Nasal decongestants are available as nasal drops and nasal sprays. (Image: Ken Hurst / Shutterstock.com)
What causes a blocked nose (nasal congestion)?
Most people think that a blocked or stuffy nose (nasal congestion) is caused by thick mucus when you have a cold or flu, but this is not so. Nasal congestion happens when the blood vessels in the mucous membranes lining the nose become swollen, affecting breathing.
For most people, a blocked nose is simply an annoyance, but for others, nasal congestion can affect their ears, their hearing and in severe cases, their sleep.
In young babies who are being breast-fed or bottle-fed, nasal congestion can affect feeding, because babies need to breathe through their nose while they feed.
What is a nasal decongestant?
Nasal decongestants are medicines that can help relieve a blocked nose. Nasal decongestants help relieve nasal congestion by narrowing (constricting) the blood vessels and reducing blood flow and swelling, allowing you to breathe more easily.
Advice about cough and cold medicines for children has changed from 15 August 2012.
- Decongestants containing pseudoephedrine, phenylephrine, oxymetazoline or xylometazoline should not be given to children younger than 6 years old.
- Ask a doctor, pharmacist or nurse practitioner for advice before giving decongestants containing pseudoephedrine, phenylephedrine , oxymetazoline or xylometazoline to children aged 6 to 11 years.
Ask your doctor or pharmacist for advice before using a nasal decongestant, to make sure that it is safe for you or your child. Always read the label on your medicine or the consumer medicine information (CMI).
Nasal decongestants are available in different forms:
- Tablets (e.g. pseudoephedrine, phenylephrine). Brand names include: Sudafed Sinus and Nasal Decongestant
- Nasal sprays (e.g. phenylephrine, oxymetazoline, tramazoline, xylometazoline). Brand names include: Vicks Sinex
- Nasal drops (e.g. ephedrine, oxymetazoline, xylometazoline). Brand names include: Otrivin Nasal Drops.
Tell your doctor about all the medicines you are taking
It is important that you tell your health professional about all the medicines you or anyone in your care is taking — including prescription, over-the-counter and complementary medicines (‘herbal’ or ‘natural’ medicines and vitamin and mineral supplements). This is because all medicines, including herbal and natural medicines, can cause side effects and may interact with other medicines.
Who can’t use nasal decongestants?
- Decongestants containing pseudoephedrine, phenylephrine, oxymetazoline or xylometazoline must not be used in children younger than 6 years. Use salt water (saline) nasal sprays or drops instead of a nasal decongestant for children.
- Ask a doctor, pharmacist or nurse practitioner for advice before giving decongestants containing pseudoephedrine, phenylephrine, oxymetazoline or xylometazoline to children aged 6 to 11 years.
- Nasal decongestants are unlikely to be effective for children under 12 years, and can cause serious side effects in children (e.g. can affect the nervous system). Use salt water (saline) nasal sprays or drops instead of a nasal decongestant for children.
- They are not effective for treating a middle ear infection (otitis media).
- They may not be safe to use if you have certain health conditions (e.g. high blood pressure or heart problems).
Phone for medicines information
Call NPS Medicines Line on 1300 MEDICINE (1300 633 424) to get information about your prescription, over-the-counter and complementary medicines (herbal, ‘natural’, vitamins and mineral supplements) from a pharmacist. Your call will be answered by healthdirect Australia.
What are the side effects of decongestants?Commonly occurring side effects (between 1 and 10 in 100 people have the side effect) include:
- burning and stinging in the nose
- increased mucus production
- rebound congestion if used for more than 4 or 5 days (see below).
- high blood pressure (hypertension)
Don’t use intranasal decongestant spray or drops for longer than 4 or 5 days.
Using a decongestant for longer than 5 days (or at higher than the recommended dose) can worsen your symptoms after you stop using the decongestant (this is ‘rebound congestion’). Your symptoms may take weeks to improve. To avoid rebound congestion, don’t use nasal decongestants for longer than 4 or 5 days, and only use the recommended dose.
If you need a decongestant for longer than 5 days, decongestant tablets containing pseudoephedrine can help to prevent rebound congestion.
Who can I ask about side effects?
If you’re concerned that you or someone in your care may have had side effects related to a medicine, seek medical advice. People with questions about their medicines or seeking general information about side effects can also call the NPS Medicines Line on 1300 633 424 (Monday-Friday, 9am-5pm).To report possible side effects call the Adverse Medicine Events (AME) line on 1300 134 237 from anywhere in Australia (Monday–Friday, 9am–5pm AEST).
- Rossi S, ed. Australian Medicines Handbook. Adelaide: AMH, July 2012.
- Ask Your Pharmacist. Changes to the use of Cough and Cold medicines in children. September 2012. (Accessed 10 October 2012)