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Decongestants offer temporary relief from discomfort, but a common ingredient was found to be ineffective. Here’s the lowdown and 8 products that do work.

If your nose is stuffed, your head is pounding, and you’re having trouble breathing due to a cold, the flu, or allergies, you want relief fast. Nasal decongestants are designed to ease your symptoms and help you carry on with your day.

They’re available over the counter (OTC) or behind the counter at relatively affordable prices. But that doesn’t always make it easy to choose one that’s right for you. For example, some stronger medications target multiple symptoms, while others simply relieve a stuffy nose caused by allergies. Some may make you drowsy, while others might make sleep difficult.

We’ve compiled a list of the best nasal decongestants for different goals and delivery methods to help you find what you need. But first, we explain what causes nasal congestion and how decongestant drugs work.

Although people often think nasal congestion is caused by excess mucus, it’s actually a result of swollen blood vessels in the tissues of your nasal passages. This swelling blocks airflow and may also cause mucus buildup, both of which can create a feeling of fullness and pressure in your nasal cavities (also known as your sinuses).

Congestion can result from infection from colds, flus, and sinusitis; nasal polyps; or irritants in your environment. Some medications, such as sedatives and beta-blockers, can cause nasal congestion. Pregnancy may even be the underlying culprit.

There are several products that can temporarily relieve nasal congestion by reducing blood vessel swelling and tissue inflammation. This helps increase airflow and flush mucus and, in turn, relieves pressure in your sinuses.

If you have nasal congestion that doesn’t clear up easily, talk with a healthcare professional. They can help you find out the cause and can recommend treatments to help.

Different decongestant drugs relieve nasal congestion in different ways. And some work better for some kinds of congestion than others.

It’s also important to note that some decongestant medications, such as those that contain the drug pseudoephedrine, may not be recommended for use if you have health conditions such as high blood pressure and glaucoma.

Here’s a basic overview of the drugs found in common OTC cold, flu, and allergy medications:

  • Decongestants narrow the blood vessels in your nasal passages, reducing swelling and sinus pressure. Two common decongestant drugs are phenylephrine and pseudoephedrine. Phenylephrine is no longer recommended in oral form.
  • Antihistamines block your body’s immune response to histamine, the chemical that triggers inflammation in your sinuses along with other symptoms, such as hives. While histamine is associated primarily with allergies, it’s also released in response to certain infections, such as the flu and the common cold.
  • Corticosteroids are steroids used to decrease inflammation of the lining of your nose and throat. For congestion, they’re typically used in nasal spray form, though they also come in oral form.
Decongestant type Best forFormPossible side effects
phenylephrinenasal congestion caused by cold and flunasal sprayrestlessness, dizziness, anxiety
pseudoephedrinenasal congestion caused by cold and flunasal spray, oral formrestlessness, headache, nausea
antihistaminessneezing and runny nose, coldsnasal spray, oral formdrowsiness
corticosteroidshay fever and allergies; may be useful for colds and flu, especially if sore throat is presentnasal sprayheadache, sore throat, bloody nose

A word about phenylephrine

Based on the Food and Drug Administration (FDA) position that oral phenylephrine is not effective for reducing congestion or other symptoms, we have eliminated our recommendations for products containing oral phenylephrine.

However, phenylephrine is considered safe and effective when used as an ingredient in nasal spray.

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Pricing guide

Prices for medications that relieve nasal congestion vary based on a number of factors, including the amount of medication and the type of decongestant. For the products recommended in this article, the price range is about $6–$35.

  • $: $5–$10
  • $$: $11–$20
  • $$$: more than $20

Best nondrowsy decongestant for allergies

Allegra Allergy

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

Allegra Allergy is a once-a-day antihistamine that is used to relieve nasal congestion, sneezing, and a runny nose. Its active ingredient is fexofenadine HCI. We like the ease of this once-daily product, especially if you have allergies or sensitivities to multiple irritants, such as pollen and dust mites.

