Health guides > Cold and flu > Best Medicine for Congestion

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What’s the Best Medicine for Congestion?

By Terez Malka, MD

Medically reviewed

July 28, 2022

Nasal congestion is one of the most common reasons people visit the doctor and miss work or school.

Most often, congestion is caused by the common cold or seasonal allergies.

While there are no cures for these conditions, medications can help ease your symptoms.

In this article, I’ll review the best medications available to help relieve congestion.

I’ll also discuss home remedies for a stuffy nose, what causes congestion, and when to seek medical care.

Decongestants

Decongestant medications help provide short-term relief for a stuffy nose.

Sometimes congestion is caused by swelling of the tissues of your nasal passages.

Decongestants help reduce this swelling, which opens your airways for easier breathing.

Decongestants help in situations like colds, the flu, allergic reactions, and sinusitis.

However, do not use them for longer than three days, as this can cause a rebound effect and worsen congestion.

Several forms of decongestants are available: nasal sprays and drops, oral tablets, capsules, and syrups.

Most decongestants are available over the counter.

Examples include:

Oxymetazoline (Claratin, Drixoral)
Phenylephrine (Sudafed PE)
Pseudoephedrine (Sudafed)

Children under six years old should not take decongestants.

Breastfeeding parents should consult their medical provider before taking decongestants.

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Antihistamines

Antihistamine medications help relieve allergy symptoms such as hay fever, hives, reactions to insect bites or stings, and pink eye.

There are many forms of antihistamines, including eye drops, oral tablets, capsules, liquids, topical creams, lotions, and nasal sprays.

Many antihistamines are available OTC, but some require a prescription.

Examples of OTC antihistamines include:

Cetirizine (Zyrtec)
Brompheniramine (Dimetane)
Diphenhydramine (Benadryl)
Fexofenadine (Allegra)
Loratadine (Alavert, Claritin)
Chlorpheniramine (Chlor-Trimeton)

Some antihistamines may make you feel drowsy.

Consult a medical provider about which antihistamine and dosage to use for children younger than 12.

Steroid Nasal Sprays

Steroid nasal sprays, also known as corticosteroid nasal sprays, are medications you spray into your nose that help reduce inflammation.

You can use them for conditions such as hay fever, sinusitis, non-allergy related congestion, and nasal polyps.

You can use these nasal sprays for longer-needed relief than some other medications.

However, overuse may depress the immune response.

Some nasal sprays and drops are available OTC, while others need a prescription.

Examples of OTC steroid nasal sprays include:

Fluticasone (Flonase)
Triamcinolone (Nasacort Allergy 24hr)
Budesonide (Rhinocort)

Talk to a medical provider about which nasal sprays are safe to use for children.

Menthol

Menthol is a natural remedy extracted from peppermint oil that may decrease nasal congestion.

It is also made in labs.

Medicated ointments with menthol have a cooling effect on the sinuses and may help you breathe better when rubbed on your chest and inhaled.

Other menthol products include nasal inhalers, cough drops, and products that can be steamed in a shower or used in a vaporizer.

Vicks VapoRub, VapoPads, and VapoSteam are examples of OTC products with menthol in them.

Cough Medicines

Many times congestion is accompanied by a cough.

There are two categories of cough medications: cough suppressants and expectorants.

Cough suppression medications, also called antitussives, help you stop coughing by blocking the cough reflex.

The most common cough suppressant is dextromethorphan, which is found in many OTC cough and cold medications.

Expectorants help you stop coughing by thinning the mucus, making it move more quickly out of your airway.

The most common expectorant is guaifenesin, which is found in cough medications like Mucinex and Robitussin.

Some cough medications may make you sleepy or dizzy.

Children under four years of age should not take cough medications.

Pain Relievers

Although pain relievers don’t help clear congestion, they may help ease discomfort from sinus pressure and reduce fevers, which sometimes accompany runny noses.

The most common OTC pain relievers include:

Acetaminophen (Tylenol)
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
Aspirin

Most of these medications are available for children, but children under 18 should never take aspirin.

Tips to Relieve Congestion

OTC medications may help bring relief from congestion symptoms but are not proven to shorten an illness.

Home remedies that may help relieve mild sinus congestion include:

Drinking plenty of fluids
Resting
Using a cool mist humidifier
Using saline sprays, nose drops, or a neti pot to thin mucus
Taking a hot, steamy shower or inhaling steam from a boiling pot of water
Trying OTC nasal adhesive strips
Using a bulb syringe to remove mucus from your infant’s nose
Sleeping with an extra pillow or raising the head of your bed
Applying a hot compress or washcloth to your sinus area to relieve pressure
Diffusing eucalyptus essential oil

Causes of Congestion

Nasal congestion usually occurs when the tissues in the nasal passages become inflamed.

Allergies can cause nasal inflammation, as can many viral respiratory infections such as the common cold, COVID-19, or the flu.

Congestion can also be caused by hormonal changes during pregnancy and certain medications such as those for high blood pressure or erectile dysfunction.

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When to See a Medical Provider

Congestion from the common cold can last a few weeks.

If symptoms persist, it may be a sign of a condition that requires medical evaluation.

If your congestion is severe, accompanied by other symptoms, or interferes with your ability to sleep or function normally, call your medical provider.

Other signs you need medical care include:

Fever
Symptoms lingering past two weeks without improving
Trouble breathing

How K Health Can Help

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Frequently Asked Questions

What's the best medicine for congestion?

There are several OTC medications available for congestion. Decongestants help relieve congestion caused by illness, while antihistamines work best for congestion caused by allergies.

How do I get rid of congestion ASAP?

Depending on the cause, you can expect congestion to last up to two weeks. For relief, you can take OTC medications that help relieve congestion. However, these do not shorten the duration of an illness.

What helps nasal congestion with Covid?

If you experience sinus congestion with COVID-19, taking a decongestant may help you breathe more easily. You can also try cough medicine, taking a hot shower and breathing in the steam, running a cool steam humidifier, staying hydrated, and getting plenty of rest. In addition, OTC pain medication like acetaminophen can help relieve pain and fever.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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