Decongestants are medications that provide temporary relief for a blocked or stuffy nose. People can take decongestants to alleviate nasal congestion from upper respiratory infections and allergies.
This article describes what decongestants do, and outlines research investigating their effectiveness.
We also list different types of decongestant medication and give tips on how to alleviate congestion in adults, children, and infants.
Nasal decongestants are a type of medication that reduces nasal swelling and congestion. They are available in oral forms and topical ones that a person can apply inside the nostrils.
Nasal decongestants may also be useful for relieving stuffy ears.
People may take decongestants to help treat congestion that they associate with the following:
- upper respiratory infections (URIs), such as the common cold, and flu
- allergic rhinitis, or hay fever
- nasal polyps
According to the American Academy of Pediatrics, decongestants reportedly reduce blood flow to the sinuses, thereby reducing swelling and opening up the nasal passages.
Though many people use decongestants to alleviate nasal congestion, there is no strong evidence that these medications are very effective.
A 2016 review reanalyzed data from 15 studies investigating whether popular decongestants were effective in treating nasal congestion from the common cold.
The study concluded that decongestants might provide a small benefit for nasal congestion in adults. However, studies that found such an effect mainly relied on participants’ subjective feedback about their symptoms.
The authors also raised concerns about the legitimacy of the findings. Of the 15 studies included in the review, nine received funding from companies that make decongestants. The funding sources of the remaining six studies were unclear.
Given the above, the researchers were unable to reach any firm conclusions about the effectiveness of single or multiple use decongestants.
There are different types of decongestant medications available. Each has slightly different ingredients, and each may produce different side effects.
Decongestant types include:
Phenylephrine is a type of nasal decongestant in over-the-counter (OTC) medications, such as Sudafed PE.
Phenylephrine is available as a standalone medication, or as part of a multidrug combination.
A 2015 clinical trial investigated the efficacy of phenylephrine in treating congestion in people with allergic rhinitis. The study found that phenylephrine was no more effective than a placebo.
An earlier study from 2009 found no significant difference between a single dose of phenylephrine vs. a placebo for alleviating nasal congestion. The study also showed that phenylephrine has no significant effect on other symptoms of common colds or URIs.
Some potential side effects of phenylephrine include:
- increased nasal discharge
Phenylephrine may cause additional issues for people with some medical conditions, and those taking certain prescription medications.
People are best to talk to their doctor before taking any medications containing phenylephrine.
Pseudoephedrine is a nasal decongestant available as a standalone product or as part of a multidrug combination.
- requires people to present ID when buying products containing pseudoephedrine
- requires retailers to log the amount of pseudoephedrine a person buys for at least 2 years
- limits the amount of pseudoephedrine a person can buy each month
It is not clear how effective pseudoephedrine is at alleviating nasal congestion.
An older study from 2009 found that pseudoephedrine was significantly more effective at alleviating nasal congestion than a placebo. However, a 2016 review notes that large scale, quality trials are necessary to determine pseudoephedrine’s efficacy as a decongestant.
Some potential side effects of pseudoephedrine include:
People with the following conditions should talk to their doctor before taking any medication that contains pseudoephedrine:
Intranasal decongestants, or “nasal sprays,” are a type of decongestant medication that a person applies directly inside the nose. These medications may reduce the risk of cardiovascular effects that doctors associate with oral decongestants.
Some potential side effects of nasal sprays include:
- dryness in the nose or throat
- rebound congestion, or chronic congestion from overuse of nasal decongestants
To reduce the risk of rebound congestion, a person can use decongestant nasal sprays for only a few days at a time.
Intranasal corticosteroids are medications that reduce swelling and excess mucus production in the nasal passages that result from inflammation, often allergic.
These medications are available as a nasal spray that people can apply directly inside the nostrils.
Though typically safe for short term use, long term use can increase the risk of the following side effects:
- stinging or burning sensations in the nose
- redness, swelling, or itching inside the nose
- dryness or crustiness within the nasal passages
- dryness or irritation of the throat
- an unpleasant taste in the mouth
There are many types of antihistamine. Examples include:
Antihistamines are available in various forms. Some cause drowsiness, whereas others are nondrowsy.
Though generally safe for adults, parents and caregivers should talk to a doctor before giving antihistamines to children.
According to the National Capital Poison Center (NCPC), taking too many antihistamines can result in an overdose. A person should always ensure that they read medication labels carefully to avoid taking too much of a particular one.
A person who experiences nasal congestion due to allergies may benefit from taking an antihistamine or nasal corticosteroid.
Otherwise, there is insufficient evidence to show that other types of decongestants are effective in alleviating nasal congestion. Nonetheless, a person may want to see if a particular decongestant works for them.
Some decongestants are not suitable for people with certain medical conditions. Others may interact with medications a person is taking.
It is important that an individual sees their doctor before taking a decongestant medication. A doctor can provide advice on the safest and most effective one to use.
A person should talk to their doctor before giving a child a decongestant or any medication for an allergy or URI.
The Food and Drug Administration (FDA) advise parents and guardians to avoid giving decongestants or antihistamines to children under two years of age. Many manufacturers extend the warning to children of 4 years of age and younger.
An issue with giving these medications to children is that they often contain multiple ingredients. Parents or guardians may accidentally give the child too much of a particular drug, which can result in poisoning.
The FDA recommend the following for alleviating congestion and other cold symptoms in children:
The FDA warn that a person should not give any decongestant or medication containing antihistamine to any child under two years. Children under 2 years of age can develop serious and potentially life threatening complications as a result of taking these medications.
The NCPC state that cough and cold medications are not suitable for children aged 4 years or younger. Similarly, they say certain cough and cold medications are not suitable for children below 12 years of age.
The NCPC say there is no evidence that decongestants and other cough and cold medications are effective in young children.
Furthermore, these medications can have potentially lethal side effects in children, including:
Saline nasal drops and cool mist humidifiers are suitable options for alleviating congestion in babies.
Decongestants are medications that reportedly reduce nasal swelling and excess nasal mucus. However, there is insufficient good quality scientific evidence to support their effectiveness.
Adults should use decongestants with caution. Certain types can cause potentially dangerous side effects in people with certain health conditions, and those taking certain medications. A person should talk to their doctor before taking a decongestant for the first time.
Decongestants are not suitable for children below 2 years of age. Some are not suitable for children below 12 years of age. A person should talk to their doctor before giving a child a decongestant or any other type of medication for colds, flu, or allergies.