Decongestants & Antihistamines for the Common Cold

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 mouth, dizziness, 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. They may be able to suggest cold medicines that don't have decongestants in them.


What Are Some Common Decongestants and Antihistamines for Colds?

There are many over-the-counter decongestants and antihistamines that can help treat your symptoms. They're sold separately or as part of a combo with other cold and pain drugs.

If you choose a combination medicine, make sure you know everything that's in it. Check to see if it has acetaminophen. If so, follow the directions on the label carefully, and don't take acetaminophen along with it, because it could cause serious liver damage.

These over-the-counter antihistamines and decongestants treat cold and allergy symptoms.


Type of Decongestant or Antihistamine Cold Medicine

Brand Name(s)


Possible Side Effects

Antihistamine(tablets, caplets, or liquid) Benadryl
Itchy, runny nose and eyes; sneezing; itchy throat Drowsiness or grogginess, upset stomach, dry mouth, poor coordination and judgment, urinary retention, loss of appetite, excitability (in children)
Decongestant(tablets or caplets) Sudafed Congestion and pressure in head, nose, and ears Lightheadedness, wakefulness, nervousness, restlessness (jittery and shaky), increased blood pressure and heart rate; irregular heartbeat

(tablets, caplets, or liquid)
Chlor-Trimeton D
Tavist D
Itchy, runny nose and eyes; sneezing; congestion Possible antihistamine and/or decongestant side effects

pain reliever
(tablets, caplets, or liquid)
Advil Cold and Sinus
Itchy, runny nose and eyes; sneezing; congestion; headache Possible antihistamine and/or decongestant side effects
Decongestant nose spray Afrin
Dristan NasalSpray
Nasal stuffiness Might lead to "rebound" congestion from dependence on the medicine if used for more than 3 days
Antihistamine eye drops

Visine-A (Formerly OcuHist)

Zaditor Opcon-A

Itchy, watery eyes; eye redness Temporary stinging in the eyes or blurred vision; "rebound" redness of the eyes if overused




WebMD Medical Reference Reviewed by Carol DerSarkissian, MD on May 12, 2021


American Academy of Family Physicians: "Cough Medicine: Understanding Your OTC Options."
National Institute of Allergy and Infectious Diseases: "Common Cold: Treatment."
UptoDate: The common cold in adults: Treatment and Prevention.

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