A stuffy nose from a cold or allergy is annoying, and decongestant sprays seem like a miracle: within a few minutes you can breathe again. The problem is that, if you use them too much, they turn against you. Here is how decongestants work and why the "5-day rule" is so important — informative.
Sprays (topical)
Xylometazoline and oxymetazoline narrow the blood vessels in the nasal lining and quickly clear the nose. But a maximum of 5–7 days. Used longer, they cause rhinitis medicamentosa: the nose becomes congested again more and more often and you become dependent on the spray (rebound effect). It is a very common trap.
Pills (oral)
Pseudoephedrine and phenylephrine are found in many cold combinations. They relieve congestion, but they can raise blood pressure and heart rate — to be avoided or discussed with your doctor if you have hypertension, heart disease or thyroid problems. They can also cause insomnia if you take them in the evening.
Gentler alternatives
For clearing the nose without the risk of rebound: saline or sea water (nasal rinses), steam, hydration. For a nose congested by allergy, nasal corticosteroids (on a doctor's recommendation) and antihistamines are more suitable than decongestants.
Children and precautions
In young children, many decongestants are contraindicated or allowed only in special forms and doses — read the leaflet and ask the pharmacist. Do not use the spray "preventively" and do not share it among family members.
What is up to you
Follow the 5–7 day rule for sprays, prefer saline for long-term use and read the composition of cold products (many already contain a decongestant). For prices at nearby pharmacies, use the HartaFarmacii search.
- ANMDMR — SmPC for xylometazoline, oxymetazoline, pseudoephedrine
- EMA — recommendations on nasal decongestants and rhinitis medicamentosa