Say No To Chronic Oral Decongestants

December 29, 2009

Many over-the-counter and prescription allergy medications contain an oral decongestant,- either pseudoephedrine or phenylephrine.   The decongestant is the “D” part of Zyrtec D, Claritin D and Allegra D.   Decongestants are also in many over-the-counter cold medications such as Dimetapp, Contact and Sudafed, to name a few.

The short term use of oral pseudoephedrine or phenylephrine during an acute upper respiratory tract infection is an acceptable option for many people.  The chronic use of this medication for people with allergies is problematic.   From my perspective these medications have too many potential side effects to use chronically.  I see patients on a regular basis who have been on these medications for months or even years.  As a rule of thumb, I do my best to get patients off of these products.

The potential side effects of oral decongestants include increased blood pressure, increased heart rate, palpitations, nervousness, interference with the normal sleep cycle, insomnia, tremor, loss of appetite and urinary hesitancy.  People with heart disease, high blood pressure, enlarged prostates and glaucoma should not use them at all and I think people without these conditions should only use them chronically as a last resort.

Years ago there was another oral decongestant on the market named phenylpropanolamine, which was an active ingredient in many cold and allergy medications.  About 9 years ago the FDA withdrew phenylpropanolamine from the market because of an increased risk of hemorrhagic stroke in woman who took phenylpropanolamine as an appetite suppressant.  Although this side effect has not been seen with pseudoephedrine or phenylephrine, as a class of medications, oral decongestants tend to have significant side effects.

The bottom line is, there are many other classes of medications, as well as therapies that do not involve medications, that are effective for people with chronic nasal congestion.  The use of a product containing an oral decongestant is rarely, if ever, necessary in this setting.


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