From the Guidelines
For a stuffy nose, I recommend using an over-the-counter nasal decongestant like pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE), or a nasal spray like oxymetazoline (Afrin), as they can help reduce nasal congestion, according to the most recent and highest quality study 1. The choice of medication depends on the underlying cause of the congestion, with pseudoephedrine typically working better but requiring ID at the pharmacy counter, while phenylephrine is available on shelves but may be less effective.
- For nasal sprays, use no more than 3 days to avoid rebound congestion, as recommended by the manufacturers and supported by studies 1.
- Saline nasal sprays can be used safely long-term, with a Cochrane review reporting minor improvements in nasal symptom scores with the use of nasal saline in both physiologic and hypertonic concentrations 1.
- Antihistamines like loratadine (Claritin) or cetirizine (Zyrtec) are helpful if allergies are causing your congestion, as they can reduce inflammation and swelling in nasal passages or block histamine if allergies are the cause, although their combination with other medications may not offer much clinical benefit 1. Non-medication approaches include:
- Using a humidifier to add moisture to the air and help loosen mucus
- Staying hydrated to thin out mucus and promote drainage
- Taking hot showers to help loosen mucus and reduce congestion If symptoms persist beyond 7-10 days or are accompanied by fever, it is essential to see a healthcare provider, as this could indicate a sinus infection requiring different treatment, as highlighted in the clinical practice guideline for adult sinusitis 1.
From the FDA Drug Label
Uses • temporarily relieves sinus congestion and pressure • temporarily relieves nasal congestion due to the common cold, hay fever or other upper respiratory allergies Principal Display Panel Compare to Sudafed® Congestion active ingredient Pseudoephedrine Hydrochloride, 30 mg Nasal Decongestant MAXIMUM STRENGTH • SINUS PRESSURE • SINUS CONGESTION 24 TABLETS actual size NON-DROWSY Padagis™
The treatment option for nasal congestion (stuffy nose) is pseudoephedrine (PO), which is a nasal decongestant that can temporarily relieve nasal congestion due to the common cold, hay fever, or other upper respiratory allergies 2. Key benefits of this treatment option include:
- Non-drowsy formula
- Maximum strength relief from sinus pressure and sinus congestion 2.
From the Research
Treatment Options for Nasal Congestion
- Topical nasal sprays, especially steroids, are effective in treating allergic rhinitis and can help alleviate nasal congestion 3
- Decongestants, such as phenylpropanolamine, pseudoephedrine, and phenylephrine, can provide relief from nasal congestion, with pseudoephedrine being a commonly used oral agent 4, 5
- Combination therapy of an antihistamine and a decongestant, such as desloratadine and pseudoephedrine, can be an effective treatment for allergic rhinitis and nasal congestion 6
- Other treatment options include nasal dilation devices, antiallergy measures, and surgical procedures 7
- Over-the-counter decongestants can be helpful in reducing nasal congestion, but their use should be limited to no more than three days to avoid rebound congestion 3, 5
Decongestant Therapy
- Topical decongestants can provide faster and more intense relief from nasal congestion, but may have a shorter duration and potential for rebound congestion 4
- Oral decongestants, such as pseudoephedrine, can provide longer-lasting relief and are often used in combination with antihistamines 4, 5
- Slow-release formulations of decongestants can allow for longer dosing intervals, but may not be bioequivalent to established brand-name products 4