7 Best Nasal Decongestants You Can Get Over the Counter
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Over-the-counter (OTC) sinus decongestants may be able to offer temporary relief from your symptoms. They have different formulas and uses, so read the labels to make the best choice.
- Best sinus decongestant for allergies:Benadryl Allergy Plus Decongestant Ultratabs
- Best OTC decongestant for a headache:Advil Sinus Congestion and Pain
- Best OTC sinus decongestant nasal spray:Afrin No Drip Severe Congestion
- Best sinus decongestant for kids:Little Remedies Decongestant Nose Drops
- Best OTC decongestant day/night duo:Sudafed PE Day and Night Sinus Pressure Tablets
- Best sinus decongestant on a budget:Cabinet Nasal Decongestant Tablets
- Best OTC decongestant for bedtime:Mucinex Night Shift Cold and Flu
If you’re having trouble breathing due to cold, flu, or allergies, sinus decongestants are designed to relieve your symptoms and help you carry on with your day.
It’s not just health insurance premiums, but also deductibles, that keep on rising. In 2018, the average deductible was $3,000 for a gold-tier family plan, $8,000 for a silver-tier family plan and $12,000 for a bronze-tier family plan, according to USC Annenberg’s Center for Health Journalism.
These medications are available OTC at affordable prices, but that doesn’t always make it easy to choose one that’s best for you.
Some stronger medications target multiple symptoms, while others will simply relieve a stuffy nose caused by allergies. Some may make you drowsy, while others might make sleep difficult.
We rounded up the best OTC decongestants to help make the decision making process easier.
Having a basic understanding of common decongestant types might help you narrow down what kind of product you’re looking for:
- Decongestant ingredients work by dilating your blood vessels to relieve pressure in your sinuses.
- Antihistamine ingredients work by blocking your body’s response to allergens.
- Corticosteroid ingredients work by reducing your immune response to allergens and decreasing inflammation.
| Decongestant type | Best for | Possible side effects |
|---|---|---|
| Phenylephrine decongestant | sinus congestion caused by cold and flu | restlessness, dizziness, anxiety |
| Pseudoephedrine decongestant | sinus congestion caused by cold and flu | restlessness, dizziness, anxiety, nausea, upset stomach |
| Intranasal decongestants | sinus congestion caused by cold and flu | restlessness, dizziness, sore throat, bloody nose |
| Intranasal corticosteroids | hay fever and allergies | headache, sore throat, bloody nose |
| Antihistamines | sneezing and runny nose | drowsiness |
- Customer reviews: We chose products that scored high marks in trust with customers, according to hundreds of verified reviews.
- Transparency: We looked for products and brands that make realistic, medically-sound claims about their products.
- Clinical trials and peer-reviewed literature: We read through what doctors and researchers have observed about different active ingredients available on the market.
Pricing guide
Best OTC sinus decongestant for allergies
Benadryl Allergy Plus Congestion Ultratabs
What we liked: These tablets contain diphenhydramine, an antihistamine ingredient that may reduce allergy symptoms, and phenylephrine, which may reduce sinus congestion. You can take one of these tablets every 4 hours throughout the day, and reviewers note that they take effect relatively quickly.
What to know: These tablets aren’t intended to clear the flu or a cold, so it’s important to only take them if your sinus congestion occurs due to allergies. Also, be aware that diphenhydramine can make you feel quite sleepy, so avoid this medication on days when you need to be alert.
Best OTC sinus decongestant for a headache
What we liked: These coated tablets contain the decongestant ingredient phenylephrine along with the pain reliever ibuprofen. You can take a tablet up to every 4 hours. The combination of nasal swelling relief, along with the pain relief medication, can quickly relieve many sinus-related headaches. Many reviewers who have frequent sinus headaches swear by this product as being better than even some prescription medications.
What to know: Make sure to keep track of the amount of ibuprofen you’re taking if you’re taking this product. Do not take additional pain relievers, like acetaminophen or aspirin, with this product unless a doctor instructs you to. It’s easy to end up taking a dose that’s higher than recommended of analgesics when you’re mixing medications.
Best OTC sinus decongestant nasal spray
Afrin No Drip Severe Congestion
What we liked: Nasal sprays like Afrin can shrink swollen nasal passages by directly applying an active ingredient to your sinuses. The advantage of this can be that sprays tend to work more quickly than tablets or liquid decongestants. Afrin’s spray contains oxymetazoline hydrochloride and menthol, which relax and refresh your nasal passages pretty much right away, according to reviewers.
What to know: Afrin should only be used temporarily to relieve sinus congestion. Rebound stuffiness can occur in as little as 3 days. Using nasal sprays for a long duration can lead to side effects.
Best OTC sinus decongestant for kids
Little Remedies Decongestant Nose Drops
What we liked: These dye-free drops contain phenylephrine in a dosage that’s safe for kids 2 and up. The dropper-dose formula can be applied 2 to 3 drops at a time directly to nasal passages, which makes for fast relief. (No waiting for tablets to kick in at bedtime). This decongestant can work for symptoms of a cold or flu, or it can be used to help manage congestion caused by allergies.
