The 5 Best Over-the-Counter Nasal Sprays
Having a basic understanding of common decongestant types might help you narrow down what kind of product you’re looking for:
7 Best Nasal Decongestants You Can Get Over the Counter
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Over-the-counter (OTC) sinus decongestants may be able to offer temporary relief from your symptoms. They have different formulas and uses, so read the labels to make the best choice.
- Best sinus decongestant for allergies:Benadryl Allergy Plus Decongestant Ultratabs
- Best OTC decongestant for a headache:Advil Sinus Congestion and Pain
- Best OTC sinus decongestant nasal spray:Afrin No Drip Severe Congestion
- Best sinus decongestant for kids:Little Remedies Decongestant Nose Drops
- Best OTC decongestant day/night duo:Sudafed PE Day and Night Sinus Pressure Tablets
- Best sinus decongestant on a budget:Cabinet Nasal Decongestant Tablets
- Best OTC decongestant for bedtime:Mucinex Night Shift Cold and Flu
If you’re having trouble breathing due to cold, flu, or allergies, sinus decongestants are designed to relieve your symptoms and help you carry on with your day.
These medications are available OTC at affordable prices, but that doesn’t always make it easy to choose one that’s best for you.
Some stronger medications target multiple symptoms, while others will simply relieve a stuffy nose caused by allergies. Some may make you drowsy, while others might make sleep difficult.
We rounded up the best OTC decongestants to help make the decision making process easier.
Having a basic understanding of common decongestant types might help you narrow down what kind of product you’re looking for:
- Decongestant ingredients work by dilating your blood vessels to relieve pressure in your sinuses.
- Antihistamine ingredients work by blocking your body’s response to allergens.
- Corticosteroid ingredients work by reducing your immune response to allergens and decreasing inflammation.
Decongestant type | Best for | Possible side effects |
---|---|---|
Phenylephrine decongestant | sinus congestion caused by cold and flu | restlessness, dizziness, anxiety |
Pseudoephedrine decongestant | sinus congestion caused by cold and flu | restlessness, dizziness, anxiety, nausea, upset stomach |
Intranasal decongestants | sinus congestion caused by cold and flu | restlessness, dizziness, sore throat, bloody nose |
Intranasal corticosteroids | hay fever and allergies | headache, sore throat, bloody nose |
Antihistamines | sneezing and runny nose | drowsiness |
- Customer reviews: We chose products that scored high marks in trust with customers, according to hundreds of verified reviews.
- Transparency: We looked for products and brands that make realistic, medically-sound claims about their products.
- Clinical trials and peer-reviewed literature: We read through what doctors and researchers have observed about different active ingredients available on the market.
Pricing guide
Best OTC sinus decongestant for allergies
Benadryl Allergy Plus Congestion Ultratabs
What we liked: These tablets contain diphenhydramine, an antihistamine ingredient that may reduce allergy symptoms, and phenylephrine, which may reduce sinus congestion. You can take one of these tablets every 4 hours throughout the day, and reviewers note that they take effect relatively quickly.
What to know: These tablets aren’t intended to clear the flu or a cold, so it’s important to only take them if your sinus congestion occurs due to allergies. Also, be aware that diphenhydramine can make you feel quite sleepy, so avoid this medication on days when you need to be alert.
Best OTC sinus decongestant for a headache
What we liked: These coated tablets contain the decongestant ingredient phenylephrine along with the pain reliever ibuprofen. You can take a tablet up to every 4 hours. The combination of nasal swelling relief, along with the pain relief medication, can quickly relieve many sinus-related headaches. Many reviewers who have frequent sinus headaches swear by this product as being better than even some prescription medications.
What to know: Make sure to keep track of the amount of ibuprofen you’re taking if you’re taking this product. Do not take additional pain relievers, like acetaminophen or aspirin, with this product unless a doctor instructs you to. It’s easy to end up taking a dose that’s higher than recommended of analgesics when you’re mixing medications.
Best OTC sinus decongestant nasal spray
Afrin No Drip Severe Congestion
What we liked: Nasal sprays like Afrin can shrink swollen nasal passages by directly applying an active ingredient to your sinuses. The advantage of this can be that sprays tend to work more quickly than tablets or liquid decongestants. Afrin’s spray contains oxymetazoline hydrochloride and menthol, which relax and refresh your nasal passages pretty much right away, according to reviewers.
What to know: Afrin should only be used temporarily to relieve sinus congestion. Rebound stuffiness can occur in as little as 3 days. Using nasal sprays for a long duration can lead to side effects.
Best OTC sinus decongestant for kids
Little Remedies Decongestant Nose Drops
What we liked: These dye-free drops contain phenylephrine in a dosage that’s safe for kids 2 and up. The dropper-dose formula can be applied 2 to 3 drops at a time directly to nasal passages, which makes for fast relief. (No waiting for tablets to kick in at bedtime). This decongestant can work for symptoms of a cold or flu, or it can be used to help manage congestion caused by allergies.
