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Over-the-counter (OTC) sinus decongestants may be able to offer temporary relief from your symptoms. They have different formulas and uses, so read the labels to make the best choice.

If you’re having trouble breathing due to cold, flu, or allergies, sinus decongestants are designed to relieve your symptoms and help you carry on with your day.

These medications are available OTC at affordable prices, but that doesn’t always make it easy to choose one that’s best for you.

Some stronger medications target multiple symptoms, while others will simply relieve a stuffy nose caused by allergies. Some may make you drowsy, while others might make sleep difficult.

We rounded up the best OTC decongestants to help make the decision making process easier.

Having a basic understanding of common decongestant types might help you narrow down what kind of product you’re looking for:

  • Decongestant ingredients work by dilating your blood vessels to relieve pressure in your sinuses.
  • Antihistamine ingredients work by blocking your body’s response to allergens.
  • Corticosteroid ingredients work by reducing your immune response to allergens and decreasing inflammation.
Decongestant typeBest forPossible side effects
Phenylephrine decongestantsinus congestion caused by cold and flurestlessness, dizziness, anxiety
Pseudoephedrine decongestantsinus congestion caused by cold and flurestlessness, dizziness, anxiety, nausea, upset stomach
Intranasal decongestantssinus congestion caused by cold and flurestlessness, dizziness, sore throat, bloody nose
Intranasal corticosteroidshay fever and allergiesheadache, sore throat, bloody nose
Antihistaminessneezing and runny nosedrowsiness
  • Customer reviews: We chose products that scored high marks in trust with customers, according to hundreds of verified reviews.
  • Transparency: We looked for products and brands that make realistic, medically-sound claims about their products.
  • Clinical trials and peer-reviewed literature: We read through what doctors and researchers have observed about different active ingredients available on the market.

Pricing guide

  • $ = under $5
  • $$ = $5–$10
  • $$$ = over $10

Best OTC sinus decongestant for allergies

Benadryl Allergy Plus Congestion Ultratabs

  • Price: $$
  • Type: oral tablet
  • Drowsy effect: yes

What we liked: These tablets contain diphenhydramine, an antihistamine ingredient that may reduce allergy symptoms, and phenylephrine, which may reduce sinus congestion. You can take one of these tablets every 4 hours throughout the day, and reviewers note that they take effect relatively quickly.

What to know: These tablets aren’t intended to clear the flu or a cold, so it’s important to only take them if your sinus congestion occurs due to allergies. Also, be aware that diphenhydramine can make you feel quite sleepy, so avoid this medication on days when you need to be alert.

Best OTC sinus decongestant for a headache

Advil Sinus Congestion and Pain

  • Price: $$$
  • Type: oral tablet
  • Drowsy effect: no

What we liked: These coated tablets contain the decongestant ingredient phenylephrine along with the pain reliever ibuprofen. You can take a tablet up to every 4 hours. The combination of nasal swelling relief, along with the pain relief medication, can quickly relieve many sinus-related headaches. Many reviewers who have frequent sinus headaches swear by this product as being better than even some prescription medications.

What to know: Make sure to keep track of the amount of ibuprofen you’re taking if you’re taking this product. Do not take additional pain relievers, like acetaminophen or aspirin, with this product unless a doctor instructs you to. It’s easy to end up taking a dose that’s higher than recommended of analgesics when you’re mixing medications.

Best OTC sinus decongestant nasal spray

Afrin No Drip Severe Congestion

  • Price: $$$ (twin pack)
  • Type: nasal spray
  • Drowsy effect: no

What we liked: Nasal sprays like Afrin can shrink swollen nasal passages by directly applying an active ingredient to your sinuses. The advantage of this can be that sprays tend to work more quickly than tablets or liquid decongestants. Afrin’s spray contains oxymetazoline hydrochloride and menthol, which relax and refresh your nasal passages pretty much right away, according to reviewers.

What to know: Afrin should only be used temporarily to relieve sinus congestion. Rebound stuffiness can occur in as little as 3 days. Using nasal sprays for a long duration can lead to side effects.

