Decongestants can reduce nasal congestion and help treat allergies or a cold

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Decongestants can reduce nasal congestion and help treat allergies or a cold
Decongestants are useful when you have a stuffy nose.DimaBerlin/Shutterstock
  • Decongestants are a type of medication that help clear a stuffy nose or nasal congestion.
  • You may need a decongestant to reduce stuffiness and breathe easier as a result of allergies or a cold.
  • Decongestants come in oral tablets — like Sudafed or Mucinex — as well as in nasal sprays like Afrin.
  • This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.
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A swollen, congested nose often accompanies a cold or allergies, which can make it hard to breathe or sleep at night.

Decongestants help clear those airways by shrinking the blood vessels in your nose, allowing you to breathe easier and reduce stuffiness.

If you have a stuffy nose with seasonal allergies, you may also want to try a combined decongestant and antihistamine medication, which can help resolve more of your allergy symptoms. Here's what you need to know about all the types of decongestants.

Types of decongestants

Most commonly, decongestants are available over the counter as oral pills. Some examples include:

  • Phenylephrine (Sudafed PE, Suphedrin PE)
  • Pseudoephedrine (Silfedrine, Sudafed, Suphedrin)

While they're used to alleviate the stuffy, clogged nose of hay fever (seasonal allergies), decongestants can also be used to reduce the symptoms of the cold or flu, chronic allergic reactions, and sinusitis.

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Most decongestants are over the counter, though some, like pseudoephedrine, may require a prescription. Talk to your doctor to see if prescription decongestants may be necessary for you.

Decongestants and antihistamines

Decongestants and antihistamines are also available as combination medication.

These may be more effective at reducing a wide range of allergy symptoms, such as sneezing, itchy eyes, watery eyes, and nasal congestion.

Some common examples of medication with both antihistamines and decongestants are:

  • Allegra-D
  • Benadryl Allergy Plus Congestion
  • Claritin D
  • Robitussin DM
  • Ryneze
  • Semprex-D
  • ZyrTEC-D

In adults and older children, one study suggests that oral antihistamines plus decongestants can be helpful in alleviating symptoms of allergies compared to placebo groups, and may be more effective than antihistamines or decongestants alone.

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In addition, combination cold medicines, such as antihistamines and decongestants, provide the most relief of allergy and cold symptoms for adults and older children, according to the American Academy of Family Physicians.

Decongestant nasal sprays

Decongestant nasal sprays can offer quick — though temporary — relief from uncomfortable sinus stuffiness.

Some examples include:

  • Vicks Sinex
  • Dristan
  • Afrin

One clinical study indicates that decongestant nasal sprays can help reduce allergy symptoms, especially rhinitis, or the medical term for a stuffy nose. However, they can also have potentially harmful side effects.

Side effects

Though not addicting, nasal sprays can become habit-forming, says Peter Bressler, MD, an allergy and immunology specialist at Duke Health.

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You're not supposed to use decongestant nasal sprays more than once in 12 hours or more than three days in a row. Afterward, your body might adapt to the medication and not find it as strong — known as rhinitis medicamentosa, or rebound stuffiness — so it's important to wait at least 24 hours after the third day to use the spray again.

If you don't follow these guidelines, overuse can cause tissue damage inside the nose, Bressler says. In severe cases, it can cause a hole in the septum, or the middle of the nose.

It's not recommended for children under six to use decongestant nasal sprays at all. People with high blood pressure and enlarged prostates should also generally avoid them.

There are also side effects for oral decongestants, including:

  • Dry mouth
  • Anxiousness
  • Clouded thinking
  • Tremors
  • Insomnia
  • Increased heart rate
  • Heightened blood pressure
  • Difficulty urinating for people with enlarged prostates
  • Exacerbated glaucoma

Overall, those with diabetes, glaucoma, heart disease, and thyroid problems should check-in with their doctor before taking decongestants, as well as those taking other medications.

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