Decongestants & Antihistamines for the Common Cold

Medically Reviewed by Brunilda Nazario, MD on September 11, 2023
3 min read

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.

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.

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 loratadine (Claritin) have not been shown to work for cold symptoms.

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.

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.

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 throatDrowsiness or grogginess, upset stomach, dry mouth, poor coordination and judgment, urinary retention, loss of appetite, excitability (in children)
Decongestant (tablets or caplets)SudafedCongestion and pressure in the head, nose, and earsLightheadedness, wakefulness, nervousness, restlessness (jittery and shaky), increased blood pressure and heart rate; irregular heartbeat
Pain reliever 
(tablets, caplets, or liquid)
Advil Cold and Sinus
Itchy, runny nose and eyes; sneezing; congestion; headachePossible antihistamine and/or decongestant side effects
Decongestant nose sprayAfrin
Dristan NasalSpray
Nasal stuffinessMight 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 rednessTemporary stinging in the eyes or blurred vision; "rebound" redness of the eyes if overused