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A Decongestant in Cold Medicines Is Ineffective. Here’s What to Use Instead.

But you still may want to look for alternatives. “Me, personally, I wouldn’t want myself or my kid to take anything that’s unnecessary and that’s demonstrated ineffective,” said Jennifer Le, a member of the advisory committee and a professor of clinical pharmacy with the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego.

Pseudoephedrine, which is found in behind-the-counter products like Sudafed, is effective at clearing congestion, Dr. Dykewicz said; just keep in mind that it can come with side effects. Some people taking the medication report trouble sleeping, feeling jittery or elevated blood pressure, he said.

Nasal decongestant sprays like Afrin or those that contain phenylephrine can also offer relief, Dr. Dykewicz said — but you shouldn’t use them for longer than three to five days. After that, you run the risk of rebound congestion: when the mucosal surfaces in your nose swell, making you feel even more clogged up than before. There are some sprays that you can use for longer stretches, without the rebound risk, namely steroid sprays that contain ingredients like fluticasone (Flonase) or triamcinolone (Nasacort), which are available over-the-counter.

If allergies are the source of your congestion, oral antihistamines like Zyrtec, Claritin or Allegra might help. You can pinpoint whether your stuffy nose comes from allergies or a viral infection, like the cold and flu, by paying attention to other symptoms, said Dr. Mark Aronica, an allergy and immunology specialist at the Cleveland Clinic. If you also have a sore throat, fever or body aches, it’s likely something other than allergies.

In many cases, you can treat a stuffed-up nose by standing in a steamy shower or using a humidifier to help clear your nasal passages, Dr. Le said. A nasal saline spray can also help clear out irritants and mucus trapped in the nose, said Dr. Andrew Lane, director of the Johns Hopkins Sinus Center.

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