant to to see if someone has added it (usually only to find that someone already has), and if nobody did, I do it. The same is my advice to any other editor - if you find new material that isn't included yet, add it, or, if you're unsure whether it is relevant, start a talk page discussion that cites the source you're unsure about. If it's a pubmed-listed article from a mainstream journal you can usually cite it. In case you're reverted: don't take it personal, but think of it as the second step of WP:BRD. Genereally, on talk pages adhere to WP:TALK and make sure your comments are civil (I saw your comment about Steve, and it was bordering on incivility.) --Six words (talk) 10:53, 13 January 2012 (UTC)

Sorry but I don't understand your point. I have tried most of what you suggest to little avail. I certainly didn't take reversion personal initially, only when they implied I am stupid, deliberately misrepresented my view, and do contain obnoxious personal attacks. Some editors (of course not you (no irony!), six words) are sitting in glasshouses and throw stones just for fun. I am afraid I am also annoyed by obvious high-school types arguing on WP. They can't and should not be stopped (they sometimes get it right) but they are so annoying Sleuth21 (talk) 00:13, 18 January 2012 (UTC)

Dextromethorphan

Why is there no mention of dextromethorphan containing Zicam products, which are definitely not homeopathic. C6541 (Talk ↔ Contribs) 23:30, 9 January 2013 (UTC)

New Edits

I would like to add a section on Zicam's advertising and product lines, to call to attention the more positive aspects of the company. The current entry focuses heavily on the recall, without room for the upstanding way the company dealt with this. Talking about the advertising would also allow room for explaining how Zicam focuses on shortening colds and the true use of its products. IStan5042 (talk) 14:40, 11 November 2013 (UTC)IStan5042

That sounds like a potentially good entry. Please write what you'd like to add, including the references, and place them here. I'd love to help you develop it into something that will "stick" and not get deleted. -- Brangifer (talk) 05:16, 12 November 2013 (UTC)

I would like to add "Benefits of Zinc" under "Ingredients & Use", with the following:

A 2011 systematic meta analysis of studies conducted by the Cochrane Collaboration indicates that zinc lozenges definitively shorten the duration and severity of cold symptoms but offers no recommendations as to dosage.[14]Methodological weaknesses are thought to have contributed to the mixed results of previous studies.

The 2011 Cochrane review is widely regarded as the most authoritative assessment to date of the effectiveness of zinc as a treatment for the common cold.[15] The New York Times article “For Cold Virus, Zinc May Edge Out Even Chicken Soup” discusses this review, noting that it found the benefits of zinc were significant. [15] It references a March 2008 report in The Journal of Infectious Diseases, which stated: “…zinc lozenges cut the duration of colds to four days from seven days, and reduced coughing to two days from five.” [15] It is suspected that zinc gluconate lozenges serve to shorten the duration of cold symptoms,[16] by reducing inflammatory cytokines.[17] IStan5042 (talk) 15:22, 13 November 2013 (UTC) IStan5042

Wasn't this content previously in the article? I believe it was removed because of a WP:SYNTH violation because the source doesn't mention Zicam, and this article isn't about zinc. The content could be used in the zinc article. Maybe it already is. -- Brangifer (talk) 16:29, 13 November 2013 (UTC)

It was previously, and I believe it should be kept in, as the zinc in Zicam is beneficial and this should be called to attention. It offers more insight to the usefulness of the medicine, rather than solely focusing on the litigation the company has faced due to one product. — Preceding unsigned comment added by IStan5042 (talk • contribs) 18:01, 13 November 2013 (UTC)

I don't see how we can do this without violating policy. Policy requires that the content be directly about Zicam, but it isn't. Did you read the SYNTH link above? Check it out. It turns out that Zicam is mentioned in the NYTimes article, but in a negative manner, and the research isn't applicable to Zicam at all:

• "Some cold sufferers have been wary about using zinc since the Food and Drug Administration warned consumers to stop using Zicam nasal sprays and swabs, which contain zinc, after numerous reports that some users lost their sense of smell after using the product. The Cochrane report did not review any studies of nasal zinc products." New York Times

Zicam's products all contain zinc, that's why the study was applicable - there's many other forms of the medicine, the product that was recalled posed a problem because of the way it was administered. As I said, I'm not proposing all negative aspects be removed, rather that the positive effects the products can have be noted.

