Suffer from Spring Allergies? These OTC Decongestants Are Recommended by Ear, Nose & Throat Doctors (2024)

Nasal decongestants can provide much-needed relief, whether you suffer from a cold, allergies, or general stuffiness. Luckily, plenty of over-the-counter (OTC) nasal decongestants are available to relieve your symptoms.

Some of the most popular and widely used nasal decongestants contain ingredients like pseudoephedrine and phenylephrine, which work fast to relieve sinus pressure and congestion. However, Dr. Geoff Trenkle, D.O., an otolaryngologist and founder of the Los Angeles Center for Ear, Nose, Throat and Allergy, doesn't recommend relying on these medications for long-term use, which can lead to overuse and worsened symptoms. You should see a healthcare provider if you experience sinus pressure that doesn’t go away after using OTC decongestants.

A few of the products on our list below contain these ingredients, but most are antihistamine-based, steroid-based, or all-natural, with ingredients like saline and xylitol. Below, we’ve rounded up the best OTC nasal decongestants doctors suggest for short- and long-term relief.We had a doctor from our Medical Expert Board review this article for medical and scientific accuracy.

There are a variety of nasal decongestants on the market, including:

• Spray: Sprays are the most common type of nasal decongestants. They work by constricting blood vessels in your nose.
• Oral pills: Another common type of nasal decongestant is a pill that can be taken by mouth. Oral decongestant pills come in drowsy and non-drowsy formulas.
• Swab: A few brands offer swabs for nasal decongestants. The swabs are doused in a decongestant formula and then swabbed inside each nostril for relief.
• Nasal decongestant vapor inhaler: A nasal inhaler is a decongestant formula used to inhale for relief.
• Nasal drops: Nasal drops are similar to eye drops. Tilt your head back and apply them to your nose to use them.
  

Our Best Spray Picks

• Most Effective: Nasacort 24HR Allergy Nasal Spray
• Best Fast Acting: Astepro Nasal Spray
• Best Non-Drowsy: NasalCrom Nasal Spray
• Best for Indoor and Outdoor Allergies: Flonase Allergy Relief Nasal Spray
• Best Natural: Beekeeper’s Naturals Nasal Spray

• Best for 24-Hour Relief: Allegra
• Best for Headaches: Advil Sinus Congestion and Pain
• Best for Congestion: Sudafed PE Day and Night Sinus Pressure & Congestion Tablets

Our Swab & Inhaler Picks

• Best for Colds: Zicam Cold Remedy Cold Shortening Medicated Nasal Swabs
• Best for Travel: Vicks VapoInhaler On-the-Go Portable Nasal Inhaler
  

Not all decongestants are the same, and choosing the right one depends on your needs and medical condition. When selecting the right decongestant for you, consider the following:

• Type of congestion: For a cold, it’s okay to use decongestants that include ingredients like pseudoephedrine and phenylephrine. However, for allergies or anything lasting more than 3-5 days, it can be dangerous to use decongestants with these ingredients, according to Dr. Purvi Parikh, an allergist and immunologist based in New York. She recommends using pills and sprays without decongestant ingredients for this type of congestion, particularly those that contain antihistamines and steroids.
• Severity of congestion: If congestion is severe, Dr. Parikh recommends seeing a doctor, like an allergist or ENT, who can diagnose the problem and prescribe medication.
• Medical conditions or pregnancy/breastfeeding: Children, pregnant or breastfeeding people, and anyone with heart disease or diabetes should consult their doctor before using decongestants like Afrin, pseudoephedrine, phenylephrine, and any medicine with “-D” in the name (for example, Claritin-D or Zyrtec-D), according to Dr. Parikh.

Our Best Spray Picks

Most Effective: Nasacort 24HR Allergy Nasal Spray

Why We Like It

Nasacort 24HR Allergy Nasal Spray is the first product Dr. Randolph Betts, MD, a family medicine practitioner based in California, recommends for nasal congestion. He notes that almost all his patients report significant 24-hour improvement and complete relief from nasal congestion after three days of use.

Betts attributes this product’s great track record to triamcinolone acetonide, which decreases inflammation. We also like that this pick is non-drowsy, easy to find at most drugstores, and free of scents and alcohol.

It’s Worth Noting

• This pick isn’t as strong as some of the other nasal sprays available on the market.

