Decongestant medications are used to provide relief from a stuffy nose (congestion) or runny nose (rhinorrhea). These symptoms are usually produced due to allergic responses or upper respiratory infections. When congestion or rhinorrhea occur, oral or nasal spray delivery of decongestant medications can provide some relief.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Pseudoephedrine hydrochloride and pseudoephedrine are over-the-counter medications that have potent activity as decongestants. The method of action is similar to those produced by adrenaline for “fight-or-flight” responses, also indicated in it belonging to the amphetamine class of chemicals. This activity produces vasoconstriction (blood vessels become smaller) in the lining of the upper respiratory tract. This, in turn, decreases the production of fluids and mucus by the cells lining the nose, throat and sinuses. The most notable formulation of this medication is Sudafed.
- Pseudoephedrine hydrochloride and pseudoephedrine are over-the-counter medications that have potent activity as decongestants.
- The method of action is similar to those produced by adrenaline for “fight-or-flight” responses, also indicated in it belonging to the amphetamine class of chemicals.
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Phenylephrine is marketed as a substitute for pseudoephedrine. The proposed method of action is also by production of an adrenaline response. However, due to more selective targeting of the drug, it is proposed to avoid some common adverse reactions associated with pseudoephedrine. Although phenylephrine was approved in 1976 by the FDA, controversial studies in 2006 and two others in 2009 found insufficient activity for phenylephrine as a decongestant to distinguish it from a placebo. Formulations with phenylephrine include Sudafed PE, PediaCare, Triaminic Thin Strips and Vicks Sinex nasal sprays.
- Phenylephrine is marketed as a substitute for pseudoephedrine.
- Although phenylephrine was approved in 1976 by the FDA, controversial studies in 2006 and two others in 2009 found insufficient activity for phenylephrine as a decongestant to distinguish it from a placebo.
Oxymetazoline is available over the counter in nasal spray and eye drop formulations. Oxymetazoline works quickly, and by acting directly on the affected areas, it typically has fewer side effects than oral decongestion medications. The method of action is also by modifying adrenaline responses, thereby producing vasoconstriction. Oxymetazoline formulations for nasal sprays include Afrin, Dristan, Vicks Sinex and Mucinex Full Force. Visine LR is an eye formulation.
- Oxymetazoline is available over the counter in nasal spray and eye drop formulations.
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- InformedHealth.org. Treating acute sinusitis. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Updated October 18, 2018.
- Barshak MB, Durand ML. The role of infection and antibiotics in chronic rhinosinusitis. Laryngoscope Investig Otolaryngol. 2017;2(1):36-42. doi:10.1002/lio2.61
- MedlinePlus. Pseudoephedrine. Updated February 5, 2020.
- MedlinePlus. Phenylephrine. Updated February 5, 2020.
- MedlinePlus. Oxymetazoline nasal spray. Updated February 5, 2020.
- Deckx L, De Sutter AI, Guo L, Mir NA, van Driel ML. Nasal decongestants in monotherapy for the common cold. Cochrane Database Syst Rev. 2016;10(10):CD009612. doi:10.1002/14651858.CD009612.pub2
- Malone M, Kennedy TM. Review: Side effects of some commonly used allergy medications (decongestants, anti-leukotriene agents, antihistamines, steroids, and zinc) and their safety in pregnancy. Int J Aller Medications. 2017;3:024. doi:10.23937/2572-3308.1510024
- CardioSmart, American College of Cardiology. Phenylephrine. Updated December 15, 2010.
- National Health Service (UK). Decongestants. Updated February 28, 2019.
Dr. Bob Goat is a health and fitness writer. His research experience includes embryology, immunodiagnostics, genetic engineering and stem cells with expertise in gene and protein expression modification and embryonic development. He has had work published in academic journals, presented research at several national and international conferences and received numerous awards. He has a Ph.D. in medical science.