CHICAGO (AP) _ Standing inside a downtown Chicago chain drugstore, shopper Beth McClanahan considered the product Zicam.
``I wouldn't have known it was homeopathic,'' she said looking at the bright orange label. ``The name Zicam sounds very scientific.''
Stuffy noses and sore throats are driving many cold sufferers to herbal and homeopathic remedies. But like McClanahan, consumers may not realize they're buying alternative medicines when they choose wildly popular products such as Airborne and Zicam _ both shelved alongside traditional medicines in the cold and flu aisles of chain drugstores.
The makers of both medicines have paid for their own clinical studies to test their products. But Airborne and Zicam have not been reviewed for safety and effectiveness by the Food and Drug Administration, unlike prescription and new over-the-counter drugs. The law allows their sale unless the FDA proves them harmful.
That concerns some experts.
``I think it's quite confusing for consumers to try to sort out which things have some data showing they actually work,'' said Dr. Ronald B. Turner, a cold virus expert at the University of Virginia School of Medicine in Charlottesville.
Zicam and other homeopathic products do say on their packaging that they are homeopathic. Zicam, which contains a small amount of zinc, is the nation's third leading nasal spray. Airborne _ plugged on Oprah Winfrey's show last fall _ is an effervescent tablet containing Chinese herbs, vitamins and echinacea. Its label notes that the FDA has not reviewed its language saying it should be taken at the first sign of cold symptoms.
For drugstore operators, it makes sense to place the remedies where consumers can find them quickly. For the manufacturers, marketing to a wider audience means more sales.
For cold sufferers, the distinction between what's conventional and what's alternative may not be as important as what they believe works.
``There's a reason for the success of these products. Consumers want them and they're effective,'' said Rider McDowell, co-founder of the company that created Airborne, an herbal supplement that's a best seller at stores like Walgreens, Osco and CVS Pharmacy.
Last month, the Institute of Medicine, citing the popularity of dietary supplements, called for tougher rules to make sure they're safe and effective.
Steven Dentali of the American Herbal Products Association says his group wants new safety requirements such as mandatory reporting of adverse side effects.
``We think our safety record's going to look pretty good,'' he said, especially compared to a few prescription drugs.
Herbal products and homeopathic remedies are regulated separately, and the law lays out only a few quality controls and labeling rules.
Homeopathy is based on the idea that tiny amounts of certain natural substances stimulate the body's healing response. Some studies seem to suggest that homeopathic remedies work, but many mainstream doctors consider them quackery.
The trend of integrating ``natural'' remedies with mainstream drugs on store shelves started in the early 1990s. A homeopathic brand called Hyland's, previously only sold in natural food stores, gets credit.
It started by accident, said Hyland's CEO J.P. Borneman. A drugstore chain shelved Hyland's remedy for babies' teething pain with the rest of its teething products. The product was selling well.
``We began to get the suspicion that a few products could hop the fence,'' Borneman said.
``By 2000, we had a half-dozen products solidly in that class. Then Cold-Eeze and Zicam came on the market and suddenly homeopathy was ubiquitous.''
The blurring of lines extends to the product formulas, too.
Cold-Eeze is not as highly diluted as some homeopathic products. A key principle of traditional homeopathy holds that the more diluted a remedy is, the better it works. While Zicam contains one part per 100 of zinc, a Cold-Eeze lozenge contains 13.3 mg of zinc.
``It's not like it's microscopic by any means,'' said Albert Piechotta, director of marketing and communications for Quigley Corp., maker of Cold-Eeze.
After homeopathic products led the way, the herbal supplement Airborne became the most recent cold remedy crossover success.
``We went out to the mainstream consumer _ the working people, the people who really can't afford to be sick,'' McDowell said.
He gives word of mouth credit for Airborne's buzz. But Oprah Winfrey's plug didn't hurt.
Winfrey featured McDowell's wife, Victoria Knight-McDowell, on her show last September in a segment on everyday women who created million-dollar products. Knight-McDowell told the story of how she was a teacher tired of catching colds in the classroom, so she created her own product.
In 2004, Airborne _ ``created by a school teacher'' _ sold more than $16 million at drugstores, according to Information Resources Inc., a company that tracks retail sales. That was a 200 percent increase over the previous year.
Airborne is now considered a ``destination product,'' said Walgreens spokeswoman Tiffani Bruce. ``Consumers come to the store and they're sick and they want to find it. So we merchandise it where they're most likely to go first, the cold and flu section.''
Back in the Chicago drugstore, McClanahan wasn't ruling out Zicam after learning it was a homeopathic product.
``I would try it,'' she said. But not on this day. She reached for Sudafed. ``I need something to clear my head.''