Antihistamines, Decongestants, and “Cold” Remedies
Insight into recommended use and side effects
• What are the side effects of antihistamines?
• Who should not use decongestants?
• What are combination remedies?
• and more…
Drugs for stuffy nose, sinus trouble, congestion and
drainage, and the common cold constitute a large segment of
the over-the-counter market for America’s pharmaceutical
industry. Even though they do not cure allergies, sinusitis,
colds, or the flu, they provide welcome relief for at least
some of the discomforts of seasonal allergies and upper
respiratory infections. However, it’s essential for
consumers to read the ingredient labels, evaluate their
symptoms, and choose the most appropriate remedy.
What are antihistamines?
Histamine is an important body chemical that is responsible
for the congestion, sneezing, and runny nose and itching
that a patient suffers with an allergic attack or an
infection. Antihistamine drugs block the action of
histamine, therefore reducing these symptoms. For the best
result, antihistamines should be taken before allergic
symptoms get well established, but they can also be very
effective if taken after the onset of symptoms.
What are the side effects of antihistamines?
Most of the older over-the-counter antihistamines produce
drowsiness, and are therefore not recommended for anyone who
may be driving an automobile or operating equipment that
could be dangerous. The first few doses cause the most
sleepiness; subsequent doses are usually less troublesome.
Some of the newer over-the-counter and prescription
antihistamines do not produce drowsiness.
Typical antihistamines include Benadryl®*, Chlor-Trimetron®*,
Claritin®, Dimetane®*, Hismanal®, Nolahist®*, PBZ®*,
Polaramine®, Seldane®, Tavist®*, Teldrin®, Zyrtec®, Allegra®,
What are decongestants?
Congestion in the nose, sinuses, and chest is due to
swollen, expanded, or dilated blood vessels in the membranes
of the nose and air passages. These membranes, with a great
capacity for expansion, have an abundant supply of blood
vessels. Once the membranes swell, one becomes congested.
Decongestants help to shrink the blood vessels in the nasal
membranes and allow the air passages to open up.
Decongestants are chemically related to adrenaline, the
natural decongestant, which is also a type of stimulant.
Therefore, the side effect of decongestants taken as a pill
or liquid is a jittery or nervous feeling causing difficulty
in going to sleep and elevating blood pressure and pulse
Who should not use decongestants?
Decongestants should not be used by a patient who has an
irregular heart rhythm, high blood pressure, heart disease,
or glaucoma. Some patients taking decongestants experience
difficulty with urination. Furthermore, decongestants are
often used as ingredients in diet pills. To avoid
excessively stimulating effects, patients taking diet pills
should not take decongestants.
Typical decongestants in pill or liquid form are Dura-Vent®,
Exgest®, Entex®, Propagest®, Novafed®*, and Sudafed®*.
* May be available over the counter without a prescription.
Read labels carefully, and use only as directed.
Decongestants are also available over the counter in nasal
spray form. This method of medication delivery brings
immediate relief to the nasal mucous membranes without the
usual side effects that accompany pills or liquids that are
swallowed. Over-the-counter decongestant nose sprays should
be reserved for urgent, emergency and short term use.
Because repetitive use can lead to lack of effectiveness and
return of the congestion, and thus lead to the urge to use
more sprays more frequently, these medications often carry a
warning label, “Do not use this product for more than three
days.” This problem will only improve once the use of the
nasal drops or spray is discontinued.
What are combination remedies?
Theoretically, if the side effects could be properly
balanced, the sleepiness caused by antihistamines could be
cancelled by the stimulation of decongestants. For instance,
one might take the antihistamine only at night and take the
decongestant alone in the daytime. Alternatively, one could
take them together, increasing the dosage of antihistamine
at night (while decreasing the decongestant dose) and then
doing the opposite for daytime use. Since no one reacts
exactly the same as another to drug side effects, a consumer
may wish to adjust the time of day the medications are taken
until finding the combination that works best.
Antihistamines/decongestants: Many pharmaceutical companies
have combined antihistamines and decongestants together in
Typical combinations of antihistamines with decongestants
are: Actifed®*, A.R.M.®*, Chlor-Trimeton D®*, Claritin D®,
Contac®*, CoPyronil 2®*, Deconamine®, Demazin®*, Dimetapp®*,
Drixoral®*, Isoclor®*, Nolamine®, Novafed A®, Ornade®,
Sudafed Plus®, Tavist D®*, Triaminic®*, and Trinalin®.
What should I look for in a “cold” remedy?
Decongestants and/or antihistamines are the principal
ingredients in “cold” remedies, but drying agents, aspirin
(or aspirin substitutes), and cough suppressants may also be
added. Therefore, consumers should choose remedies with
ingredients best suited to combat their own symptoms. If the
label does not clearly state the ingredients and their
functions, the consumer should ask the pharmacist to explain
Which medicine do I need?
The chart below makes it simple for you to determine which
type of medicine is right for you based on the symptoms that
Dry Mouth & Nose
Insomnia, Rapid Heart Beat
||All of Above
Any of Above (more or less)
© 2007 Stefan Kieserman, M.D.
Any information provided on
this Web site should not be considered medical advice or a
substitute for a consultation with a physician. If you have a
medical problem, contact your local physician for diagnosis and