What is the best over-the-counter (OTC) medication for rhinorrhea (runny nose)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: May 30, 2025 • View editorial policy

From the Guidelines

For a runny nose, the most effective over-the-counter (OTC) medication is an oral antihistamine like Zyrtec (cetirizine), Claritin (loratadine), or Allegra (fexofenadine), especially if allergies are the cause, as they block histamine receptors to reduce nasal secretions and can be taken once daily 1. When considering treatment options, it's essential to weigh the benefits and risks of each medication. Oral antihistamines are generally effective in reducing rhinorrhea, sneezing, and itching associated with allergic rhinitis, but have little objective effect on nasal congestion 1. Some key points to consider when choosing an OTC medication for a runny nose include:

  • Oral antihistamines are effective for allergic rhinitis, but may have limited effect on nonallergic rhinitis syndromes 1
  • Decongestant nasal sprays like Afrin (oxymetazoline) provide quick relief, but should not be used for more than 3 days to avoid rebound congestion 1
  • Saline nasal sprays are a gentler alternative that can be used as needed without side effects
  • Combination products like Claritin-D or Zyrtec-D contain both antihistamines and the decongestant pseudoephedrine for more comprehensive relief, though these require ID at the pharmacy counter 1 It's also important to note that antihistamines work best when taken regularly during allergy season rather than only when symptoms appear. If your runny nose persists beyond 7-10 days or is accompanied by fever or colored discharge, consult a healthcare provider as it may indicate an infection requiring different treatment. Intranasal antihistamines, such as olopatadine (Patanase) or azelastine (Astelin), are also effective for allergic rhinitis, but are available by prescription only 2. Ultimately, the choice of OTC medication for a runny nose depends on the individual's specific needs and medical history, and it's always best to consult with a healthcare provider for personalized advice.

From the FDA Drug Label

Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: • runny nose • itchy, watery eyes • sneezing • itching of the nose or throat The best OTC medication for a runny nose is loratadine 3.

From the Research

Over-the-Counter (OTC) Medications for Runny Nose

  • Loratadine/pseudoephedrine combination is effective in relieving nasal congestion in patients with seasonal allergic rhinitis, as shown in a double-blind, placebo-controlled study 4.
  • This combination has been found to reduce nasal edema and secretions, and improve nasal patency, although the difference in nasal patency was not statistically significant 4.
  • In comparison to fluticasone propionate nasal spray, loratadine-pseudoephedrine tablets have been shown to have a faster onset of action and greater improvement in nasal airflow in patients with allergic rhinitis 5.

Alternative OTC Options

  • Nasal sprays, including steroidal, saline, decongestant, antihistamine, and anticholinergic preparations, are available for the treatment of sinonasal disease, but their use should be guided by evidence-based guidelines 6.
  • Beclomethasone Dipropionate (BDP) delivered via Spray-sol has been found to be more effective than BDP nasal spray in reducing nasal symptoms, including rhinorrhea, in patients with allergic rhinitis 7.

Considerations

  • The choice of OTC medication for runny nose should be based on the individual's specific symptoms and needs, as well as the potential side effects and interactions of the medication 6.
  • It is essential to follow the instructions for use and dosage recommendations for any OTC medication to ensure safe and effective treatment 6.

References

Guideline

the diagnosis and management of rhinitis: an updated practice parameter.

Journal of Allergy and Clinical Immunology, 2008

Guideline

clinical practice guideline: allergic rhinitis.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2015

Research

Comparative nasal airflow with loratadine-pseudoephedrine and fluticasone nasal spray for allergic rhinitis.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2021

Research

Nasal sprays: commonly used medications that are often misunderstood.

British journal of hospital medicine (London, England : 2005), 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.