The Asthma Center


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.


Brand Name Decongestant Mucolytic/Expectorant
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
Entex PSE®
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
Pseudovent™ PED
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:

  • Nervousness
  • Tremor
  • Palpitations
  • Insomnia
  • Decreased appetite
  • Fast heart rate
  • Increased blood pressure
  • Urinary retention in males with enlarged prostate

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.