How decongestants work and their possible side effects


A decongestant is a medicine that helps relieve a stuffy nose . Dilated blood vessels in the lining of the nose and airways cause congestion in the nose, sinuses, and chest. Decongestants constrict blood vessels, reducing swelling and inflammation.

This allows more air to pass through and the mucus to drain. Outcome? Often times, it is a much-needed relief for cold and flu symptoms.

While many people successfully treat their symptoms with decongestants, they may not always be the right option for you.

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Uses and types

Decongestants are considered relatively effective for mild congestion caused by allergies, viruses, and other medical conditions.

However, if your illness turns into an infection, they probably won't work. You may need antibiotics to treat the infection before decongestants can help clear the congestion .

In addition to oral medications, decongestants are also available as nasal sprays and liquid medications. Some combination medications, such as Tylenol Sinus, Advil Cold & Sinus, and Aleve Cold & Sinus , contain decongestants in addition to pain relievers.

Common decongestants include pseudoephedrine, phenylephrine, and oxymetazoline.

Sudafed (pseudoephedrine)

Sudafed and its active ingredient, pseudoephedrine, come in several forms:

  • Regular tablet
  • 12 and 24 hour extended release tablets
  • Liquid solution

You can also buy generic pseudoephedrine, and it is included in numerous combinations of cold and flu products.

Other brand name medications that contain pseudoephedrine include:

  • Cold contact
  • Drixoral is a decongestant that does not cause drowsiness.
  • Kid Kare drops
  • Nasofed
  • Sudodrin
  • Supedrin
  • Uniformed

In addition to being used as a decongestant, this medication is also used to prevent ear problems due to pressure drops during flight or diving.

Although pseudoephedrine is technically an over-the-counter drug, it faces certain limitations in its availability because it was used to make methamphetamine . It means:

  • You must request it at the pharmacy.
  • You may need to show proof of identity.
  • You cannot buy many at one time.

Sudafed PE (phenylephrine)

Sudafed PE and generic phenylephrine are also available in several forms:

  • Tablet
  • Liquid cough medicine
  • Streak dissolves quickly

Phenylephrine is also used in many cold and flu combination products. It is also included in some hemorrhoid treatments due to its ability to constrict blood vessels.

Other brand-name products that contain phenylephrine include:

  • Active colds and allergies.
  • Advil to eliminate congestion
  • Pediacare Children's Decongestant
  • Supedrin PE

Phenylephrine was not used to make illicit drugs like pseudoephedrine, so it is readily available on store shelves. There is no limit to the amount you can buy at one time.

Afrin Nasal Spray (Oxymetazoline)

Afrin and several other brands of nasal sprays contain the drug oxymetazoline. Common shapes are also available. Along with congestion, it is used to relieve nasal discomfort caused by colds and seasonal allergies.

Oxymetazoline is sprayed into the nose, usually on a 10 or 12 hour dosing schedule.

Other brands that include oxymetazoline include:

  • Anephrine nasal spray
  • Dristan nasal spray
  • Mucinex Nasal Spray
  • Vicks Sinex nasal spray
  • Zikam nasal spray

Who shouldn't use decongestants?

Most people can safely use decongestants, but they are not for everyone. Do not take decongestants if you have any of the following:

Do not give decongestants to children younger than 6 years old. Talk to your child's doctor or pediatrician before giving them to children ages 6 to 12.

You should always speak with your doctor about any medications you are currently taking and the possible interactions that could occur with the administration of a decongestant (or any other medication, for that matter), even if they are available without a prescription.

If you are pregnant, trying to get pregnant, or breastfeeding, talk to your doctor before taking decongestants.

How to take decongestants

Most decongestants can be used three to four times a day, but extended-release medications are used once or twice a day. Follow your doctor's advice and read the directions on the label to ensure safe and accurate dosing.

If you are using a combination product that contains a decongestant and pain reliever, check the label before taking additional medications to make sure you are not duplicating their active ingredients. Your healthcare professional and pharmacist can help you determine which medications can be safely combined.

Nasal sprays work faster than oral decongestants. However, keep in mind that using them for longer than recommended can make your nasal congestion worse.

Side effects

Decongestants can cause mild side effects. Some possible side effects of oral and nasal decongestants include:

  • Nausea or vomiting
  • Nervousness
  • Anxiety
  • Soft spot
  • Headache
  • Dry mouth

Common side effects with nasal sprays include:

  • Burning, tingling, or dry nostrils
  • Increased runny nose
  • Sneezing

The more serious side effects that you should report to your healthcare professional right away include:

  • Anxiety
  • Arterial hypertension
  • Changes in heart rate or rhythm.
  • Insomnia
  • Shaking
  • Severe dizziness or fainting
  • Numbness or pain in the arms or legs
  • Hallucinations
  • Seizures
  • Psychosis
  • Urinary tract dysfunction

Note that stroke and intracranial hemorrhage can also occur with decongestants.

Chemically, decongestants are linked to adrenaline, which acts as a natural decongestant and stimulant. Caffeine can enhance the stimulant effect and worsen the side effects associated with stimulants, such as nervousness and trouble sleeping.

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