Most people who have allergies are familiar with nasal
congestion. This can include a stuffy nose, clogged sinuses, and mounting
pressure in the head. Nasal congestion is not only uncomfortable. It can also
affect sleep, productivity, and quality of life.
Antihistamines may help prevent allergy symptoms. But
sometimes you may need to take additional medications. This is especially the
case if you need to relieve sinus pressure and a congested nose. Decongestants
are over-the-counter medications that help break this cycle of congestion and
Decongestants work by causing blood vessels to constrict.
This helps relieve congestion caused by the dilation of blood vessels in the
Phenylephrine and phenylpropanolamine are two common forms
of these drugs. These over-the-counter drugs can bring temporary relief from
congestion. However, they don’t treat the underlying cause of allergies. They
merely offer relief from one of the more problematic symptoms of common inhalant
Decongestants are relatively inexpensive and readily
available. Still, they’re more difficult to obtain than over-the-counter
Pseudoephedrine (e.g., Sudafed) is another class of
decongestants. It’s offered in limited forms in certain states. It may be
available through the pharmacist, but other states might require a
prescription. This ensures proper and legal use, and prevents drug
interactions. Pseudoephedrine is a raw material used in the illegal manufacture
of the dangerous street drug crystal methamphetamine.
Congress passed the Combat Methamphetamine Epidemic Act of
2005 to limit the damage to communities caused by abuse of this drug. President
George W. Bush signed it into law in 2006. The law strictly regulates the sale
of pseudoephedrine, pseudoephedrine-containing products, and
phenylpropanolamine. Many states have also enacted sales
restrictions. Typically, you have to see a pharmacist and show your ID.
Quantities are also limited per visit.
Side Effects and Limitations
Decongestants are stimulants. Potential side effects include:
- high blood pressure, or hypertension
In rare cases, pseudoephedrine use may be linked to an
abnormally rapid pulse, or palpitations, also called an irregular heartbeat. Most
people do not experience side effects when they use decongestants correctly.
You will need to avoid these medications or take them under
close supervision if you have the following:
- type 2 diabetes
- overactive thyroid gland, or hyperthyroidism
- closed angle glaucoma
- heart disease
- prostate disease
Pregnant women should avoid pseudoephedrine.
Decongestants are often taken once every 4-6 hours, ideally
for no more than one week at a time. Other forms are considered
controlled-release. This means they are taken once every 12 hours, or once a
People who are taking any drug from a class known as
monoamine oxidase inhibitors (MAOIs) should not take decongestants. Certain
other drugs, such as the antibiotic linezolid (Zyvox), may also cause a serious
Consult with your doctor before taking a decongestant if
you’re currently taking any other medications. You shouldn’t take more than one
decongestant at a time. Although they might have separate active ingredients,
you may still put yourself at risk for an interaction.
Nasal Spray Decongestants
Most people take decongestants in a pill form. Nasal sprays feature
a decongestant that is delivered directly into the nasal cavities. The American
Academy of Family Physicians (AAFP) recommends that you don’t use spray
decongestants for longer than three days at a time. Your body may grow
dependent on them, and then the products will no longer be effective in
Nasal spray decongestants may provide temporary relief from
congestion. However, they’re especially prone to inducing tolerance for the
drug. This tolerance may result in “rebound” congestion that leaves the user
feeling worse than before treatment. Examples of these nasal sprays include:
- oxymetazoline (Afrin)
- phenylephrine (Neo-synephrine)
- pseudoephedrine (Sudafed)
Studies have shown that the combination of an antihistamine
drug and a decongestant is better at relieving the symptoms of allergic
rhinitis due to seasonal inhalant allergies. These drugs only offer symptomatic
relief and should be used with some caution. But they can be important weapons
in the ongoing battle against the misery of allergies.
to See a Doctor
Sometimes taking decongestants aren’t enough to alleviate
severe nasal allergy symptoms. If you’re still having bothersome symptoms
despite taking medications, it may be time to see a doctor. The AAFP
recommends seeing a doctor if your symptoms don’t improve after two weeks. You
should also call a doctor if you develop a fever or severe sinus pain. This
could indicate sinusitis or a more severe condition.
An allergist can help you determine the exact causes of your
congestion and recommend methods of more long-term relief. Prescription
decongestants may be necessary for the most severe cases.