As far as policy, the same guidelines should be used for the Zinc gluconate article, as the information on Zicam is not directly appropriate. 155.212.71.122 (talk) 16:58, 15 November 2013 (UTC) IStan5042

The content would be suitable at the zinc article, but not here. -- Brangifer (talk) 07:01, 14 November 2013 (UTC)

That article simply references several peoples' opinions, and as I've said, the nasal sprays recall has long since been dealt with. The point of this entry is not to focus singularly on the litigation, but on Zicam as a company and a product. The benefits of zinc are grounded in the most trusted study on the subject to date, and are very relevant in that they offer explanation as to why the product proves effective. 155.212.71.122 (talk) 14:16, 14 November 2013 (UTC)IStan5042

You're not getting the point(s): (1) The point of the article is to document whatever RS have said, and do say, about Zicam, past and present. More content is certainly welcome, but it must follow policies. (2) The Wikipedia:No original research#Synthesis of published material that advances a position policy forbids doing what you are proposing. Now if you had reviews or metaanalyses about Zicam, by name, which met our WP:MEDRS guideline, it would be a totally different matter. Please familiarize yourself with these policies. -- Brangifer (talk) 01:14, 15 November 2013 (UTC)

I do believe I understand, as in the guidelines, it states: "Wikipedia's articles, while not intended to provide medical advice, are nonetheless an important and widely used source of health information. Therefore, it is vital that the biomedical information in all types of articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge." The Cochrane collaboration is a relevant, third party source and now it has been removed from this entry. It provided valuable insight to how Zicam can be beneficial, in that it uses zinc to shorten colds.

Since it has been so pared down, the entry now reads as a warning against using a product that has since been taken off shelves. This is a disservice to anyone who may come across Wikipedia looking for information on the company. The references currently used within the entry are not meta-analyses themselves. If these can be included, articles such as this one http://well.blogs.nytimes.com/2011/02/15/for-cold-virus-zinc-may-edge-out-even-chicken-soup/ which are based upon research done in studies like the Cochrane collaboration, should also be allowed.

Furthermore, the Zinc gluconate entry now includes a whole paragraph dedicated to the safety concerns of Zicam, which seems to be an extremely leading generalization. I am not proposing that the product recall information be removed, but that it should be fairly juxtaposed with other information that is more recent and pertinent to a full understanding of the company and its products. 155.212.71.122 (talk) 15:10, 15 November 2013 (UTC) IStan5042

I have been at a loss about what to do here. I keep telling you, but you keep ignoring what I've said. You must not violate WP:SYNTH. The sources must mention Zicam. I really get tired of repeating that. I expect that you will now cease to push that idea. If you don't believe me, then take the matter to Wikipedia:No original research/Noticeboard. That's where the experts lurk.

Also, on another note, I have left messages at User talk:IStan5042 and User talk:155.212.71.122 about logging in. Remember to do it. This is not negotiable. -- Brangifer (talk) 08:18, 27 November 2013 (UTC)

There are things you could do. You say the product is no longer sold. Then document that fact with RS. -- Brangifer (talk) 08:20, 27 November 2013 (UTC)

Latest series of edits by IP

Copied from IP's talk page.

I did not realize I was not logged in. Please stop erasing my edits without giving reason. That is what the Zicam talk page is for. IStan5042 (talk) 14:16, 27 November 2013 (UTC)

Don't you look at the edit history or the signatures before and after you make each edit? You should. That would tell you that you were editing as an IP, and also the consequences of each edit.

My edit summary did tell you the reason for why I deleted what you did, and also that I would help you get it right. I checked each edit in the editing history and saw that you were having lots of problems getting it right. That's understandable. I've been a newbie too and it does take time to learn how things are done. Not only does one have to deal with formatting and wikimarkup codes, but also with our manual of style rules, which you don't know yet. Your edits were removing references, botching up the references by using nonstandard formats, then manually restoring refs, messing with the references section (it normally only has the "reflist" code), adding content which we had already discussed on the talk page as synth violations, changed wording of an exact quote so that the lead contained content not in the body (a violation of WP:LEAD), etc..

It was just a lot easier to make a mass revert than try to fix each problem. We can discuss what you were trying to do on the talk page. Explain yourself there. You were obviously trying to do something, but took a painful route to get there.

Now that I have gone back and used a different view which compares a previous version with your last edit, it's easier to see the net result. I'm going to restore to that point and then systematically delete or fix what you did, using edit summaries to explain each change. I'm going to copy this to the article's talk page so we can continue there. -- Brangifer (talk) 16:01, 27 November 2013 (UTC)

Done for now. Will check back later because of some uncertainties. -- Brangifer (talk) 16:57, 27 November 2013 (UTC)