Best OTC sinus decongestant for kids

Little Remedies Decongestant Nose Drops

  • Price: $$
  • Type: nose drops
  • Drowsy effect: no

What we liked: These dye-free drops contain phenylephrine in a dosage that’s safe for kids 2 and up. The dropper-dose formula can be applied 2 to 3 drops at a time directly to nasal passages, which makes for fast relief. (No waiting for tablets to kick in at bedtime). This decongestant can work for symptoms of a cold or flu, or it can be used to help manage congestion caused by allergies.

What to know: It can be difficult to get little ones to sit still and have the drops applied into their noses. You may have better luck putting the formula in a spray-mist bottle or another mist-based bottle to help apply it into their noses.

Best OTC decongestant day/night duo

Sudafed PE Day and Night Sinus Pressure Tablets

  • Price: $$
  • Type: oral tablet
  • Drowsy effect: daytime formula is nondrowsy; nighttime formula has drowsy side effects

What we liked: These tablets contain phenylephrine for sinus congestion relief during the daytime and an additional antihistamine ingredient for nighttime use. These ingredients can treat environmental allergies and congestion caused by the common cold. There are 12 tablets meant for daytime use and 8 that you can take at night, which means you can take a few extra tablets during the day if you need to, but stick to one right before bedtime once you’re ready to sleep.

What to know: There’s no pain relief ingredient included in either the day or nighttime formulas of these tablets. That means that if you have a headache and treating your sinus pressure doesn’t give you relief, you might still find yourself reaching for acetaminophen at the end of the day.

Best OTC sinus decongestant on a budget

Cabinet Nasal Decongestant Tablets

  • Price: $$$
  • Type: oral tablet
  • Drowsy effect: no

What we liked: This mega-size container of 225 tablets is a great solution if multiple people in your family tend to get allergies or sinus headaches. The no-frills phenylephrine formula is comparable to the dosage you’d find in a name brand but at a fraction of the cost. The formula doesn’t contain anything that will make you sleepy, and you can take a tablet every 4 hours on days when symptoms affect you.

What to know: Some customers complained that the bottle is too large to fit in their medicine cabinet, which seems like a small complaint for a product if you’ll be using it often. This particular tablet only targets sinus congestion, so it will not relieve symptoms like fever or a cough.

Best OTC decongestant for bedtime

Mucinex Nightshift Cold and Flu Liquid

  • Price: $$$
  • Type: liquid
  • Drowsy effect: yes

What we liked: This liquid formula contains a pain reliever, a cough suppressant, and an antihistamine ingredient that can work together to give you a good night’s sleep when you’re sick. It does not contain any decongestant, however, so keep that in mind when taking this treatment. It’s great for bedtime because it calms coughing fits that may be keeping you up at night. Although it does not contain a decongestant, the antihistamine ingredient may also reduce nasal congestion caused by seasonal allergies.

What to know: Unlike the other decongestants on this list, this product doesn’t contain anything that loosens mucus. Some reviewers note that they really dislike the taste of this medication.

DecongestantBest forPriceTypeDrowsy effect?
Benadryl Allergy Plus Congestion Ultratabsallergies$$oral tabletyes
Advil Sinus Congestion and Painheadache$$$oral tabletno
Afrin No Drip Severe Congestionnasal spray$$$ (twin pack)nasal sprayno
Little Remedies Decongestant Nose Dropskids$$nose dropsno
Sudafed PE Day and Night Sinus Pressure Tabletsday and night use$$oral tabletdaytime formula: no, nighttime formula: yes
Cabinet Nasal Decongestant Tabletslarge supply on a budget$$$oral tabletno
Mucinex Nightshift Cold and Flu Liquidbedtime$$$liquidyes

When you’re figuring out which decongestant to buy, you’ll need to determine what’s causing your congestion.