Product Details

• Form: Nasal spray
• Active Ingredients: Triamcinolone acetonide
• Non-Drowsy: Yes
• Best For: Nasal congestion, sneezing, runny nose, itchy nose

Best Fast Acting: Astepro Nasal Spray

Why We Like It

Astepro Nasal Spray is a steroid-free spray that reduces nose congestion, itchiness, and runniness. Whether your congestion is due to allergies or a cold, Dr. Parikh says the spray works within 30 minutes to treat the root of the problem and provide long-term relief.

Some nasal sprays can be more effective than pills at targeting sneezing and stuffiness, and this one is highly effective. The formula contains 205.5 micrograms of azelastine HCl, a powerful antihistamine, and is also fragrance—and alcohol-free.

It’s Worth Noting

• The aftertaste isn’t the most pleasant (which isn’t unexpected for most nasal sprays). Another thing to note is that the spray might make you drowsy, so it’s best to use it before you go to bed.

Product Details

• Form: Nasal spray
• Active Ingredients: Azelastine HCI
• Non-Drowsy: No
• Best For: Nighttime use

Best Non-Drowsy: NasalCrom Nasal Spray

Why We Like It

NasalCrom Nasal Spray is a non-drowsy option for allergy-related congestion. According to Dr. Trenkle, this product is known as a mast cell stabilizer, meaning it’s more preventive and can help manage nasal allergy symptoms with minimal side effects.

The main ingredient in the spray is cromolyn sodium in a dosage of 5.2 milligrams. Trenkle recommends this spray for anyone who wants a non-decongestant option for allergies, adding that it’s best to start using it daily about a week before you expect to get congested (such as allergy season).

It’s Worth Noting

• This is not a steroid-based nasal spray, so it might be less effective than other sprays. It’s also geared towards folks with allergies and might not relieve colds or sinusitis.

Product Details

• Form: Nasal spray
• Active Ingredients: Cromalyn sodium 5.2 milligrams
• Non-Drowsy: Yes
• Best For: Allergies

Best for Indoor and Outdoor Allergies: Flonase Allergy Relief Nasal Spray

Why We Like It

Flonase Allergy Relief Nasal Spray fights nasal decongestion caused by allergies by blocking six allergic substances, while many other allergy pills can only block one. It relieves nasal congestion, runny nose, sneezing, itchy nose, and watery eyes.

Dr. Parikh recommends Flonase to her patients because it actually treats the inflammation causing the congestion rather than providing temporary symptom relief. It’s also safe to use in the long term, though she notes that it’s important to use it consistently for the most relief.

It’s Worth Noting

• You probably won’t find immediate relief with Flonase, so plan to use it for a few days before expecting results.

Product Details

• Form: Nasal spray
• Active Ingredients: Fluticasone propionate
• Non-Drowsy: Yes
• Best For: Allergies

Best Natural: Beekeeper's Naturals Nasal Spray

Why We Like It

If you prefer to go the natural route regarding nasal decongestion, consider using Beekeeper’s Naturals Nasal Spray, which Dr. Trenkle recommends to his patients. Saline sprays provide gentle relief from congestion while moisturizing your nasal passages, and they’re also safe for frequent use.

Dr. Trenkle likes nasal sprays that contain xylitol because they have a cleansing effect, reducing the adherence of bacteria and irritants in the nasal passages. This pick from Beekeeper’s Naturals contains a saline solution, xylitol, propolis extract, eucalyptus, and oregano to help clear congestion naturally.

It’s Worth Noting

• This is a natural formula, and you probably won’t see as dramatic results as you would with other medicated nasal decongestants.

Product Details

• Form: Nasal spray
• Active Ingredients: Saline, xylitol
• Non-Drowsy: Yes
• Best For: Blocked nasal passages

Best for 24-Hour Relief: Allegra

Why We Like It

Allegra is an antihistamine that millions have used to relieve the typical symptoms of allergies, like sneezing, itchy, watery eyes, runny nose, and itchy nose or throat. The active ingredient is fexofenadine HCl 180 milligrams, which provides relief for a full day.

In the event that another nasal decongestant doesn’t work, Dr. Betts suggests trying Allegra. It’s all about determining which active ingredient works best for your body and your symptoms. We also love that this pill works pretty fast.

It’s Worth Noting

• Some people find that Allegra makes them feel a little sleepy.