What to know: Allegra Allergy is not meant for children. You should not use it if you have kidney disease or if you use aluminum or magnesium antacids. Do not take it with fruit juice.

Best decongestant nasal spray

Afrin No Drip Severe Congestion

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

Because nasal sprays like Afrin are directly applied to the nasal tissue, they work quickly to reduce inflammation there, providing fast relief.

Afrin’s spray contains oxymetazoline hydrochloride and menthol, which relax and open your nasal passages pretty much right away, according to reviewers.

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

Best nasal decongestant for kids

Little Remedies Decongestant Nose Drops

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

These dye-free drops contain phenylephrine in a dosage that’s safe for kids ages 2 years and up. The dropper-dose formula can be applied 2–3 drops at a time directly to nasal passages, which makes for fast relief (no waiting for oral medications 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 to apply the drops. You may have better luck putting the formula in a spray-mist bottle or another mist-based bottle to help apply it to their noses.

Best decongestant for indoor/outdoor allergies

Zyrtec Allergy

  • Price: $$$
  • Type: oral tablet
  • Drowsy effect: may cause mild drowsiness in some people

Zyrtec (cetirizine) is a second-generation antihistamine, which means it doesn’t cross the blood-brain barrier. That’s why it won’t cause severe sedation or drowsiness.

Zyrtec is taken once a day to relieve nasal congestion and other allergy symptoms.

What to know: This medication provides 24-hour relief. Don’t take more than the recommended dose. Don’t drink alcohol or take sedatives while using Zyrtec. Children under 6 years old should not take Zyrtec. If you’re over age 65 or have liver or kidney disease, talk with your doctor before using this product.

Best for colds and flu

Sudafed Sinus Congestion 12-hour

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

This is a behind-the-counter medication, which means it’s not kept in the aisle but rather behind a pharmacy or retail counter and can be purchased only with proof of age.

It contains pseudoephedrine, an effective decongestant that narrows blood vessels in your nasal passages to reduce swelling and relieve blockage. It can provide temporary relief for up to 12 hours.

It’s important to note that this product is different from Sudafed PE, which is available on store shelves but contains phenylephrine and is therefore no longer recommended.

What to know: Sudafed is not recommended for children. It is also not recommended for adults who have high blood pressure, glaucoma, or diabetes or are pregnant.

Best decongestant on a budget

NasalCrom Nasal Spray Allergy

  • Price: $$ for 200 doses
  • Type: nasal spray
  • Drowsy effect: no

NasalCrom (cromolyn sodium) is a mast cell stabilizer used to prevent the release of histamine and other chemicals that can cause symptoms such as nasal congestion.

It is used to treat nasal congestion and inflammation caused by conditions such as bronchial asthma and allergies. We like that NasalCrom can be used to prevent sinus inflammation and congestion, as well as to treat it. We also like that it’s steroid-free.

What to know: Cromolyn sodium is also used in products that treat eye allergies. However, NasalCrom is a nasal spray and should not be used in your eyes.

Best nasal decongestant for bedtime

Mucinex Nightshift

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

This liquid formula contains acetaminophen for pain relief, dextromethorphan for cough suppression, and triprolidine, an antihistamine that reduces common cold symptoms such as watery eyes, sneezing, and a runny nose.

Triprolidine is a first-generation antihistamine that causes drowsiness, so make sure not to take Mucinex Nightshift during the day if you plan on being active.

It’s great for bedtime because it calms coughing fits that may be keeping you up at night. Dextromethorphan is an antitussive. It works by reducing activity in the section of your brain that controls coughs.

What to know: Despite its name, this product doesn’t contain ingredients that loosen mucus. Some reviewers note that they dislike the taste of this medication.

Best for congestion caused by pet allergies

Flonase Allergy Relief

  • Price: $$
  • Type: nasal spray
  • Drowsy effect: no

The active ingredient in Flonase is fluticasone propionate, a type of corticosteroid known as a glucocorticoid. Flonase relieves nasal congestion by working with your immune system to reduce inflammation in your nasal passages.

