Fast Facts: Nasal Congestion

If you have a stuffy nose and are looking for over the counter (OTC) treatment options you are in the right place. This article is organized to provide you with just the facts in a short, easily digestible format.

Sections

Choosing a medication

When to get your doctor involved

Nasal spray administration technique

References

Choosing a medication

You can treat nasal congestion using a nasal spray or oral tablets. Both routes of administration have effective options, but I tend to lean more towards nasal sprays. They work fast, put medication directly where you need it, and are less likely to cause systemic side effects.

Decongestant nasal sprays

There are four active ingredients currently on the market, but I prefer products that contain oxymetazoline 0.05% (Afrin, Dristan, Mucinex Sinus Max, etc.).

Pharmacist Favorite

These nasal sprays take seconds to minutes to kick in and last for up to 12 hours.

There are two things you should keep in mind when using one of these sprays.

1. Don’t use it for more than 3 days in a row. Daily use can lead to rebound nasal congestion when you stop using it.

2. Proper technique is important for both safety and efficacy. Ready my tips below to make sure you are doing it right.

There are a lot of different products that contain oxymetazoline. Here is a handy table with some of the popular brands.

Oral tablets

The most effective oral decongestant is pseudoephedrine.

• It is available in 4-6 hour, 12 hour, and 24 hour tablets.
• You can’t buy it online. It’s only in brick-and-mortar pharmacies.
• Bring your drivers license or some form of ID with you to purchase it.
• Pseudoephedrine is a mild stimulant and can keep you up at night. The 4-6 hour immediate release tablets can be dosed closer to bedtime if the longer acting products are a problem.
• Avoid products with the active ingredient phenylephrine. They don’t work.²

Don’t use pseudoephedrine and talk to your doctor first if you have

• heart disease
• untreated high blood pressure
• diabetes
• an enlarged prostate

For congestion related to seasonal allergies combination products of an antihistamine and pseudoephedrine are another option.

Consider reading my in-depth guide on seasonal allergies. Drugs that tackle allergy symptoms often also help with nasal congestion.

When to get your doctor involved

• If over the counter products are ineffective
• If the congestion is only on one side and not relived using OTCs
• If you have signs of a sinus infection (pain in your sinuses or teeth, fever, significant mucus, decreased sense of smell, etc.)

Plugged nostrils from seasonal allergies or the common cold typically respond well to over the counter drugs, but there are a number of other conditions, such as deviated septum or enlarged adenoids, that can cause nasal congestion. Seek help from a healthcare professional if you think you need it.

Summary

Nasal sprays containing oxymetazoline 0.05% are my favorite option for treating nasal congestion. They are fast, effective, and less likely to cause side effects like insomnia when compared to products with pseudoephedrine.

Nasal Spray Administration Technique

There are a few things you need to know about how to administer nasal sprays to get maximum benefit and reduce the risk of injuring the sensitive tissues in your nose.^{3, 4}

1. Start by gently blowing your nose to clear out any mucus. The medication needs to contact and get absorbed by the tissues in your nose.

2. Shake and/or prime the sprayer if needed. The steroid nasal sprays should be shaken vigorously to make sure the medication is uniform and well mixed. The first time you use your sprayer you will need to prime it, which just means spray into the air till you get a nice mist.

3. Position your nose in line with your toes. Your head should be neutral. Not tilted back or tucked in.

4. Always spray the nostril opposite from the hand holding the sprayer. (left hand sprays right nostril, right hand sprays left nostril) The goal is to point the tip of the sprayer away from the center of your nose and slightly towards your ear.

5. Sniff not snort. A gentle sniff as you depress the sprayer is what we are looking for.

References