Decongestants: OTC Relief for Congestion

Over-the-counter (OTC) drugs are medicines you can buy without a prescription from your doctor. The only OTC decongestants available in pill form are pseudoephedrine (two brand names: Contac Non-Drowsy, Sudafed) and phenylephrine (one brand name: Sudafed PE). In some states, you may have to talk to a pharmacist before buying medicines that contain pseudoephedrine, but you will not need a prescription from your doctor.

Decongestant nose sprays and drops are also available over-the-counter. However, these products shouldn’t be used for more than 3 days because your body can become dependent on them. This will cause your nose to feel even more stuffed up when you quit using them.

Decongestants work by narrowing blood vessels in the lining of the nose. This reduces how much blood flows through the area so that swollen tissue inside the nose shrinks and air can pass through more easily.

Decongestants can help relieve a stopped-up nose caused by a cold or the flu (influenza), sinusitis or allergies.

Healthy adults who only use decongestants once in a while usually don’t experience side effects. However, anyone can experience side effects.

Decongestants can temporarily cause nervousness, dizziness and sleeping problems. They can also cause heart palpitations (the feeling that your heart is racing) or high blood pressure.

If decongestants make you feel restless or make it difficult for you to sleep, you may want to cut back on how much caffeine you drink while taking this medicine. Do not give decongestants to children four years old and younger.

Don’t take decongestants if you have high blood pressure that is not controlled.

Talk to your doctor before using a decongestant if you have any of the following health problems:

Decongestants can interact with many other medicines you take. If you take any of the medicines listed below, talk to your doctor before taking a decongestant:

Decongestants are often combined with antihistamines and/or pain relievers. If you take one of these combination medicines, it’s important to understand each of the active ingredients and the interactions they may have with other drugs you take.

In general, try to avoid combination products that treat many symptoms at once. For example, you might use a decongestant for a stuffy nose. Don’t use a decongestant combined with other active ingredients like cough medicine, antihistamines or acetaminophen unless you are certain you aren’t taking other medicines with those ingredients. This will help to keep you from taking too much of one of these ingredients.

Be sure not to take too much pseudoephedrine. Many OTC cold and allergy products and some prescription drugs contain pseudoephedrine. If you combine these drugs, you’ll take much more than you intend.

Call your doctor if your congestion lasts more than two weeks, if you have a fever, or if you have severe pain in your face or sinuses. If you are regularly using an OTC decongestant nasal spray to keep your nose clear, talk with your doctor about other treatments that are safer to use.