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Cold, Flu, & Cough Health Center

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Decongestants & Antihistamines for the Common Cold

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Are you all stuffed up and sneezing away because of a cold? Decongestants and antihistamines can help. They come in different forms, and they're often mixed into combination drugs that you can buy without a prescription.

It pays to do a little homework to make sure you're picking the right medicine for your symptoms.

How Do Decongestants Work?

They help reduce swelling in the passageways of your nose, which relieves the feeling of pressure and improves the flow of air. You'll be able to breathe a whole lot better.

Decongestants come in pill form or nasal sprays. Don't use the sprays for more than 3 days, or you may get more stuffed up.

How Do Antihistamines Work?

Some types of them can help relieve your runny nose and sneezing when you have a cold.

They block a chemical your body makes called histamine that makes the tissues in your nose itch and swell.

Most experts say that histamine isn't the major cause of a runny nose when you have a cold. Even so, some of the older antihistamines, such as brompheniramine and chlorpheniramine, can bring relief.

Newer antihistamines like fexofenadine (Allegra) and loratidine (Claritin) have not been shown to work for cold symptoms.

Are Decongestants and Antihistamines Safe?

A decongestant called phenylpropanolamine (PPA) was used for years as an ingredient in many cold drugs to clear up a stuffy nose. In 2000, researchers found it was linked to an increased risk of stroke, especially in women ages 18 to 49. The FDA then banned it from use in all prescription and over-the-counter medications.

Today's medicines don’t have PPA, but make sure you don't have any old cold meds in your house that might contain the ingredient.

What Are the Side Effects?

The main one for antihistamines is drowsiness, so it can be tough to take during the day. That's why they're often included in nighttime cold medicines.

Other common side effects include dry mouthdizziness, and headache.

Decongestants may keep you awake and are usually taken during the day. Nasal sprays are less likely to have that side effect and may be helpful at night for congestion.

Decongestants can also raise blood pressure. So if your BP is high already, or you've got heart disease, check with your doctor before you use them. He may be able to suggest cold medicines that don't have decongestants in them.

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