Decongestants can possibly cause more harm than good
Q: I have used decongestants over the years when I’m ill, but my doctor recently said I should be cautious because nonprescription decongestants can have significant side effects. Is this true?
A: While many people rely on nasal decongestants to ease nasal symptoms of a cold or flu, these medications may cause harm, especially if used improperly or taken by patients who shouldn’t use them.
Commonly used decongestants include phenylephrine and pseudoephedrine. Often these ingredients are included in multisystem cold and flu preparations. Always read label ingredients for medications and warnings on boxes to know what you are taking and whether it is the correct product, especially if you have certain medical conditions or take other medications or supplements.
Taking an oral decongestant can temporarily ease congestion, but it also can create an increase in your blood pressure and blood sugar, aggravate glaucoma or urinary conditions, increase seizure risk and affect heart conditions. If you have one of these conditions, this may be a concern. Decongestants can interfere with the effectiveness of certain blood pressure, epilepsy, heart, diabetes or thyroid medications, but also may affect the chronic condition itself. If you have any of the above conditions, check with your primary health care provider or pharmacist before taking an oral nasal decongestant.
Other common side effects that nasal decongestants can cause include insomnia, nervousness, anxiety and tremors.
Side effects occur more frequently as the dose is increased. Oral decongestants should never be taken with monoamine oxidase inhibitors, or MAOIs, or within two weeks of stopping them. MAOIs are used for Parkinson’s disease, anxiety and depression. Avoid excess caffeine or herbal supplements while taking oral decongestants, as they may increase the risk of side effects through drug interaction. Those taking amphetamines for ADHD or weight loss are at higher risk of side effects and should not take oral decongestants without speaking to their health care provider or pharmacist.
Using nonprescription decongestant nasal sprays for more than three or four days can cause worse nasal congestion once the decongestant wears off, a condition called rebound rhinitis. All too often, people think their colds are worsening, so they increase their use of nasal spray, leading to worsening congestion. The way to reverse rebound rhinitis is to stop the nasal spray in one nostril until that nostril is clear, then stop it in the other nostril until that nostril clears. Other occasional side effects of nasal sprays include nosebleeds, headache and rapid heartbeat.
Children are more prone to side effects from nasal sprays and may experience sedation, agitation and, in rare cases, seizures. Other over-the-counter nasal sprays help with nasal congestion indirectly, but are not decongestants. Sprays containing fluticasone, budesonide or triamcinolone are corticosteroids and work differently by lessening your nasal passage reaction to allergens. When nasal sprays are dosed, they should be directed away from the septum, or nose center, to avoid nosebleeds. You would use the right hand to spray the left nostril and left hand to spray the right nostril.
Thankfully, symptoms usually last no more than a week and a half. If you have continued congestion, visit your health care provider to explore treatments that may be more effective.