What to know: It can be difficult to get little ones to sit still and have the drops applied into their noses. You may have better luck putting the formula in a spray-mist bottle or another mist-based bottle to help apply it into their noses.
Best OTC decongestant day/night duo
Sudafed PE Day and Night Sinus Pressure Tablets
- Price: $$
- Type: oral tablet
- Drowsy effect: daytime formula is nondrowsy; nighttime formula has drowsy side effects
What we liked: These tablets contain phenylephrine for sinus congestion relief during the daytime and an additional antihistamine ingredient for nighttime use. These ingredients can treat environmental allergies and congestion caused by the common cold. There are 12 tablets meant for daytime use and 8 that you can take at night, which means you can take a few extra tablets during the day if you need to, but stick to one right before bedtime once you’re ready to sleep.
What to know: There’s no pain relief ingredient included in either the day or nighttime formulas of these tablets. That means that if you have a headache and treating your sinus pressure doesn’t give you relief, you might still find yourself reaching for acetaminophen at the end of the day.
Best OTC sinus decongestant on a budget
Cabinet Nasal Decongestant Tablets
What we liked: This mega-size container of 225 tablets is a great solution if multiple people in your family tend to get allergies or sinus headaches. The no-frills phenylephrine formula is comparable to the dosage you’d find in a name brand but at a fraction of the cost. The formula doesn’t contain anything that will make you sleepy, and you can take a tablet every 4 hours on days when symptoms affect you.
What to know: Some customers complained that the bottle is too large to fit in their medicine cabinet, which seems like a small complaint for a product if you’ll be using it often. This particular tablet only targets sinus congestion, so it will not relieve symptoms like fever or a cough.
Best OTC decongestant for bedtime
Mucinex Nightshift Cold and Flu Liquid
What we liked: This liquid formula contains a pain reliever, a cough suppressant, and an antihistamine ingredient that can work together to give you a good night’s sleep when you’re sick. It does not contain any decongestant, however, so keep that in mind when taking this treatment. It’s great for bedtime because it calms coughing fits that may be keeping you up at night. Although it does not contain a decongestant, the antihistamine ingredient may also reduce nasal congestion caused by seasonal allergies.
What to know: Unlike the other decongestants on this list, this product doesn’t contain anything that loosens mucus. Some reviewers note that they really dislike the taste of this medication.
Decongestant | Best for | Price | Type | Drowsy effect? |
---|---|---|---|---|
Benadryl Allergy Plus Congestion Ultratabs | allergies | $$ | oral tablet | yes |
Advil Sinus Congestion and Pain | headache | $$$ | oral tablet | no |
Afrin No Drip Severe Congestion | nasal spray | $$$ (twin pack) | nasal spray | no |
Little Remedies Decongestant Nose Drops | kids | $$ | nose drops | no |
Sudafed PE Day and Night Sinus Pressure Tablets | day and night use | $$ | oral tablet | daytime formula: no, nighttime formula: yes |
Cabinet Nasal Decongestant Tablets | large supply on a budget | $$$ | oral tablet | no |
Mucinex Nightshift Cold and Flu Liquid | bedtime | $$$ | liquid | yes |
When you’re figuring out which decongestant to buy, you’ll need to determine what’s causing your congestion.
If it’s allergies, you’ll probably want a product that contains an antihistamine ingredient like diphenhydramine. Antihistamines target your body’s immune response to allergens like pollen. Antihistamines usually make the person taking them a bit drowsy, so keep in mind, taking them at any time other than bedtime may have you needing a nap.
If you have cold or flu symptoms, you may be looking for a product that includes phenylephrine or pseudoephedrine. These ingredients work by shrinking your blood vessels, which can help you breathe more easily and reduce the symptoms of a sinus headache or a stuffy nose.
However, both of these ingredients can cause you to feel restless and can make it difficult to fall asleep. These types of drugs can also make you nauseous. Generally, phenylephrine may have fewer serious side effects than pseudoephedrine. Always consult a doctor before taking these meds if you are pregnant or breastfeeding.
Some OTC sinus decongestant formulas include both antihistamines and decongestant ingredients, and some add pain relief ingredients such as ibuprofen to their formula. It’s best to treat for symptoms that you have, not for additional symptoms that you don’t have.
If you’re already taking OTC pain relief medication for, say, a sinus headache, you don’t want to add additional pain relief meds into the mix if you don’t need to.
It’s difficult to keep track of dosage when you’re mixing medications that have overlapping active ingredients, and too much of any pain reliever can lead to complications like stomach issues, rebound headaches, and kidney damage.