What to know: It can be difficult to get little ones to sit still and have the drops applied into their noses. You may have better luck putting the formula in a spray-mist bottle or another mist-based bottle to help apply it into their noses.
Best OTC decongestant day/night duo
Sudafed PE Day and Night Sinus Pressure Tablets
- Price: $$
- Type: oral tablet
- Drowsy effect: daytime formula is nondrowsy; nighttime formula has drowsy side effects
What we liked: These tablets contain phenylephrine for sinus congestion relief during the daytime and an additional antihistamine ingredient for nighttime use. These ingredients can treat environmental allergies and congestion caused by the common cold. There are 12 tablets meant for daytime use and 8 that you can take at night, which means you can take a few extra tablets during the day if you need to, but stick to one right before bedtime once you’re ready to sleep.
What to know: There’s no pain relief ingredient included in either the day or nighttime formulas of these tablets. That means that if you have a headache and treating your sinus pressure doesn’t give you relief, you might still find yourself reaching for acetaminophen at the end of the day.
Best OTC sinus decongestant on a budget
Cabinet Nasal Decongestant Tablets
What we liked: This mega-size container of 225 tablets is a great solution if multiple people in your family tend to get allergies or sinus headaches. The no-frills phenylephrine formula is comparable to the dosage you’d find in a name brand but at a fraction of the cost. The formula doesn’t contain anything that will make you sleepy, and you can take a tablet every 4 hours on days when symptoms affect you.
What to know: Some customers complained that the bottle is too large to fit in their medicine cabinet, which seems like a small complaint for a product if you’ll be using it often. This particular tablet only targets sinus congestion, so it will not relieve symptoms like fever or a cough.
Best OTC decongestant for bedtime
Mucinex Nightshift Cold and Flu Liquid
What we liked: This liquid formula contains a pain reliever, a cough suppressant, and an antihistamine ingredient that can work together to give you a good night’s sleep when you’re sick. It does not contain any decongestant, however, so keep that in mind when taking this treatment. It’s great for bedtime because it calms coughing fits that may be keeping you up at night. Although it does not contain a decongestant, the antihistamine ingredient may also reduce nasal congestion caused by seasonal allergies.
What to know: Unlike the other decongestants on this list, this product doesn’t contain anything that loosens mucus. Some reviewers note that they really dislike the taste of this medication.
| Decongestant | Best for | Price | Type | Drowsy effect? |
|---|---|---|---|---|
| Benadryl Allergy Plus Congestion Ultratabs | allergies | $$ | oral tablet | yes |
| Advil Sinus Congestion and Pain | headache | $$$ | oral tablet | no |
| Afrin No Drip Severe Congestion | nasal spray | $$$ (twin pack) | nasal spray | no |
| Little Remedies Decongestant Nose Drops | kids | $$ | nose drops | no |
| Sudafed PE Day and Night Sinus Pressure Tablets | day and night use | $$ | oral tablet | daytime formula: no, nighttime formula: yes |
| Cabinet Nasal Decongestant Tablets | large supply on a budget | $$$ | oral tablet | no |
| Mucinex Nightshift Cold and Flu Liquid | bedtime | $$$ | liquid | yes |
When you’re figuring out which decongestant to buy, you’ll need to determine what’s causing your congestion.
If it’s allergies, you’ll probably want a product that contains an antihistamine ingredient like diphenhydramine. Antihistamines target your body’s immune response to allergens like pollen. Antihistamines usually make the person taking them a bit drowsy, so keep in mind, taking them at any time other than bedtime may have you needing a nap.
If you have cold or flu symptoms, you may be looking for a product that includes phenylephrine or pseudoephedrine. These ingredients work by shrinking your blood vessels, which can help you breathe more easily and reduce the symptoms of a sinus headache or a stuffy nose.
However, both of these ingredients can cause you to feel restless and can make it difficult to fall asleep. These types of drugs can also make you nauseous. Generally, phenylephrine may have fewer serious side effects than pseudoephedrine. Always consult a doctor before taking these meds if you are pregnant or breastfeeding.
Some OTC sinus decongestant formulas include both antihistamines and decongestant ingredients, and some add pain relief ingredients such as ibuprofen to their formula. It’s best to treat for symptoms that you have, not for additional symptoms that you don’t have.
If you’re already taking OTC pain relief medication for, say, a sinus headache, you don’t want to add additional pain relief meds into the mix if you don’t need to.
It’s difficult to keep track of dosage when you’re mixing medications that have overlapping active ingredients, and too much of any pain reliever can lead to complications like stomach issues, rebound headaches, and kidney damage.
Treating your congestion with OTC products doesn’t always provide relief. Get professional medical care if you experience any of the following:
- persistent congestion that lasts for a week or more
- a high fever that lasts for more than 48 hours
- chest pain of any sort
- difficulty breathing
There are also home remedies that you can use to relieve discomfort and clear your congestion. Natural decongestion remedies include:
- sleeping with a humidifier in your room
- diffusing essential oils
- using saline sprays
- taking steamy showers
- using a neti pot
