What are OTC decongestants?
Decongestants are medicines that help relieve a congested (stuffy) nose. This can be caused by a cold virus or by the flu, sinusitis, or allergies. Most decongestants come in pill or liquid form. When you buy them at the store without a prescription, they are called over-the-counter (OTC).
Decongestant nose sprays and drops are also available over the counter. However, these products shouldn’t be used for more than 3 days. Your body can become dependent on them. If you become dependent on these medicines, your nose may feel even more stuffed up when you quit using them. This is known as the “rebound effect.”
The active ingredient in most decongestants is either phenylephrine or pseudoephedrine.
Is pseudoephedrine safe? Why is it sold behind the counter?
Pseudoephedrine is safe and effective when taken as directed. But some people use OTC pseudoephedrine illegally. They combine it with other products to make methamphetamine (“meth”). Meth is an illegal and dangerous street drug. To help keep people from making meth, OTC medicines that contain pseudoephedrine are sold behind the counter. In most states, you don’t need a prescription from your doctor to buy these medicines. But you will have to ask your pharmacist for them. Additional restrictions include:
- Limit on the amount you can purchase each month.
- You must show photo identification when purchasing the medicine.
- Stores must record and keep personal information about customers who buy the medicine.
Some states have more requirements for medicines containing pseudoephedrine. These requirements may include a doctor’s prescription.
Path to improved health
How do decongestants work?
A virus, infection, or allergies cause the lining of your nose to become inflamed. This makes you feel stuffy. Decongestants work by narrowing the blood vessels. This reduces how much blood flows through the area. Swollen tissue inside the nose shrinks, and air can pass through more easily.
How can I safely take OTC decongestants?
Before you take OTC decongestants, read the directions on the drug facts label. This will tell you how much medicine to take and how often to take it. If you have any questions about how much medicine to take, call your family doctor or pharmacist. Keep a record of the OTC medicines you are using and when you take them. If you need to go to the doctor, take this list with you.
Follow these tips to make sure you are taking the right amount of medicine:
- Take only the amount recommended on the medicine’s label. Don’t assume that more medicine will work better or quicker. Taking more than the recommended amount can be dangerous.
- If you are taking a prescription medicine, ask your doctor if it’s okay to also take an OTC decongestant.
- Don’t use more than 1 OTC decongestant medicine at a time unless your doctor says it’s okay. They may have similar active ingredients that add up to be too much medicine.
How can I safely store OTC decongestants?
Store all medicines up and away, out of reach and sight of young children. Keep medicines in a cool, dry place. This helps prevent them from becoming less effective before their expiration dates. Do not store medicines in bathrooms or bathroom cabinets. These are often hot and humid.
Things to consider
Like any medicine, decongestants can sometimes cause side effects. They can temporarily cause nervousness, dizziness, and sleeping problems. They can cause heart palpitations (feeling like your heart is racing) or higher blood pressure. Healthy adults who only use them once in a while usually don’t experience side effects.
If decongestants make you feel restless or make it difficult for you to sleep, you may want to cut back on caffeine. Or you may need to discontinue the medicine.
Who shouldn’t take decongestants?
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:
- heart conditions
- high blood pressure
- prostate problems
- thyroid problems.
Do not give decongestants to children younger than 6 years of age.
Can OTC decongestants cause problems with any other medicines I take?
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:
- diet pills
- medicines for asthma
- medicines for high blood pressure.
Decongestants are often combined with antihistamines or pain relievers. It’s important to understand each of the active ingredients in combination medicines. They could cause interactions with other medicines you take.
For safest practice, try to avoid combination products that treat many symptoms at once. Only use a combination decongestant if you aren’t taking other medicines that contain the same active ingredients. This will help you avoid taking too much of any 1 ingredient.
When should I talk to my doctor?
Call your doctor if:
- Your congestion lasts more than 2 weeks.
- You have a fever.
- 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. There are other treatments that are safer to use.
Questions to ask your doctor
- What kind of decongestant is best for me?
- Am I taking any other medicines that will interact with a decongestant?
- Do I need a prescription decongestant or can I buy one over the counter?
- Can I use a decongestant that’s combined with other medicines, like acetaminophen?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.