Treating your congestion with OTC products doesn’t always provide relief. Get professional medical care if you experience any of the following:
- persistent congestion that lasts for a week or more
- a high fever that lasts for more than 48 hours
- chest pain of any sort
- difficulty breathing
There are also home remedies that you can use to relieve discomfort and clear your congestion. Natural decongestion remedies include:
- sleeping with a humidifier in your room
- diffusing essential oils
- using saline sprays
- taking steamy showers
- using a neti pot
The 5 Best Over-the-Counter Nasal Sprays
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.
How we vet brands and products
Healthline only shows you brands and products that we stand behind.
- Evaluate ingredients and composition: Do they have the potential to cause harm?
- Fact-check all health claims: Do they align with the current body of scientific evidence?
- Assess the brand: Does it operate with integrity and adhere to industry best practices?
Was this helpful?
- Best overall nasal spray:Afrin Pump Mist Maximum Strength
- Best nasal spray for kids:Children’s Flonase
- Best nasal spray for sinus infection:Mucinex Sinus-Max Nasal Spray
- Best nasal spray for allergies:Flonase Allergy Relief Spray
- Best saline nasal spray:Arm and Hammer Simply Saline Nasal Care
Nasal sprays are medications that you spray directly into your nose. These products are sometimes recommended to treat symptoms of sinus pressure and inflammation, which can be caused by allergies or a sinus infection.
These sprays can apply active ingredients directly to the site of your discomfort, which can help to provide quick relief for pressure and congestion.
Nasal sprays that are only available with a prescription have a higher dose of active ingredients and a slightly increased risk of side effects. But many nasal spray products are available over the counter and can be purchased conveniently at any drug store or even online.
Certain products are designed to be better at treating certain conditions, but wading through and narrowing down what might work best can be a daunting task. We read through hundreds of customer reviews, product descriptions, and medical literature so you don’t have to.
OTC nasal sprays can be categorized by their active ingredients (or lack thereof).
- Steroid: OTC steroid nasal sprays are meant to reduce inflammation. That’s why they’re recommended for treating allergies and chronic sinusitis. The steroid sprays may contain budesonide or fluticasone.
- Antihistamine: Antihistamine sprays are meant to blunt the impact of an allergen that your body is reacting to. These products are mostly recommended for allergies. Active antihistamine ingredients in nasal sprays are azelastine or olopatadine.
- Nasal decongestant: These types of sprays aim to shrink irritated blood vessels that line your nose, reducing inflammation to help you breathe more easily. Ingredients may include oxymetazoline hydrochloride or phenylephrine hydrochloride.
- Saline: Saline sprays don’t contain active ingredients, but they can loosen mucus and help you to breathe more easily.
We chose these products based on the following criteria:
- Hundreds of verified customer reviews: We read through what people like you had to say about the pros and cons of every product on this list.
- Transparent and honest claims: We disqualified any product that makes medically inaccurate or exaggerated claims about how their product can work in their advertising.
- Clinical trials and peer-reviewed studies: We checked the research on the active ingredients and long-term side effects of the products on this list so you could have peace of mind making your choice.
Pricing guide
Best overall nasal spray
Afrin Pump Mist Maximum Strength
- Price: $
- Who it works for: The active ingredient in this spray is oxymetazoline, a nasal decongestant. That makes Afrin Pump Mist a good choice if you’re experiencing congestion related to allergies, a sinus infection, or a combination of both. One dose (two to three pumps) of Afrin lasts 12 hours.
- What to know: This product shouldn’t be used for more than 3 consecutive days. It contains polyethylene glycol, which some people may be allergic to. Afrin can be habit forming. If you’re still having symptoms after 3 days, speak with a doctor and switch to another treatment.
Best nasal spray for kids
Children’s Flonase
- Price: $$
- Who it works for: The children’s formulation of Flonase contains glucocorticoid, a medication that relieves congestion caused by allergies. It’s also nondrowsy, so your child can take a dose before they’re off to school or a game. Glucocorticoid is an anti-inflammatory, but not an antihistamine, which may make it more effective at treating congestion. One spray per day in each nostril is enough.
- What to know: This product isn’t approved for kids under 4. Note that continuous use or overuse of Flonase can affect your child’s growth, so it shouldn’t be used as a long-term solution. Be sure to supervise your child when using this product, and make sure they take the recommended dosage. Note that this spray won’t treat congestion that’s caused by a cold or sinus infection.
Best nasal spray for sinus infection
Mucinex Sinus-Max Nasal Spray
- Price: $$
- Who it works for: Oxymetazoline chloride is the active ingredient in this spray, which is meant to treat mild to moderate sinus congestion. As a bonus, this spray contains cooling menthol, which can help soothe inflamed nasal passages and give you a burst of clean, cool sensation. Reviewers say this formula works immediately.
