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Decongestants

Decongestants are medications that are used to treat a blocked nose, most commonly caused by colds, influenza and hay fever.

  1. Treat a blocked nose.
  2. Provide relief for cold and flus.
  3. May also be used for sinusitis and allergies.

If you have any questions or concerns about decongestants and the conditions they treat, you can speak with one of our GPhC-registered clinicians via our online video consultation service, from 9.30am-4.30pm, Monday to Friday.

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Product information

What are decongestants?

Decongestants are a group of medications that can be bought over the counter. They are primarily used to treat a blocked nose. A blocked nose can be caused by a number of conditions, including cold and flus, sinusitis, and allergies, such as hay fever. They work by reducing inflammation in the nasal passages, allowing you to breathe more freely.

What is the common cold? 

The common cold is caused by an infection from one of a number of viruses. It’s rarely serious and is easily treated with over the counter medications and rest. Symptoms of the common cold include a blocked nose, coughing, sneezing, fever, loss of taste and smell, headaches, sore throats and pressure within the sinuses. 

The symptoms are the same for adults and children, and you will not always get all of them every time you get a cold. Some people rarely get colds and when they do, they are mild, while other people may experience multiple colds each year with moderate symptoms. The common cold is very rarely a severe condition, unlike influenza.

The common cold lasts for anywhere between a few days and a few weeks. While there is no cure as such, you can manage symptoms with simple over the counter medications and rest. Because it’s contagious whilst you are symptomatic, you should take precautions to not spread the virus. This includes washing your hands regularly, catching coughs and sneezes in a tissue and disposing of the tissue quickly and safely. 

Is the common cold preventable?

In terms of prevention, you can take simple self-care measures, such as washing your hands, particularly before eating, not sharing household items with someone who is showing symptoms, not touching your face and maintaining good, general health. 

Symptoms can be treated with a few basic medications that can be bought from your local pharmacy. These include cough medicines and paracetamol to reduce your temperature and to ease aches and pains. Many cold and flu medicines contain paracetamol and decongestants, so you should take care not to take more than the recommended dose when combining them. Additionally, taking rest and staying hydrated can help the body to clear itself of the virus. 

What is sinusitis?

Sinusitis is an infection of the sinuses after a cold or flu. In most cases, it clears up in a few weeks, but it can be a persistent condition that requires further treatment in some cases. Common symptoms of sinusitis include a blocked nose, headaches, tenderness in the areas around the eyes, cheeks and forehead, a loss of sense of smell, toothache, fever, bad breath and green or yellow mucus, usually coming from the nose.

How is sinusitis treated?

The same self-care measures that are effective for the common cold can be used for sinusitis. This includes plenty of rest and staying hydrated. You should also avoid triggers that may cause further congestion, such as smoke and allergens. A nasal rinse, which uses a salt-based solution to ease congestion, can also help. 

In terms of specific medications for sinusitis, paracetamol and ibuprofen are some of the most commonly used treatments for reducing fevers or managing pain. 

If your symptoms have not cleared up within a few weeks, you should book an appointment with your GP, who may prescribe antihistamines, if the congestion is being caused by an allergen, or a steroid spray. Antibiotics may be prescribed if the infection is bacterial, but given that sinusitis is usually caused by a virus, this is rare.  

If these treatments do not relieve symptoms, and the infection shows no sign of clearing up, you may be referred to an ear, nose and throat (ENT) specialist. In some persistent or severe cases, surgery may be suggested. Functional endoscopic sinus surgery (FESS) can remove a lot of the blocked tissue through using a very small balloon. A general anaesthetic is required, but the surgery itself is fairly straightforward. 

What is hay fever?

Hay fever is an allergic reaction to pollen, a substance that is produced by plants. It’s most likely to occur at certain times of the year, specifically between March and September. Warm, windy and humid weather tends to occur when the pollen count reaches its peak.

What symptoms can hay fever cause?

Symptoms of hay fever can be similar to cold symptoms, and include a blocked nose, sneezing, coughing, the loss of a sense of smell, headaches and fatigue. It may also lead to red and itchy eyes, an itchy throat, nose and ears and pain in the temples. If you have asthma, hay fever can present with shortness of breath, wheezing and tightness in the chest. A sure sign that what you are experiencing is hay fever, rather than a cold, is that symptoms can last for a few months, rather than a few days or weeks.

