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 still 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 stopped-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.

Side effects aren’t usually a problem for healthy adults who only use decongestants once in a while. Side effects can be a concern for people who have health problems or use decongestants for long periods of time.

Pseudoephedrine may make some people feel nervous or dizzy. It can cause palpitations (feeling like your heart is racing) or problems sleeping. It can also raise blood pressure in some people.

Yes. Decongestants can interact with many other medicines you take. If you take any of the products 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’re taking.

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 pseudoephedrine than you intend.

See the Know What’s in the Medicines You Take chart (PDF file: 6 pages / 75 KB. More about PDFs.) to help sort out what drugs have the same ingredient so you can avoid taking too much.

If you have any of the conditions below, talk to your doctor before taking a decongestant:

If decongestants make you feel restless or cause you sleep problems, you may want to cut back on how much caffeine you drink while taking this medicine.

When you choose an OTC decongestant, check the drug label for possible side effects or interactions with other drugs you’re taking. This information will appear in the “Warnings” section of the label.

Be sure to also check that you’re not taking two medicines that contain the same active ingredient. You’ll find this information in the “Active Ingredient” section.

Before you take a decongestant, check the label for a drug called phenylpropanolamine (also called PPA). The U.S. Food and Drug Administration recalled this drug for safety reasons. If a product contains PPA, don’t take it.

Always read and follow the directions on the label. Be sure you understand what the label says before taking the medicine. If you have any questions, ask your family doctor or pharmacist.