Product Details

• Form: Pill
• Active Ingredients: Fexofenadine HCl 180 milligrams
• Non-Drowsy: Yes
• Best For: Allergies

Best for Headaches: Advil Sinus Congestion and Pain

Why We Like It

Dealing with sinus congestion and a headache is the worst. Thankfully, Advil Sinus Congestion and Pain can help alleviate both symptoms simultaneously. These pills contain 200 milligrams of ibuprofen and 10 milligrams of phenylephrine HCl to relieve a headache while also decreasing sinus pressure, nasal swelling, and congestion.

This pick will work fast and should relieve symptoms for a while. However, you can take one tablet every four hours while symptoms persist (but don’t take more than six tablets within 24 hours).

It’s Worth Noting

• These pills should not be taken for long-term use and are formulated for use as needed. Consult your doctor if you are experiencing headaches and nasal congestion frequently.

Product Details

• Form: Tablet
• Active Ingredients: 200 milligrams ibuprofen, 10 milligrams phenylephrine HCl
• Non-Drowsy: Yes
• Best For: Headache, colds, sinusitis

Best for Congestion: Sudafed PE Day and Night Sinus Pressure and Congestion Tablets

Why We Like It

To treat sinus congestion day and night, reach for these Sudafed PE Day and Night Sinus Pressure and Congestion Tablets. Dr. Betts recommends this medicine to his patients and notes that Sudafed is the oldest recommended OTC decongestant for coughs and colds.

The diphenhydramine HCl ingredient in the evening dose allows you to sleep and rest, which is the ultimate recommendation for kicking a cold. The daytime tablets contain phenylephrine HCl, a nasal decongestant that won’t make you fall asleep mid-day.

It’s Worth Noting

• The pills' packaging makes them difficult to remove. Also, take care not to mix the daytime and evening doses.

Product Details

• Form: Pill
• Active Ingredients: Phenylephrine HCl, diphenhydramine HCl
• Non-Drowsy: Yes
• Best For: Allergies and colds

Best for Colds: Zicam Cold Remedy Cold Shortening Medicated Nasal Swabs

Why We Like It

Zicam Cold Remedy Cold Shortening Medicated Nasal Swabs provide a unique homeopathic solution to nasal congestion caused by colds. Dr. Betts says he recommended them after COVID-19 because his patients found them soothing and highly effective for cold relief.

The formula has a proprietary blend of three natural plant extracts and contains cooling menthol and eucalyptus for soothing relief upon application. This product does a great job of moisturizing a dry nose and is easy to apply. The swabs help you breathe easier and provide a cooling sensation that many find soothing.

It’s Worth Noting

• For best results, start using the swabs at the first signs of a cold. If you're multiple days into a cold, you might get less benefit from these nasal swabs.

Product Details

• Form: Nasal swabs
• Active Ingredients: Galphimia glauca, luffa operculata, sabadilla
• Non-Drowsy: No
• Best For: Colds

Best for Travel: Vicks VapoInhaler On-the-Go Portable Nasal Inhaler

Why We Like It

The Vicks VapoInhaler On-the-Go Portable Nasal Inhaler is our favorite budget option because it can be found at most drugstores, is convenient for on-the-go use, and helps to clear out your nostrils.

Dr. Betts recommends this affordable option to his patients because it’s useful anytime and any place. He notes that the blend of ingredients, which includes menthol and camphor, is soothing and non-medicated, so there’s no way to overuse it.

It’s Worth Noting

• Because this inhaler is non-medicated, you might not experience the strong relief you would with some of the other medicated nasal decongestants on this list.

Product Details

• Form: Nasal inhaler
• Active Ingredients: Menthol, camphor
• Non-Drowsy: Yes
• Best For: Refreshing, soothing congestion

Our Review Process

To find the best nasal decongestants on the market, we interviewed multiple doctors for their recommendations for the best active ingredients and any products to avoid. During our review process, we considered the ingredient list, the form of nasal decongestant (nasal sprays versus pills, for example), and the type of congestion each product is best for.

For this story, we interviewed an otolaryngologist, a primary care physician, and an allergist:

• Dr. Geoff Trenkle, D.O., an otolaryngologist, CEO, and Founder of the Los Angeles Center for Ear, Nose, Throat, and Allergy
• Dr. Randolph J. Betts, M.D., a family medicine doctor in Covina, CA
• Dr. Purvi Parikh, M.D., an allergist with Allergy & Asthma Network in New York

Who We Are

Daley Quinn is a freelance journalist specializing in beauty and health who has contributed to numerous publications, such as Elle, Real Simple, Allure, The Cut, WWD, and more. She also runs a blog called The Daley Dose. She interviewed multiple experts for their recommendations for the best nasal decongestants on the market.