Two over-the-counter products, Seasonal Allergy Relief and Intense Sinus Relief, both made by Zicam, promise to relieve hay-fever symptoms. Intense Sinus Relief contains oxymetazoline, a nasal decongestant the Food and Drug Administration has found to be safe and effective. The other Zicam product is homeopathic; it hasn't been reviewed by the FDA and its active ingredients, including sulphur, have been diluted almost to vanishing.

But despite this major difference between the two products, our 11 mystery shoppers, who visited 52 drugstores throughout the U.S., frequently found them alongside each other on drugstore shelves. So consumers might mistakenly buy a homeopathic remedy when they're really looking for conventional medicine. That wastes money and might lead to inadequate treatment.

Homeopathy is a centuries-old form of medicine in which a substance that could cause symptoms is diluted until it becomes virtually undetectable. For example, the "active" ingredients in the homeopathic flu remedy Oscillococcinum are wild duck heart and liver, apparently because those organs are said to contain tiny amounts of the flu virus. The ingredients are so diluted, there probably isn't one molecule of them per package. Yet homeopathy's supporters say that infinitesimal amount can improve health.


UNproven results

There's little evidence to back up this notion, according to a 2005 meta-analysis in the Lancet of 110 placebo-controlled homeopathy trials matched with 110 trials of conventional drugs. A subset of large, high-quality studies showed that any benefit from homeopathic remedies was "compatible with" the effect of a placebo. An accompanying editorial said the findings were less surprising than the fact that debate over homeopathy continues, "despite 150 years of unfavorable findings."

The FDA is officially required to regulate homeopathic drugs, but a spokeswoman said the agency doesn't review those products and so does not approve them as safe and effective. That's partly because the items are so diluted that they're thought to pose little direct risk, she said.


confusion in the aisles

Even people who want homeopathic products might not get what they expect. Andy P. Bormeth, executive director of the Homeopathic Pharma-copoeia Convention of the United States, says that "official" homeopathic remedies should carry the initials HPUS, indicating that they conform to the organization's guidelines. Only four of 12 homeopathic products we checked were labeled that way.

In addition to Zicam's hay-fever products, we found homeopathic yeast pills sold next to a similarly packaged, FDA-approved drug for urinary pain. Nature's Cure sells its homeopathic and conventional yeast-infection remedies as a "combination pack." Drugstore representatives we contacted said they display the remedies together because consumers shop for products based on symptoms. But Michael Cohen, president of the nonprofit Institute for Safe Medication Practices, says, "It's misleading and potentially harmful to merchandise homeopathic remedies alongside conventional drugs." Relying on a homeopathic yeast-infection remedy instead of an FDA-approved drug could allow the infection to get worse.


WHAT YOU CAN DO

Check whether over-the-counter products are labeled homeopathic. If they are, don't buy them. There's not enough evidence to justify their use. If you do opt for one, stick with a product with the HPUS label. Be especially wary of homeopathic drugs that contain alcohol and are intended for children, since the FDA does not limit how much alcohol is allowed in these remedies.