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November 21, 2009
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Nasal Allergy Medications (cont.)

What are decongestants?

Nasal stuffiness or congestion occurs as a result of swelling of the nasal membranes. Histamine opens the blood vessels and encourages fluid leakage from them, thereby causing the tissues to become "congested." This reaction reduces the space inside the nose through which we breathe and results in the typical "blocked" or stuffy nose. While antihistamines can control many symptoms of allergic rhinitis, they are not very helpful for treating nasal congestion once it has already occurred. At this point, decongestants can be a very useful addition.

How do decongestants work?

Decongestants act on a receptor on the blood vessels. The blood vessels thereby shrink, which in turn reduces the blood flow to the area and lessens the leakage of fluid into the tissues. The result is a nasal passage that feels more "open." It is important to remember that decongestants do NOT help with an itchy, sneezing, and runny nose.

Two forms of decongestants, oral and topical, are currently available. They are probably equally effective, although the topical nasal sprays or drops work more quickly (a few minutes compared to thirty minutes). Most preparations are OTC and are relatively inexpensive. As we will see later, decongestants are frequently combined with antihistamines and are sometimes combined with mucous thinners (mucolytics).

Table III: Common Decongestants

Generic Name Brand Name
pseudoephedrine (oral: liquid, tablets) Sudafed (Novafed)
phenylephrine (topical: drops, spray) Neosynephrine
oxymetolazone (topical: drops, spray) Afrin


Next: When should I use topical decongestants? »

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