It’s effective at reducing allergic reactions caused by pet dander, dust, dust mites, and other allergens.

We like that you can use your HSA or FSA account to purchase Flonase. It’s also available by prescription, which might mean you can get it from your doctor with insurance coverage.

What to know: Don’t use Flonase if you take certain medications for HIV or for fungal infections. Children under 4 years old should not use this product. Don’t combine Flonase with other steroids or use it to treat asthma.

Best forPriceTypeDrowsy effect
Allegra Allergyallergies$$$oral tabletno
Afrin No Drip Severe Congestionnasal spray$$ (twin pack)nasal sprayno
Little Remedies Decongestant Nose Dropskids$nose dropsno
Zyrtec Allergyindoor/outdoor allergies$$$oral tabletmild, in some people
Sudafed Sinus Congestion 12-hour*colds and flu$$oral tabletno
NasalCrom Nasal Spray Allergylarge supply on a budget$$nasal sprayno
Mucinex Nightshift Cold and Flu Liquidbedtime$$liquidyes
Flonase Allergy Relief Nasal Spray pet allergies$$ nasal spray no

* available behind the counter with proof of age or other requirements

  • Clinical trials and peer-reviewed literature: We read through doctors’ and researchers’ observations about the different active ingredients available on the market.
  • Transparency: We looked for products and brands that make realistic, medically sound claims about their products.
  • Customer reviews: We chose products that scored high marks in trust with customers, according to hundreds of verified reviews.

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 such as diphenhydramine. Antihistamines target your body’s immune response to allergens and irritants in the environment.

If you have cold or flu symptoms, you may be looking for a product that includes ingredients that constrict the blood vessels in your nose, such as phenylephrine or pseudoephedrine. As we mentioned, phenylephrine is considered safe and effective only when taken as a nasal spray, not as an oral tablet.

Some OTC sinus decongestant formulas include multiple ingredients for symptoms such as sinus congestion and headache. It’s a good idea to check each ingredient separately for potential side effects and contraindications.

If you take other OTC drugs or supplements or prescription medications, make sure they’re safe to use along with the decongestant you choose.

Keep in mind that taking too much pain medication can cause complications, including stomach issues, rebound headaches, and kidney damage.

Chronic allergies and nasal congestion caused by colds or the flu sometimes require prescription drugs or other treatments. If treating your congestion with OTC products isn’t giving you enough relief, see your doctor. And always get medical care for symptoms such as:

  • 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
  • coughing up blood
  • severe headache that doesn’t respond to OTC pain medication

In addition to using nasal decongestant drugs, there are home remedies that may help provide relief. At-home treatments for nasal congestion include:

  • sleeping with a humidifier in your bedroom
  • diffusing essential oils that are thought to clear your sinuses, such as eucalyptus and peppermint
  • using a sterile saline spray (only as directed)
  • taking steamy showers or baths
  • using a neti pot with sterilized water
  • staying hydrated by drinking plenty of water, tea, or other beverages

That depends on the underlying cause of your congestion. If you have nasal congestion that’s caused by allergies, an antihistamine may be your best bet. If you have significant stuffiness caused by a virus, consider using a decongestant.

Decongestants are made up of two drugs: phenylephrine, which is effective only as a nasal spray/topical application, and pseudoephedrine, which is available as an oral medication and in spray/topical form.

The term “decongestants” sometimes also refers to other medications that help relieve nasal and sinus congestion, such as antihistamines and corticosteroids. which are available as pills, liquids, and nasal sprays and drops.

Some people get the quickest results from combining fast-acting nasal sprays or oral medications with vapor rub. Vapor rubs use menthol and camphor to provide a temporary feeling of relief from nasal congestion, and they may help ease a cough and muscle pain.

Rubs should be applied to your chest and neck only — never use a vapor rub in or near your nose, as it can be absorbed through the mucous membrane lining and is potentially toxic.

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

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