Mercy Ear-Nose-Throat Specialist, Dr. Ileana Showalter, Discusses Over-the-Counter Decongestants For Colds

OTC (Over The Counter) decongestants are very effective at managing congestion associated with the common cold, sinusitis and allergies.  Neosynephrine and oxymetazoline (Afrin) are highly effective and have an onset of action of seconds.  They are not recommended to individuals with uncontrolled high blood pressure or heart problems.  They are not meant to be used more than three to five days in a row due to causing what we call a “rebound effect.”

In other words, you grow dependent on the medication for nasal decongestion.  The oral decongestants pseudoephedrine and phenylephrine do not cause this reaction and are very effective.  They have a slower onset of action, most of the time within minutes of taking the recommended dose.  Again, patients with heart disease and uncontrolled hypertension should consult their physicians prior to taking these meds. 

A second category of decongestants are the nasal steroid sprays like Flonase and Nasacort.  These need to be used of several days prior to seeing a significant effect in terms of decongestion.  You may want to consult with your physician as to the correct way of using the spray, since they can irritate your nasal membranes resulting in nosebleeds and ulcers.

--Dr. Ileana Showalter, Otolaryngology, Mercy Medical Center