Nasal decongestants are medications used to relieve nasal congestion, and they’re commonly available in spray or drop form.
In the UK, these are available over the counter (without a prescription), and are usually labeled as:
- “Sinusitis nasal relief”
- “Blocked nose relief”
Most common active ingredients
The most common active ingredients include:
- Naphazoline
- Ephedrine
- Pseudoephedrine
- Oxymetazoline
- Phenylephrine
- And others
How do they work?
These medications act very quickly on the nasal mucosa. They are sympathomimetic agents, meaning they mimic the effects of adrenaline on your body.
They work by narrowing the blood vessels in the nose. This reduces blood flow in the area and helps reduce the swelling that causes the feeling of a blocked nose.
Result: Almost immediate relief.
Side effects of nasal decongestants
Although these medications are generally well tolerated, they are recommended only for adults, and should be used only for short periods of time (7–10 days maximum), especially in cases like:
- Heavy colds
- Allergies
- Sinusitis
- Nasal polyps
- Sleep apnea
Overuse or long-term use can lead to:
- Rebound congestion (where the symptoms return even worse)
- Dependence, meaning you can no longer breathe well without them
Other possible side effects include:
- Headache
- High blood pressure
- Fast heart rate (tachycardia)
- Dry nasal passages and painful crusts
- Medication-induced rhinitis (rhinitis medicamentosa)
- In severe cases, nasal septum perforation
What if I’ve become dependent?
Once dependency is established, it can be very hard to stop on your own. In that case, it’s best to consult an ENT (ear, nose, and throat) specialist.
Who should avoid these medications?
Nasal decongestants are not recommended in the following cases:
- Pregnancy
- Heart conditions (especially high blood pressure)
- Children
- Glaucoma
- Hyperthyroidism
- Migraines
It’s always best to read the information leaflet inside the package, or ask your pharmacist before using.
By Dr. Chiara Cerovac, ENT Specialist