Decongestants are effective for controlling symptoms of nasal and sinus congestion. Swollen, inflamed mucous membranes cause congestion. Decongestants constrict the blood vessels in swollen mucous membranes. This constriction makes tissues shrink and decongest because constricted blood vessels allow for less fluid to leak into the inflamed tissues.
Decongestants are available as nasal sprays, tablets, capsules and liquids. Nasal decongestants (nasal sprays) are sprayed directly into the nose. They may relieve congestion without many systemwide side effects. However nasal decongestants cannot be used for more than 3 – 5 days due to “rebound” nasal congestion. “Rebound” nasal congestion occurs when turbinate swelling returns quickly or “rebounds” following frequent use of nasal decongestants. A vicious cycle of repetitive use of these sprays to treat rebound nasal congestion makes it difficult to stop using these sprays. Nasal decongestant sprays can be purchased over the counter. Some well known brands include: Afrin®, Neo-Synephrine® and 4-Way® Nasal Spray.
Decongestant tablets, capsules and liquids are available over the counter and by prescription. They are often combined with other active ingredients such as pain medicines, antihistamines and mucous thinners. Some common over the counter brands containing decongestant combinations include: Advil® Cold and Sinus, Claritin D®, Dimetapp®, Sudafed®, Triaminic® and Tylenol® Sinus. Frequently prescribed products containing decongestants include: Allegra-D®, Entex® PSE, Extendryl®, guaifenesin/pseudoephedrine, Pseudovent™ PED, Semprex®-D, Zyrtec-D® and Clarinex D®. Some common decongestants are listed below.
|Deconsal® II (Carolina)||phenylephrine 20mg||guaifenesin 375mg|
|Deconsal® II (Celltech)||pseudoephedrine 60mg||guaifenesin 600mg|
|Dimetapp® Decongestant Pediatric Drops (OTC)||pseudoephedrine 7.5mg/0.8mL|
|Dimetapp® Extentabs (OTC)||pseudoephedrine 120mg|
|DuraTuss® Tablets||pseudoephedrine 120mg||guaifenesin 600mg|
|DuraTuss® GP Tablets||pseudoephedrine 120mg||guaifenesin 1200mg|
|Entex LA®||phenylephrine 30mg||guaifenesin 600mg|
|Entex Liquid®||phenylephrine 7.5mg/5mL||guaifenesin 100mg/5mL|
||pseudoephedrine 120mg||guaifenesin 600mg|
|Guaifed® capsules||phenylephrine 15mg||guaifenesin 400mg|
|Guaifed-PD® Capsules||phenylephrine 7.5mg||guaifenesin 200mg|
|Mucinex® D||pseudoephedrine 60mg||guaifenesin 600mg|
|Nasatab® LA Tablets||pseudoephedrine 120mg||guaifenesin 500mg|
|Profen Forte®||pseudoephedrine 90mg||guaifenesin 800mg|
|Prolex®-D Tablets||phenylephrine 20mg||guaifenesin 600mg|
|Prolex®-PD Tablets||phenylephrine 10mg||guaifenesin 600mg|
|Pseudovent™||pseudoephedrine 120mg||guaifenesin 250mg
||pseudoephedrine 60mg||guaifenesin 300mg|
|Robitussin®||pseudoephedrine 30mg||guaifenesin 100mg/5mL|
|SINA®-12X||phenylephrine 25mg||guaifenesin 200mg|
|SINA®-12X Suspension||phenylephrine 5mg/5mL||guaifenesin 100mg/5mL|
|Sudafed® Children’s Nasal Decongestant Chewables (OTC)||pseudoephedrine 15mg|
|Sudafed® Children’s Nasal Decongestant Liquid (OTC)||pseudoephedrine 15mg/5mL|
|Sudafed® Nasal Decongestant Tablets (OTC)||pseudoephedrine 30mg|
|Sudafed® 12Hr Tablets (OTC)||pseudoephedrine 120mg|
|Sudafed® 24Hr Tablets (OTC)||pseudoephedrine 240mg|
|Zephrex LA®||pseudoephedrine 120mg||guaifenesin 600mg|
OTC = Over the counter
Risks and Precautions
Decongestants may cause several side effects including:
Decongestants should be avoided if you have uncontrolled high blood pressure, prostate enlargement, overactive thyroid conditions, or insomnia. Decongestants can be used if you have controlled high blood pressure; however blood pressure should be monitored frequently when you begin taking decongestants. You should avoid decongestants if you have a history of recent strokes, severe heartbeat irregularities, or unstable angina. It is possible you may experience sleeplessness while taking decongestants. You can reduce this side effect by taking lower doses and/or shorter acting products early in the morning. If you are taking MAO inhibitors, you should avoid decongestants completely.
If you have experienced jumpiness, jitters, palpitations, or a racy feeling from decongestants, an oral tolerance induction program may help. This program involves a progressive slow dose increase, starting with very low doses given daily. The dose is gradually increased over 1 – 2 months. Eventually doses that achieve nasal and sinus decongestion can be reached without side effects. This tolerance usually remains effective while medicine is maintained on a daily basis. If you stop taking decongestants, the tolerance is lost and the program will need to be repeated.