- What to know: This spray should only be used once every 12 hours, and it’s not a long-term treatment for ongoing sinus and allergy issues, as it can be habit forming. If your symptoms haven’t subsided after 3 days, speak with a doctor and switch to another treatment.
Best nasal spray for allergies
Flonase Allergy Relief Spray
- Price: $$$
- Who it works for: Flonase is a nondrowsy formula that contains fluticasone, which is meant to treat hay fever symptoms. Fluticasone is a corticosteroid treatment that can reduce inflammation in your sinuses without the sleepy side effects of an antihistamine. Unlike other nasal sprays, Flonase is non-habit forming, so you can use it year-round. In addition to sinus congestion, it addresses watery eyes and itching.
- What to know: You only need two sprays in each nostril daily to get the full impact of Flonase. Some known side effects include nosebleeds and a sore throat. These side effects become more likely with overuse.
Best saline nasal spray
Arm and Hammer Simply Saline Nasal Care
- Price: $$
- Who it works for: This saline nasal spray adds moisture to clogged nasal passages. It loosens mucus with the help of baking soda, instead of constricting nasal passages. Some reviewers who live in dry climates use it to irrigate their nose.
- What to know: Unlike other nasal sprays, it’s safe to mix this saline spray with other types of cold and allergy medication. If you need relief from severe cold, flu, or allergy symptoms, try one of the stronger sprays on this list. Note that this spray is more of a fine mist and can take some getting used to.
The best nasal spray for you depends on what you need the product to do. Aim to treat your symptoms based on the underlying cause. If you need a nasal spray because of seasonal allergies, look for a spray that contains a steroid. If you’re treating a sinus infection, look for one with decongestant ingredients.
Start with a product that has a lower amount of active ingredients before trying something with a higher amount.
How to use
Most nasal sprays are used the same way.
- First, blow your nose to get your nasal passages as clear as possible. This will ensure you’re not simply blowing mucus back into your sinus cavity.
- Next, make sure that the spray cap is off and the spray is open. You may need to shake the bottle or release a small amount of spray from the pump to get it ready to use.
- Point the end of the nasal spray directly under one of your nostrils. Close your mouth before you gently spray and inhale. Your goal is to get the spray into your sinuses, not to feel it in the back of your throat.
Always carefully read the packaging of any product that you use before you start using a nasal spray. Dosage may vary according to what you are using. Most nasal sprays are only meant to be used once or twice per day for a maximum of three consecutive days.
Using nasal spray too much can give you nosebleeds or cause rebound congestion.
Nasal sprays aren’t typically intended as a long-term solution for allergies and frequent sinus congestion. Some people report that nasal sprays can be habit-forming, and side effects such as rebound inflammation and nosebleeds can occur if you overuse these products. Alternatives to consider include:
- Run a cool-mist humidifier or essential oil diffuser in your home to keep sinus congestion to a minimum.
- Consider a HEPA-filter air filtration device if environmental allergies are a problem indoors.
- Apply a warm compress to your forehead and nasal passages to soothe painful congestion.
- Keep oral allergy medications in mind as an alternative to nasal sprays.
- Breathe in steam or take a warm shower to loosen mucus that’s inflaming your sinus passages.
- Drink an herbal tea with peppermint.
Nasal sprays can help you manage hay fever or sinus infection symptoms. But there are times when you may need to see a doctor about your symptoms.
Talk with a doctor about your congestion if you have one or more of the following symptoms:
- nasal congestion that lasts for 2 weeks or more
- a high fever that lasts for over 72 hours
- nasal discharge that appears green and comes with a recurring fever or headache
How do OTC nasal sprays compare with prescriptions?
In general, OTC nasal spray options have many of the same active ingredients as their prescription-strength counterparts. The main difference is the dosage that’s included in the spray. Prescription-strength sprays are also more likely to contain corticosteroid ingredients.
How do nasal allergy sprays compare with oral allergy medication?
Nasal allergy sprays tend to take several days to start working, while oral allergy medications can start working within a few hours. However, in the long run, nasal sprays may be more effective than taking oral medication. Generally, however, they both have the same effects.
Are nasal allergy sprays safe to use?
Nasal allergy sprays are safe to use occasionally for the treatment of a runny nose or nasal congestion. Nasal decongestant sprays can cause what’s called rebound congestion if used for 3 consecutive days. Before using any type of nasal spray, read package instructions carefully.
Shopping for the right nasal spray starts with learning a thing or two about the active ingredients they contain. Once you know the basics, it’s much easier to narrow down which symptoms you need to treat and which nasal spray might work best.
Some nasal sprays can be habit-forming and aren’t appropriate for long-term use. Speak with your doctor about a longer-term treatment plan if nasal sprays aren’t giving you symptom relief.
Last medically reviewed on August 29, 2022