decongestants

Decongestants are medicines used to relieve nasal congestion by narrowing blood vessels in the nasal mucosa. They are available in systemic (oral) forms and topical (nasal spray or drop) forms. Common oral agents include pseudoephedrine and phenylephrine; topical agents include oxymetazoline, xylometazoline, and naphazoline. Mechanism: these drugs stimulate alpha-adrenergic receptors, causing vasoconstriction and reduced swelling of the nasal mucosa, which improves airflow.

Indications include temporary relief of nasal congestion from upper respiratory infections, allergic rhinitis, hay fever, and sinusitis. They are often used to ease breathing difficulties during a cold or seasonal allergies.

Safety and precautions: decongestants are not suitable for everyone. They can raise blood pressure and heart rate and may exacerbate hypertension, cardiac arrhythmias, ischemic heart disease, or glaucoma. They should be used with caution in pregnancy, the elderly, and individuals with thyroid disorders, diabetes, or prostate enlargement. Monoamine oxidase inhibitors and other stimulants can interact with decongestants. Use in children requires age-appropriate dosing and medical guidance.

Adverse effects vary by preparation. Systemic decongestants can cause insomnia, nervousness, hypertension, and tachycardia. Topical nasal decongestants may cause local irritation, dryness, or a burning sensation and, with prolonged use, rebound congestion—the return of congestion once the medication is stopped.

Usage guidelines commonly advise limiting topical decongestants to 3–5 days to avoid rebound effects; oral decongestants are typically used for short periods, often up to 7 days. If symptoms persist, seek medical evaluation. Alternatives include intranasal corticosteroids, oral antihistamines, and saline rinses.