Hay fever medicine – decongestants
Decongestants can be taken in tablet form, as nasal sprays and as eye drops. They can be a very good treatment for the stuffiness that often occurs in hay fever, but should be used with great caution. When used for longer than three days a ‘rebound’ condition known as rhinitis medicamentosa can occur, in which increased congestion can make it difficult to breathe through the nose. You then have no choice but to stop using the medication immediately and wait until the situation improves by itself, putting up with severe stuffiness until you return to the state you were in before you started using it.
If you are pregnant or planning to become pregnant, it’s important to seek your doctor’s advice before taking decongestants of any kind. The same applies for a woman who is breastfeeding.
Oral decongestants
Although decongestants in tablet form can certainly help to unblock the nose and sinuses, they should also be taken for no more than three days, for the same above-mentioned reasons. There is also evidence of a very slight risk of potentially serious side effects. For instance, it has been found that one oral decongestant, called phenylpropanolamine, can cause strokes as a result of bleeding in the brain, especially in a person with high blood pressure. It can also give rise to problems in people with diabetes, thyroid problems or heart disease.
When a decongestant is combined with an antihistamine in tablet form, tests have shown that they work very well on a short-term basis. Some oral decongestants combined with an antihistamine can be purchased over the counter, but you are strongly advised to ask your doctor to recommend the most suitable one for you. The potential risks of taking phenylpropanolamine have diminished the enthusiasm for this drug, and another fact to be considered is that oral decongestants can interact with other medications such as those for depression or Parkinson’s disease.
Decongestant nasal sprays
Decongestant sprays with the ingredient oxymetazoline hydrochloride (brand names Afrin, Vicks and Sinex), which are effective for less severe symptoms, can be bought directly from chemists and some supermarkets. For short-term use, they are far safer than oral decongestants, and work by constricting blood vessels in the lining of the nose, rapidly opening up the nasal passages, reducing congestion and making it easier to breathe. As the medicine in the spray is localized to the nose, there is less risk of side effects occurring. When a course of hay fever treatment begins, just before the start of the hay fever season, doctors often recommend the short-term use of a decongestant spray in combination with an antihistamine or steroidal spray. This is because the rapid action of the decongestant enables the other sprays to be more effective.
Note that decongestant sprays should be used for no longer than three days, as longer usage can make a blocked nose more blocked. Steroidal and antihistamine sprays don’t have this side effect.
Decongestant eye drops
To give fast relief for itchy, watery eyes, decongestant eye drops may be used. After application, you may experience temporary stinging or burning in the eyes, but this should soon disappear. If you encounter any other side effects, such as eye irritation, headache, cough, dry mouth and nausea, it is best to stop using the drops and seek your doctor’s advice.
As with other types of decongestant, the eye drops should not be used for more than three consecutive days, to prevent the onset of rebound congestion.