Why doctors are warning against using decongestants to beat a stuffy nose

Treatment for Allergies or Common Cold. Woman Using Nasal Spray Drops of Medicine in Her Nose. Rhinitis, Allergy.
Decongestants can come in the form of tablets or nasal sprays, and are popular during cold and flu season. (Getty Images)

Cold and flu season often means contending with a stuffy, blocked nose that is uncomfortable and irritating.

In a desperate bid to be able to breathe again, many people turn to nasal decongestants that are easily available over-the-counter at pharmacies and supermarkets. However, experts are warning patients not to take them under certain circumstances.

The NHS has issued a warning for people who have health issues such as diabetes or high blood pressure to avoid taking decongestants.

Most people can use these medications safely, but they are not suitable for everyone. The NHS said that decongestants "should not be used by the following groups of people without getting advice from a pharmacist or GP first".

These groups include:

  • People taking other medicines

  • People with diabetes

  • People with high blood pressure

  • People with an overactive thyroid

  • Men with an enlarged prostate

  • People with liver, kidney, heart or circulation problems

  • People with increased pressure in the eye (glaucoma)

In addition to the NHS warning, TV doctor Xand Van Tulleken, who frequently appears on BBC Morning Live to give health advice, has also urged people not to buy decongestants in the form of nasal sprays.

We take a look at why doctors are warning against using decongestants.

Tired mature man uses laptop
Having a blocked nose is uncomfortable and irritating, so many people turn to decongestants to help them breathe easier. (Getty Images)

The NHS issued a warning about decongestants because they are not suitable for everyone. Some people with specific health conditions may experience adverse side effects.

Many decongestant products contain pseudoephredine, which you don’t need a prescription to take. However, studies have suggested that taking the medication may cause blood pressure to rise, making it unsuitable for people with high blood pressure.

People with diabetes are also advised against taking decongestant medicines as they are believed to increase blood sugar levels. It’s best to check with your doctor or pharmacist before purchasing over-the-counter decongestants as a diabetic.

In addition to people with specific health issues, the NHS also states that decongestants should not be given to children under the age of six. Children aged six to 11 should take them for no longer than five days.

Pregnant and breastfeeding women are also told to steer clear of decongestants as the science is unclear on "whether it’s safe to take any type of decongestant" during this period.

The NHS adds that pregnant and breastfeeding women "should only use them if told to by a healthcare professional".

Patients are urged to read the patient information leaflet that comes with the medicine, as it states who should not use it and who should get advice before using it.

Senior Man is having flu and he is using nasal spray to help herself. Man using nasal spray. Nasal spray to help a cold. Sick with a rhinitis woman dripping nose. Man applies nasal spray
Using decongestants in the form of a nasal spray is popular, but can have serious consequences if not used within the recommendations of the manufacturer. (Getty Images)

On Tuesday 19 November, Dr Xand appeared on BBC Morning Live to urge people to be cautious about decongestant nasal sprays. Nasal sprays are a popular way to get quick, short-term relief from a blocked nose - but this can have consequences.

These sprays work by reducing the swelling in the nose that causes congestion, making them effective at helping people breathe easier for a while. But Dr Xand warned of a phenomenon known as "rebound congestion".

He explained: "So when you stop using them, the blood vessels in your nose have gotten used to using them so they wear off quite quickly and then you can get more congestion afterwards.

"It’s actually a very well-described phenomenon and it means you can get congestion going on and on and on for ages. So personally, I would steer clear of them."

Dr Xand’s warning comes after a TikTok user named Curtis Arnold-Hammer shared his experience of becoming "addicted" to Sudafed, a popular over-the-counter nasal spray that contains pseudoephredine.

Arnold-Hammer shared a series of TikTok videos talking about his experience. He said he relied on Sudafed so much over a two-and-a-half-year period that he ended up needing a nose operation.

In one video, he explained: "I literally could not breathe without it. I cannot stress that enough."

Sudafed and other nasal spray products warn users not to use it for more than seven consecutive days. You should also only use the spray a maximum of three times in 24 hours, according to the patient information leaflet.

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