Decongestants

Decongestants Overview

Decongestants relieve a stuffy nose, one of the most common and bothersome allergy symptoms. Antihistamines help most with sneezing, itching and a runny nose but do little for congestion, which is why decongestants are often used alongside them (ACAAI).

How Do Decongestants Work?

Allergies make the nose produce extra mucus and cause the nasal tissues to swell, which blocks airflow. Decongestants narrow the blood vessels in the nose, shrinking the swollen tissue so air can pass more easily (ACAAI).

Types of Decongestants

Decongestants come as pills, liquids, nose drops and nasal sprays. Oral decongestants are sold with and without a prescription and are often combined with antihistamines or other ingredients (ACAAI).

• Nasal sprays work within minutes and last for hours, but don’t use them for more than 3 days. Longer use can cause rebound congestion (MedlinePlus).
• Oral pills: pseudoephedrine is a common option. In November 2024 the FDA proposed removing oral phenylephrine from OTC decongestants because it isn’t effective when taken by mouth; as of October 2026 that proposal is not yet final (FDA).
• Other options for congestion include nasal steroid sprays and nasal antihistamines (FDA).

Common decongestant ingredients include pseudoephedrine (oral), and oxymetazoline and phenylephrine nasal sprays. Read the Drug Facts label to see which active ingredient a product contains.

Benefits

Decongestants offer fast, temporary relief from a stuffy nose caused by:

• sinusitis
• rhinitis
• common cold
• hay fever
• allergic rhinitis with sinus pressure
• other seasonal allergies
• chronic allergic reactions
• stuffy nose due to cold
• inflammation of the nose due to allergies

Decongestants relieve congestion only; they don’t treat other allergy symptoms (ACAAI). For ongoing allergy congestion, nasal steroid sprays are usually the most effective long-term option (ACAAI).

Side Effects

While decongestants are useful to treat stuffy nose, it might still show several side effects, including:

• anxiety
• insomnia
• rebound congestion
• dizziness
• high blood pressure
• restlessness
• headache
• tremors
• loss of appetite
• urinary retention

Some people may experience side effects similar to that of an irritant, including:

• burning
• dryness
• local irritation
• sneezing
• stinging

If you have high blood pressure, heart disease, an overactive thyroid, diabetes, glaucoma or an enlarged prostate, or are pregnant, check with your doctor before using a decongestant (ACAAI). For children, the FDA does not recommend OTC cough and cold medicines under age 2, and manufacturers label them “do not use in children under 4” (FDA).

Precautions of Decongestants

• Oral decongestants can cause insomnia, especially if taken in the afternoon or evening, and may raise heart rate or blood pressure (ACAAI).
• People with medical conditions such as overactive thyroid gland, hypertension, prostate diseases, pregnancy, and heart diseases should avoid using pseudoephedrine.
• Don’t use decongestant nasal sprays for more than 3 days (MedlinePlus).
• Certain drugs such as linezolid and monoamine oxidase inhibitors have a greater tendency to react with decongestants and cause a severe reaction. Therefore, people using these drugs should avoid using a decongestant.
• It is advised to drink more amounts of fluids, especially water, when taking a decongestant and other medications for seasonal allergies.
• Always read the Drug Facts label, don’t combine products with the same ingredients, and ask a pharmacist if you take other medicines.

Conclusion

Decongestants offer quick, short-term relief from a stuffy nose due to allergies or colds. Use nasal sprays for no more than 3 days, check with your doctor if you have heart or blood pressure problems, and consider nasal steroids for ongoing allergy congestion. See also nasal sprays and spring allergies.

---

Written by: Madiha Ather Hashmi (June 25, 2020)

This article is for general education and is not medical advice. Talk with your doctor or pharmacist about your symptoms and before starting, stopping, or combining any medicine.

What actually helps

We may earn a commission from qualifying purchases. Learn more.

HEPA air purifier & filters

A portable HEPA purifier sized to the room can lower airborne particles such as pollen and dust; it only works if you replace filters on schedule. (EPA: Guide to Air Cleaners in the Home)

See the Levoit Core 300 on Amazon

Saline nasal rinse kit

Rinsing with saline can clear pollen from the nose; use distilled, sterile or boiled-then-cooled water, never plain tap water. (FDA: Is rinsing your sinuses with neti pots safe?)

See the NeilMed Sinus Rinse kit on Amazon

Dust-mite pillow & mattress covers

Allergists recommend zippered, allergen-proof encasings for pillows, mattresses and box springs, plus hot-water washing of bedding. (ACAAI: Dust Allergy)

See Hospitology zippered pillow encasements on Amazon

Decongestant FAQs

How long can I use a decongestant nasal spray?

No more than 3 days, to avoid rebound congestion (MedlinePlus).

Does phenylephrine work?

The FDA proposed removing oral phenylephrine in 2024 because studies show it isn’t effective by mouth. The proposal isn’t final yet, and nasal-spray phenylephrine isn’t affected (FDA).

Can kids take decongestants?

The FDA doesn’t recommend OTC cough and cold medicines for children under 2, and labels say not to use under 4 (FDA).

Are decongestants safe with high blood pressure?

Check with your doctor first; decongestants can raise blood pressure (ACAAI).

Sources

Looking for more treatment options? Find a full list of other seasonal allergy treatment options here.