Advocate Health doctor offers tips on what to look for in a decongestant

Recently, the Food and Drug Administration found that one of the most popular over-the-counter decongestants - phenylephrine - is largely ineffective when taken orally. So, with cold and flu season ramping up, what will help manage your symptoms?

"A lot of over-the-counter products address multiple symptoms with combinations of medicines," explains Dr. Amy Howard, a family medicine physician with Advocate Health Care. "The first step is to be sure you're reading everything that's in the product so that you know what you're getting."

Taking an oral product with phenylephrine won't harm you, although we still caution those with high blood pressure, arrhythmias and other chronic diseases to consider alternatives, Dr. Howard says. But it also won't necessarily help you feel better either.


"If you're sticking with an oral medication, think about an antihistamine to help with congestion," says Dr. Howard. "They work by reducing swelling in your nasal cavity and tend to come with fewer side effects."


While you don't need a prescription, products containing pseudoephedrine are kept behind the pharmacy counter and offer effective congestion relief. Dr. Howard cautions that people with high blood pressure, diabetes, glaucoma and thyroid problems should consult their physician first because pseudoephedrine can cause harmful side effects for people also managing chronic disease.

Nasal sprays

"Nasal sprays can also offer relief from a congested nose," Dr. Howard explains. "Look for sprays that include inhaled steroids like fluticasone. You can also consider nasal sprays that contain phenylephrine, as recent studies demonstrate that nasal phenylephrine is still effective."

Dr. Howard cautions that using these decongestant nasal sprays can cause rebound congestion. You should only use them for three days at a time.

"Additionally, nasal saline or neti pots aren't medicated and can help flush your nasal cavity, reduce inflammation and clear blockages," Dr. Howard continues.


If you're struggling with a cough too, Dr. Howard recommends looking for products that include dextromethorphan, to suppress your cough, and guaifenesin, an expectorant that thins mucus. Honey is a natural cough suppressant.

If you have a consistently high fever or your symptoms last longer than a week, check in with your doctor to make sure it isn't something more serious.

Other remedies

In addition to managing your symptoms with medicine, Dr. Howard suggests using a humidifier or taking a hot shower, drinking a lot of fluids to stay hydrated, and getting plenty of rest. It's also important to stay home if you're sick, especially if you have a fever.

"There are lots of viruses going around, including COVID," Dr. Howard concludes. "It's important to start taking care of your body before you get sick - eating a healthy diet of fruits and vegetables and getting exercise - so that you're in a better position to ward off future infections."

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