Nasal decongestant hacks: Experts share options after ‘unsound’ drugs exposed

Medical experts are sharing the best options for allergy sufferers after advisers to the Food and Drug Administration recently voted against the effectiveness of a nasal decongestant found in versions of Benadryl, Mucinex and other popular over-the-counter medications.

The unanimous vote on Sept. 12 declared oral forms of phenylephrine ineffective. The most popular oral decongestant in the US, phenylephrine generated almost $1.8 billion in sales in 2022.

But scientists say very little of the medication actually reaches the nose to relieve congestion. This conclusion was drawn from five studies conducted over the past two decades.

“We do believe that the original studies were methodologically unsound and do not match today’s standard,” Dr. Peter Starke, an FDA official who led the review of phenylephrine, said earlier this month.

“By contrast, we believe the new data are credible and do not provide evidence that oral phenylephrine is effective as a nasal decongestant,” he added.

Here’s a look at alternatives for people seeking much-needed relief.

Phenylephrine is found in many brand-name OTC oral preparations, including:

• Sudafed PE
• Alka-Seltzer Plus Severe Cold & Flu Formula 
• Mucinex
• Robitussin Peak Cold Nighttime Nasal Relief
• Sinex
• DayQuil
• Benadryl
• Tylenol Sinus
• Advil Sinus Congestion
• Lusonal
• Many store brands such as Equate, Walgreens, CVS, etc.

Nasal sprays

Although the effectiveness of oral phenylephrine is under fire, nasal spray phenylephrine is still thought to provide temporary relief from congestion.

There are other medicated nasal spray options as well.

Doctors recommend using a corticosteroid nasal spray like Flonase or oxymetazoline nasal spray like Afrin and Zicam.

Experts warn that decongestant nasal sprays should not be used for longer than three days at a time. Prolonged use can lead to so-called rebound congestion.

Pseudoephedrine

Pseudoephedrine — which was moved behind the pharmacy counter in 2006 to deter methamphetamine production, giving rise to the popularity of phenylephrine — is still a great option for congestion relief.

Found in Sudafed, pseudoephedrine can only be purchased in limited quantities.

Buyers present a government-issued ID and sign a logbook that can be checked by law enforcement.

Antihistamines

Many medical professionals recommend oral antihistamines like Zyrtec, Allegra and Claritin to treat seasonal allergies.

These drugs reduce or stop the effects of a chemical produced by the body during an allergic reaction.

“These medications actually treat the underlying inflammation in addition to providing relief,” Dr. Purvi Parikh, an allergist and immunologist at Allergy & Asthma Associates of Murray Hill in NYC, told NBC News.

Steam

Medical experts also suggest that steam can help clogged sinuses — whether it comes from a long, hot shower or the comforting chicken noodle soup mom whips up to make you feel better.

“If you’re gonna smell something, why not some nice noodles and some chicken? … The steam going up your nose is gonna be wonderful,” board-certified pulmonary critical care and sleep medicine physician Dr. Raj Dasgupta, chief medical adviser at Sleep Advisor, told ABC News.

“That’s one you could do like just really briefly like maybe in the morning or when you get home from work,” he added.

Rest and relaxation

A good night’s sleep or a cozy cuddle on the couch is almost always a good way to fight off cold or allergy symptoms.

“I think that when you’re feeling sick, it’s always a good time to re-address some of those sleep hygiene things,” Dasgupta said.

He recommends putting technology away before bed and making sure your sleep quarters are cool and dark — and if congestion is a problem, sleeping with the head of the bed elevated or sleeping on pillows can help.