OTC Decongestants

Decongestants, Oral

The two main types of decongestants available in OTC medications you take by mouth are phenylephrine and pseudoephedrine. They are available alone, but often you will find them in combination cold & flu and allergy medications, as tablets and in liquid form.

Both of these medications help decrease the amount of fluid the tissue in your nose releases which helps with your congestion. They do this partly by causing the blood vessels in your nose to constrict. This is why you should avoid these medications especially if you have high blood pressure or heart disease, since blood vessel constriction can make your blood pressure go higher, increasing your risk for a stroke, and can increase your risk of a heart attack.

When you take these decongestants, you may notice your heart rate is higher, you have problems sleeping, or you might feel more anxious when you take these medications as well. Make sure you check the Drug Facts label to see if these medications are right for you, or ask your doctor or pharmacist if you have any questions.

Although pseudoephedrine is available without a prescription, you will need to go to the pharmacy counter and show your ID to purchase it. The amount you can purchase is limited, although this may vary by state. This is because of a federal law that went into effect in 2006 to prevent pseudoephedrine from being used to make the illegal street drug methamphetamine.

Decongestants, Nasal Spray

Phenylephrine is also available as a nasal spray over-the-counter, along with oxymetazoline. In general, using a nasal spray will limit the side effects of these medications compared to taking them as tablets or pills. This is because the medication is mainly absorbed in your nasal area, but a small amount of the medication can drip in your mouth, and your blood circulation can carry some of the medication to the rest of your body.

These medications work as I described above for oral decongestants, so the same cautions should be taken. You should also note that you should not use these nasal sprays for more than three days in a row at a time. This is because you may develop something called “rebound congestion,” which means that your body gets used to having the medication in your nasal passage. Then when you stop using the spray, your nose gets congested again, even if you don’t have a cold anymore.


You’ll need to always read and follow the Drug Fact labels, and ask your doctor or pharmacist if you have any specific questions, especially if you are pregnant, have other medical conditions, or take other medications.


For more information see:

Go Back to OTC Quick Reference for Cold & Flu