A nasal decongestant is a medication that helps reduce swelling in the nasal and sinus tissues so that they produce less mucus. Depending on the strength of the agent used, these drugs can have a minor to significant effect on nasal congestion. There are many medications classed as nasal decongestants and they have different modes of application. Some are applied directly in the nose via sprays and others are taken orally. Most decongestant medicines are available in over the counter formulations, but a few are prescription only.
These medicines provide some beneficial effect because they act as vasoconstrictors. This means they narrow blood vessels, which helps calm inflamed nasal tissues and reduces mucus production. When the nasal decongestant is directly applied to nasal passages, via spraying or inhalation, the rest of the body is minimally affected by vasoconstriction. When decongestants are taken orally, they may have a more significant effect on the rest of the body, and since many of them can cause symptoms like excitation or racing heart, their use is not appropriate for all people. Those obtaining over the counter oral or spray decongestants should carefully read labels or consult with a pharmacist if they take medications or have any medical conditions.
Some of the common over the counter compounds that are in nasal decongestant medicines include pseudoephedrine, phenylephrine, and oxymetazoline. The first two are often used orally, and the last is available in nasal sprays. There are some controversies regarding use of these medicines and others not listed. Pseudoephedrine can be synthesized into street drugs because of its relationship to amphetamines, and some countries now only allow purchase of it at pharmacy counters to avoid people stockpiling the drug for illegal use.
Oxymetazoline and other nasal decongestant sprays receive significant criticism. Most decongestant nasal sprays are only suggested for use for a couple of days at a time. Using them more can actually reverse effects and create rebound congestion. Some people simply use more nasal spray to cope with this and end up with nasal spray addiction, which is hard to treat. Congestion resulting from overuse of topical nasal sprays can become severe.
Doctors usually recommend against nasal decongestant spray use, but they also may advise people to use oral decongestants in limited ways. In addition to causing vasoconstriction, many of these medicines have a drying effect on the sinuses, which doesn’t promote healing. Physicians could especially advise limiting use of decongestants during colds or flus, as it might actually extend an illness. Nevertheless, many people do find use for these medicines when ill, though very severe congestion isn’t always completely relieved through their use.
It’s worth noting that nasal decongestant medicines may be combined with other medications. Sometimes antihistamines and decongestants are sold together. Alternately, a decongestant could be combined with expectorants, cough suppressants, and/or pain relievers. Again, it’s advised these be used in limited fashion, as they may provide brief relief from symptoms, but could extend the time a person is ill.