No one likes having a stuffy nose, but a new warning from the FDA is encouraging manufacturers of over-the-counter nasal decongestants to make their products tamper-free. The FDA is warning against over-use of Benzedrex, the brand name for the nasal decongestant propylhexedrine.

Propylhexedrine is safe when used as directed and available over the counter. But, the FDA is warning that when used improperly the user could experience

“... fast or abnormal heart rhythm, high blood pressure, and paranoia, can lead to hospitalization, disability, or death.” According to a statement from the agency, there have been increasing reports of propylhexedrine misuse.

Propylhexedrine can be used to get high. Propylhexedrine is not an amphetamine but it can work a bit like one, and according to the Laguna Treatment Hospital, a rehabilitation center in California, propylhexedrine is chemically very similar to methamphetamine. There have been reports of people dying from abusing propylhexedrine and combining it with other compounds to inject intravenously.

To prevent misuse the FDA is calling on manufacturers to “consider product design changes that support its safe use,” things that would make it harder for people to tamper with the device. They also encouraged manufacturers to reduce the amount of propylhexedrine in each individual inhaler.

According to the Laguna Treatment Hospital, people who are abusing the nasal decongestants often need to get the active ingredients out of the packaging and process them before misusing them. The FDA reports that there is no medication that can reverse the effects of propylhexedrine, so only the adverse symptoms can be treated.

Sabrina Emms is a science journalist. She got her start as an intern at a health and science podcast out of Philadelphia public radio. Before that she worked as a researcher, looking at the way bones are formed.