What you can do to help manage hay fever

There is no cure for hay fever, but you can manage symptoms with some simple methods and treatments, particularly when the pollen count is at its highest. This may include wearing wraparound sunglasses to prevent pollen from coming into contact with your eyes, putting vaseline under your nose (which can act as a trap), closing your windows and doors, staying indoors when possible, changing your clothes and having a shower after you have been outside, regularly dusting and vacuuming and using a HEPA filter in your car or vacuum. 

How is hay fever treated?

Medication for mild hay fever may include use of antihistamines or decongestants, but for long term treatment, steroids can provide significant relief. Should steroids prove to be ineffective, your GP may refer you to an immunotherapist, who will introduce your body to small amounts of pollen through injections, to allow the body to become accustomed to the substance. As the pollen count is low in winter, therapy will usually be undertaken during that period, over the course of three months.

If you would like to speak to a GMC-registered clinician about decongestants or any related conditions, our online video consultation service is available from 9.30am-4.30pm, five days a week. Our clinicians can also provide referrals to specialists for treatment and fit notes, where suitable.  

Page last reviewed:  03/07/2020
Side effects and warnings

What side effects can decongestants cause? 

While most decongestants are well tolerated, with few or no side effects in most cases, it is important to note that they do exist and can be severe occasionally. Your  prescribing doctor or pharmacist can discuss any potential side effects with you, and the patient information leaflet that comes with your medication should list all known side effects for that specific treatment, as well as their frequency. 

The following information relates to the over the counter treatment Sudafed, and may not be relevant for your specific medication. If you experience any of the following, you should discontinue use and seek immediate medical assistance: hallucinations and allergic reactions. 

Other side effects include insomnia, restlessness and nightmares.

Are decongestants safe to use alongside other treatments? 

All substances can interact with others in the body, so it is very important that you inform your prescribing doctor or pharmacist of any medications that you are currently taking or have recently taken prior to starting treatment. This includes supplements and herbal treatments. 

In the case of Sudafed, you should not take this medication if you are using monoamine oxidase inhibitors (MAOI) antidepressants.

Your prescribing clinician or pharmacist may also determine that Sudafed is unsuitable for you if you are taking any of the following: antihypertensives (for high blood pressure), sympathomimetics (for asthma or appetite suppression) and Tricyclic antidepressants (for mood disorders).

Warnings and precautions for use of decongestants

You should inform your prescribing doctor or pharmacist about any health conditions that you have or are prone to, so that they can determine if the treatment is safe for you to use or not. 

In the case of Sudafed, you should avoid using it if you have: high blood pressure, heart disease or allergies to any of its ingredients.

Your prescribing doctor may also deem Sudafed to be unsuitable if you have: liver problems, kidney problems, diabetes, an overactive thyroid gland, glaucoma and issues with your prostate.

Are decongestants safe to use if you are pregnant? 

It’s unclear whether decongestants are safe to use during pregnancy, and in the event that you are pregnant, are thinking of becoming pregnant or are breastfeeding, you should discuss use of this treatment with your prescribing doctor before you start taking it. Some decongestants are safe to use whilst breastfeeding, such as nasal sprays, but you should still check with your prescribing doctor or pharmacist before using them. 

You should not take decongestants that come in the form of tablets or liquids as these can be found in trace amounts in the breast milk.

What types of decongestants are available? 

Decongestants are available in many forms, each of which are specifically designed to treat specific causes of your blocked nose. For example, sprays are appropriate for people with allergies. Other forms of decongestants include tablets, capsules, powders, liquids and drops.

Page last reviewed:  03/07/2020
Questions and Answers

Can decongestants affect my ability to drive? 

It’s rare that your ability to drive will be affected by decongestants, with the exception of some antihistamines, which can cause drowsiness. If you are uncertain, you should ask your prescribing doctor or pharmacist to ensure that they are safe to use whilst operating heavy machinery.

Is it safe to consume alcohol whilst taking decongestants?

Some decongestants should not be taken with alcohol, although many will present few or no issues when used in combination. If you are unsure, speak to your prescribing clinician, or check the patient information leaflet that comes with your medication. 

Can I buy decongestants over the counter? 

In most cases, decongestants can be purchased over the counter without a prescription.

How can I buy decongestants online? 

Our GPhC-registered clinicians can discuss decongestants and any related conditions with you via our online video consultation service. They are available for appointments between 9.30am-4.30pm, Monday to Friday. Our clinicians can also issue fit notes and referral to specialists for treatment, where appropriate.  

Page last reviewed:  03/07/2020

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