If it’s allergies, you’ll probably want a product that contains an antihistamine ingredient like diphenhydramine. Antihistamines target your body’s immune response to allergens like pollen. Antihistamines usually make the person taking them a bit drowsy, so keep in mind, taking them at any time other than bedtime may have you needing a nap.

If you have cold or flu symptoms, you may be looking for a product that includes phenylephrine or pseudoephedrine. These ingredients work by shrinking your blood vessels, which can help you breathe more easily and reduce the symptoms of a sinus headache or a stuffy nose.

However, both of these ingredients can cause you to feel restless and can make it difficult to fall asleep. These types of drugs can also make you nauseous. Generally, phenylephrine may have fewer serious side effects than pseudoephedrine. Always consult a doctor before taking these meds if you are pregnant or breastfeeding.

Some OTC sinus decongestant formulas include both antihistamines and decongestant ingredients, and some add pain relief ingredients such as ibuprofen to their formula. It’s best to treat for symptoms that you have, not for additional symptoms that you don’t have.

If you’re already taking OTC pain relief medication for, say, a sinus headache, you don’t want to add additional pain relief meds into the mix if you don’t need to.

It’s difficult to keep track of dosage when you’re mixing medications that have overlapping active ingredients, and too much of any pain reliever can lead to complications like stomach issues, rebound headaches, and kidney damage.

Treating your congestion with OTC products doesn’t always provide relief. Get professional medical care if you experience any of the following:

  • persistent congestion that lasts for a week or more
  • a high fever that lasts for more than 48 hours
  • chest pain of any sort
  • difficulty breathing

There are also home remedies that you can use to relieve discomfort and clear your congestion. Natural decongestion remedies include:

  • sleeping with a humidifier in your room
  • diffusing essential oils
  • using saline sprays
  • taking steamy showers
  • using a neti pot

When should I use a nasal decongestant?

If you have mild congestion caused by cold, flu, or seasonal allergies, you may want to consider an OTC nasal decongestant. This can help clear up your nasal passages and help you breathe more easily.

You don’t have to take a decongestant as part of your at-home treatment routine. Once your infection clears away or your allergies aren’t triggered, the congestion will clear up on its own.

Can or should I take a sinus decongestant for a sinus infection?

You can take certain decongestants for a sinus infection.

Decongestants that contain only pseudoephedrine or phenylephrine are more typically recommended for a sinus infection. Decongestants with additional ingredients like antihistamines may suppress your body’s immune response and interfere with your body’s ability to clear the infection.

If you have a severe sinus infection or if you’re taking antibiotics, talk with your doctor about the best OTC medication choice for you.

Do sinus decongestants work for ear congestion?

Sinus decongestants can work to relieve pressure in the upper sinus cavities. If you have ear congestion, relieving this pressure can help manage your pain. But sinus decongestants can’t treat an underlying ear infection.

Is it safe to take sinus decongestants while pregnant?

It depends on the active ingredient. OTC pseudoephedrine and phenylephrine should only be taken during pregnancy under your doctor’s supervision. They should not be taken during the first trimester, only after, and even then, only with your doctor’s recommendation.

Talk with your doctor before taking drugs containing these ingredients if you are pregnant or plan to become pregnant. Research in animals has shown adverse effects on the fetus when the birthing parent takes these drugs. There haven’t been enough studies with humans to be certain how the drug might affect the fetus. These drugs should only be taken if the potential benefit justifies the potential risk.

Can you take sinus decongestants if you have high blood pressure?

Phenylephrine is not considered to be safe if you have high blood pressure. Sinus decongestants that contain pseudoephedrine may actually raise your blood pressure and counteract the blood pressure medication that you’re taking. If you have high blood pressure, speak with your doctor about which decongestant they recommend for you.

The best way to choose an OTC decongestant is to look at the active ingredients. A good decongestant should treat only the symptoms you have, and not any additional symptoms you don’t have.

OTC decongestants are not a solution for severe, long lasting sinus infections and chronic allergies. You may need to speak with your doctor about a long-term strategy if you find that OTC decongestants aren’t effectively managing your symptoms.