Decongestants are easy to use, cheap, and effective. Generally, these drugs are used to treat nasal congestion and other symptoms associated with colds and allergies.
Nasal congestion is the blockage of nasal passages due to common colds, flu, or allergies. Nasal congestion can also be caused by the overuse of some nasal sprays or drops (if your stuffiness is getting worse, you may be suffering from a rebound effect known as chemical rhinitis).
Nasal congestion is also known as a nasal blockage, nasal obstruction, a blocked nose, or stuffiness. It happens when the nasal membranes become swollen from inflamed blood vessels. And that is when we need decongestants because they open the nasal passages by narrowing the blood vessels that supply the nose.
These medicines do not cure colds or allergies, and they will not stop all symptoms. Nasal decongestants serve one specific purpose — they can relieve only stuffiness. When you are considering whether to use a decongestant to stop the irritating symptoms associated with a cold, you should know that decongestants are not the only solution. Tea or chicken soup can be excellent natural alternatives. You also can use adhesive strips to help unblock the nasal passages.
Side effects of nasal decongestants
The biggest problem with decongestants and their side effects is the risk of making an existing heart problem worse. You should always consult your doctor before taking any decongestants, especially if you are suffering from high blood pressure (in which case these medications can lead to dangerous side effects). Generally, decongestants can be divided into two main categories – decongestant nasal sprays and nose drops, and oral decongestants.
Decongestant Nasal Sprays and Nose Drops
Frequently occurring side effects of nasal sprays and nose drops are sneezing, burning, stinging, and nasal dryness. These side effects are usually temporary and do not require medical intervention, but if you feel or observe any of the following side effects, please contact your doctor:
- increased blood pressure
- a headache
- a fast, slow, or fluttery heartbeat
- nervousness
- dizziness
- nausea or vomiting
- sleep problems
The side effects of oral decongestants
The most common side effects of orally taken decongestants are nervousness, dizziness, drowsiness, headache, nausea, weakness, and sleep problems. If you feel any of these side effects, please contact your doctor immediately. Other possible side effects are:
- increased blood pressure
- a fast, irregular, or fluttery heartbeat
- a severe headache
- tightness or discomfort in the chest
- breathing problems
- hallucinations
- trembling or shaking
- convulsions (seizures)
- painful or difficult urination
Nasal decongestants: Interactions with other medications
Nasal decongestants may negatively interact with other medicines. If you are using any of the medicines or street drugs listed below, consult your doctor before you start taking decongestants:
- Monoamine oxidase inhibitors (MAO inhibitors) such as phenzeline (Nardil®) or tranylcypromine (Parnate®), used to treat depression and Parkinson's disease.
- caffeine
- tricyclic antidepressants like imipramine (Tofranil®) or desipramine (Norpramin®)
- the antidepressant maprotiline (Ludiomil®)
- amantadine (Symmetrel®)
- amphetamines
- cocaine
- insulin
- diet pills
- medicine to relieve asthma or other breathing problems
- methylphenidate (Ritalin®)
- appetite suppressants
- other medicine for colds, sinus problems, hay fever or other allergies
- beta-blockers such as atenolol (Tenormin®) and propranolol (Inderal®)
- digitalis glycosides, used to treat heart conditions
This is not an extensive list of drugs that may interact with decongestants in a dangerous manner, so please consult your doctor or pharmacist. Nasal decongestants may be over the counter medications, but that does not mean they are harmless. Also, if you are suffering from any of the conditions below, please consult your physician before using decongestants:
- Heart disease
- High blood pressure.
- Kidney disease.
- Glaucoma (increased blood pressure in the eye)
- Thyroid disease.
- Diabetes.
- Trouble urinating due to an enlarged prostate gland
How to take decongestants
Decongestants are sold as tablets, nasal sprays, capsules, liquids or nasal drops. They can come combined with other medicines for allergies or cold treatment, designed to treat more than one symptom. When buying decongestants, you must decide whether to take prescription or nonprescription (over-the-counter) products. Base this decision on your physician’s or pharmacist’s advice. Commonly used decongestants are those containing oxymetazoline (Afrin® and other brands) and pseudoephedrine (Sudafed®, Actifed®, and other brands). Oxymetazoline can also be used in eye drops to relieve redness and itching.
Most nasal spray decongestants act almost immediately (within 10 minutes), and reduce nasal congestion for up to 12 hours. But keep in mind that they only affect the nose and sinuses, and can have side effects mentioned above.
Oral decongestants must be swallowed and absorbed .They start working in about an hour or two, and reduce nasal congestion for up to 24 hours. They are the form to use if you need to relieve symptoms for more than a few days. The following chart shows you the positive and negative sides of different types of decongestants.
Type of Decongestant
Good Side
Bad Side
Nasal spray/drops
- Relieves symptoms immediately
- Delivered directly to the nose
- Easy to use
- Relieves symptoms right after allergy exposure
- Limited use
- Easily overused
- Rebound effect
Oral tablets
- Relieves symptoms for longer periods of time
- Takes an hour or more to show any effect
- Restlessness, nervousness, insomnia
- Not advised for patients suffering from heart problems, diabetes, enlarged prostate, high blood pressure, nursing mothers, or those taking beta-blockers
For different forms of decongestants there are different recommended dosages. Consult your physician or a pharmacist for the right dosage, and always take the medicine exactly as directed.
Special conditions
People on other medicines or people with any kind of chronic health problem could have difficulties taking decongestants, and should consult their physician beforehand.
Pregnancy
Pseudoephedrine, the active ingredient in decongestants, is a substance in the risk category for pregnant women. Studies have confirmed an increased risk of premature termination pregnancy or birth defects in laboratory animals, but it is not known whether such effects occur in humans. Don’t take that chance!
Breastfeeding
Decongestants with pseudo-ephedrine can be used by breastfeeding women because this substance is secreted into the breast milk in very low doses. However, pseudo-ephedrine is believed to decrease the milk supply, so if using decongestants with this substance, you should take more fluid to compensate for this side effect. Decongestants not based on pseudo-ephedrine can sometimes be passed into breast milk, and have side effects on the baby. So, breastfeeding women should consult their doctor before using any type of decongestant. If it’s absolutely necessary to take the medicine, the baby should be bottle-fed.
Children
Substances contained in decongestants are closely related to the hormone adrenaline, and sometimes can make children jittery. Small children and infants are very sensitive to this effect. Children under 6 months of age should not take any type of decongestant. Older children should take only decongestants specially made for kids, and take them only as directed. Doctors recommend decongestants in nasal spray form rather than oral decongestants, because they treat a limited area of the body and the side effects are drastically decreased.
Elderly
It is believed that older people are more likely to feel adverse side effects when taking decongestants. Patients over 60 should be very careful using drugs that contains pseudo-ephedrine. They must consult their doctor, and it is generally recommended to use only the short-acting forms to reduce potential side effects.