Spring allergy season is around the corner. Here's what you can do to deal with congestion.

CBS News

19-03-2025

The start of spring kicks off a nasal nuisance for many people. One drug meant to clear congestion has struggled to do its job.
Saline rinses, Flonase and antihistamines were the choices of a few people WCCO talked with when asking how best to clear congestion. None of their responses included products containing phenylephrine, the decongestant found in over-the-counter medications like Advil: Sinus Congestion and Pain, or NyQuil: Severe Cold and Flu.
Last fall, the FDA
declared the drug ineffective
when taken as a pill or liquid.
"Unfortunately, when you take (phenylephrine) by mouth it's metabolized in the gut and by the liver where very little of the medicine actually makes it back to the nose," Dr. John Sweet, an allergist with Hennepin Healthcare, said.
Phenylephrine works by constricting the blood vessels in the nose, leading to less drainage and congestion. There is still one effective way to take the drug.
"When it's used in nasal spray, delivered directly to the nose, it can have a very immediate and strong effect in decreasing nasal congestion," he said.
Phenylephrine nasal sprays should be used no more than three days in a row. Overuse can make congestion worse.
"If you're looking for a quick fix, pseudoephedrine," Sweet said when asked what people should use for immediate relief from congestion.
That drug is found in Sudafed, as well as allergy meds that end in "D" like Claritin-D and Allegra-D. Pseudoephedrineis effective when taken orally.
Sweet suggests a steroid nasal spray like Flonase (fluticasone), Nasonex (mometasone) and Nasarel (flunisolide) to use daily to relieve congestion. Nasal steroids need at least a week to start working, so begin using them before allergies stuff your nose.
Taking antihistamines like Claritin (loratadine), Zyrtec (cetirizine) and Allegra (fexofenadine) in addition to a nasal steroid can bolster your ability to fight congestion.
Medicine isn't the only remedy Sweet suggests:
Despite the plethora of options, those battling congestion were somewhat annoyed to learn phenylephrine wasn't working as it should have.
"With medicine, we're always advancing. We make some assumptions. Sometimes they're wrong. And, with research, we actually can figure out what we're wrong about, and we have to make a little course correction," Sweet said. "Unfortunately, the oral phenylephrine was not as effective as we once thought."