MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Topical nasal decongestants

Drug safety update

February 2024: Pseudoephedrine: very rare risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS)

 June 2017: Pseudoephedrine and ephedrine: regular review of minimising risk of misuse in the UK

 September 2015: Pseudoephedrine and ephedrine: update on managing risk of misuse

 September 2015: Pseudoephedrine and ephedrine: update on managing risk of misuse in the UK

 December 2014: Pseudoephedrine and ephedrine: nasal decongestants

 December 2014: Over-the-counter cough and cold medicines for children

Inhalation of warm moist air is useful in the treatment of symptoms of acute infective conditions.

Sympathomimetics are likely to cause rebound congestion and are of limited value. They are available from pharmacies over the counter at a cost less than a prescription charge. They should be used for short periods of time only (usually not longer than 7 days). The CHM/MHRA advise that these medicines should not be used in children under 6 years of age.

Ephredrine nasal drops are the safest sympathomimetic preparation. Xylometazoline, altough more potent, is more likely to cause rebound congestion.

Sodium chloride 0.9% nasal drops may relieve nasal congestion by helping to liquify mucous secretions.

Orally administered nasal decongestants may not be as effective as preparations for local application but they do not give rise to rebound nasal congestion on withdrawal.

Caution: diabetes, hypertension, hyperthyroidism, raised intraocular pressure, prostate hypertrophy, hepatic impairment, renal impairment and ischaemic heart disease and avoid in patients taking monoamine oxidase inhibitors (MAOIs).

Likely to be of limited value and more likely to cause rebound congestion

Pack Price
10 ml £2.97