Decongestant in many cold medicines doesn't work according to FDA panel

Sick woman laying on the couch, reaching for medicine

In 2005, cold medicines containing pseudoephedrine, an effective decongestant, were moved behind the pharmacy counter. In response, many drug companies replaced pseudoephedrine with phenylephrine, which could be sold over the counter.

The FDA wants over-the-counter medications to be safe and effective. While the FDA has determined that phenylephrine is not effective as an oral medication, it hasn’t been proven unsafe. That’s why you can still find cold medicines containing phenylephrine on the shelves for now.

“The availability of these products may change in the future,” explains Nebraska Medicine pharmacist Kaitlyn Stewart, PharmD. “In the meantime, the other ingredients these cold medicines contain can be helpful. Acetaminophen and ibuprofen can relieve sinus pain or muscle aches due to fever. You just won’t find relief for a stuffy nose.”

What are the best remedies for nasal congestion?

If you’re looking for an oral decongestant, Stewart recommends Sudafed (pseudoephedrine) which is kept behind the pharmacy counter. While a prescription isn’t necessary in most states, you must show your ID to the pharmacist.

“Oxymetazoline nasal sprays (Afrin) also work quickly to relieve congestion,” says Stewart. “However, you can only use them for up to three days. Otherwise, you run the risk of rebound congestion, which is congestion that doesn’t go away completely.”

Before giving oral decongestants or nasal sprays to children, check the product labeling for age recommendations. If your child is younger than the labeling recommends, contact your pediatrician for advice.

Other effective remedies for a stuffy nose include:

  • Saline nasal sprays
  • Saline rinses
  • Using humidifiers
  • Applying topical ointments containing camphor, menthol or eucalyptus oils.

When should I see a doctor for nasal congestion?

If you have other symptoms, such as a high fever, sinus pain and yellow or green discharge, you may have a bacterial infection. In that case, you’ll want to see a doctor who may prescribe an antibiotic. If your congestion is due to allergies, you’ll also need an antihistamine allergy medication.

If you're  unsure which decongestant is right for you, consult your primary care provider or ear, nose and throat specialist. Depending on your situation, they may recommend a combination of nasal treatments to relieve your symptoms.

If you’d like to see a doctor about your nasal congestion, call 800.922.0000 to schedule an appointment.