Decongestants are popular nonprescription drugs. They come as pills, capsules, liquids and nose sprays. Oral products contain pseudoephedrine (as in most Sudafed products) or phenylephrine (Contac, Sudafed PE). Sprays contain phenylephrine (Neo-Synephrine) or oxymetaxoline (Afrin, Dristan). These chemicals reduce congestion from colds and hay fever by reducing swelling in nasal passages, making breathing easier. They also help prevent ear pain caused by air pressure changes when flying. Pseudoephedrine and oxymetaxoline are generally more effective than phenylephrine.
How safe are decongestants?
They're safe enough to be approved for sale over-the-counter, but it’s very important to read the warnings on the label. Don’t use decongestants for more than a few consecutive days, since they lose their effectiveness and can cause a rebound effect. If you have high blood pressure, heart disease, glaucoma, thyroid disease, an enlarged prostate or diabetes, or if you are pregnant or breast-feeding, you should talk with your health care provider before using these drugs. You may be able to use decongestant nasal sprays even if you are advised against pills or capsules. Decongestants interact with many other drugs, so consult your health care provider or pharmacist if you take any medications on a regular basis. Finally, these drugs can cause nervousness, sleeplessness and palpitations in some people.
What about decongestant/antihistamine combinations?
Besides relieving congestion, such combination products help dry up a runny nose and stop sneezing. They often also contain a pain reliever. We don’t recommend them because they’re usually overkill and increase the risk of unwanted effects. If allergies are making you congested, try antihistamines first; you may not need decongestants. If allergies are not your problem, then antihistamines usually won’t help. The antihistamines in many combination products cause drowsiness, which may help you sleep at night, but can cause impairment and lead to accidents, even the next day and even if you don’t feel drowsy. Newer products may contain nondrowsy antihistamines. Older antihistamines can also cause or worsen memory problems, confusion and cognitive impairment in older people.