All you need to know about decongestants

 We asked Raymond Anderson of Anderson's Pharmacy in Portadown, County Armagh – President of the Commonwealth Pharmacists' Association – how decongestants work and what you should be aware of when taking them.

Q What are decongestants and how do they work?

A Decongestants work by drying up the excessive production of mucus or catarrh usually associated with cold symptoms. The body produces more mucus than normal to try and 'flush out' invading micro-organisms. Remember though, changes in temperature and humidity can also cause some nasal congestion.

Q What symptoms do they relieve?

A Decongestants relieve the symptoms of colds by stopping the body produce too much catarrh and are good for both blocked and runny noses as well as for symptoms associated with sinus problems. Remember though, allergies – for example reactions to substances such as pollen and dust – also cause production of more mucus and catarrh. However these are better treated with medicines called antihistamines to prevent the symptoms occurring.

Q Which type – tablets or nasal sprays – work best?

A For symptoms of a blocked nose, a type of decongestant that acts locally such as a nose spray is better.  However, if you are suffering from a more general feeling of catarrh in the sinus, throat and head, then a decongestant in tablet form is more effective

Q Are they found in other medicines – cold and flu remedies, for instance? (include whether or not you can use them with painkillers, being careful to avoid double dosing etc)

A Decongestants can be found in a number of products, many of which contain other drugs such as paracetamol or ibuprofen. So you must take care to make sure you don’t double dose, which is something that's easy to do when you're feeling unwell and want to get better quickly. Decongestants are also found in different forms of medication, such as sachets to make hot drinks, liquid medication for coughs and colds as well as tablets and capsules.

Q Are decongestants suitable for everyone?

A Care needs to be taken with patients who are diabetic or have high blood pressure. Also patients who have glaucoma, prostrate problems or heart disease need to be careful when taking decongestants. Always tell your pharmacist or doctor if you are taking other medication.

Decongestants are not advised during pregnancy or for those with severe heart disease. Also recent advice recommends children under the age of six should not be taking decongestants.

Q Do they react with other medicines?

A The main interactions which can occur with decongestants are if you are taking medication for blood pressure such as a beta blocker, or are taking certain antidepressants. There are some other less common interactions so always check with your pharmacist before taking decongestants – as always, if you are taking any other medication, ask your pharmacist for advice.

Q Do they have any side effects?

A As with all drugs there is the potential for some patients to suffer side effects –  though these tend to be minor. Many people think decongestants will cause drowsiness. This is not the case, however – in fact it is more likely they will do the opposite and may keep some people awake if they are taken just before bedtime. Also by the very nature of their action decongestants can cause a dry mouth and throat.

In the case of nose sprays you must limit their use to a maximum of seven consecutive days. If you use decongestant nose sprays for longer, they can cause 'rebound' congestion (see below). Some people will keep using the spray because they still have the congestion, when in fact the spray can be the cause of the problem.

Q Can they cause problems if you use them for too long?

A Yes, as mentioned above, 'rebound' congestion can be a problem particularly with nasal sprays. People are not always aware of the need to limit the use of these products to a maximum of seven days. For this reason nasal washes are becoming more popular. These may not always the most pleasant to use, however they are drug free and can be very effective in relieving symptoms associated with blocked sinuses.

Q Are there any natural alternatives that relieve congestion?

A As mentioned in the previous answer, the use of nasal washes and rinses containing small amounts of salt are becoming more popular. These are not the most pleasant to use but can be very effective.

Inhalants are another possible alternative. Menthol and eucalyptus inhalants can be beneficial if decongestants are not suitable for you or if you prefer an alternative.

Decongestants can be found in a number of products, many of which contain other drugs such as paracetamol or ibuprofen. So you must take care to make sure you don’t double dose, which is something that's easy to do when you're feeling unwell and want to get better quickly

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