Best OTC Sinus Decongestants

  • Best over-the-counter sinus decongestant for allergies: Benadryl Allergy Plus decongestant ultratabs
  • Best over-the-counter sinus decongestant for a headache: Advil Sinus Congestion and Pain
  • Best over-the-counter sinus decongestant nasal spray: Afrin No-Drip Severe Congestion
  • Best over-the-counter sinus decongestant for kids: Little Remedies Decongestant Nasal Drops
  • Best OTC sinus decongestant day / night duo: Sudafed PE Day and Night Tablets for Sinus Pressure
  • Best OTC Sinus Decongestant on a Budget: Nasal Decongestant Tablets Cabinet
  • Best over-the-counter sinus decongestant for bedtime: Mucinex Night Shift Cold & Flu

Sinus decongestants are products that can relieve pressure in the head and nose. If you’re having trouble breathing due to a cold, flu, or allergies, these products are designed to relieve your symptoms and help you get on with your day. These medications are available over the counter at affordable prices, but it doesn’t always make it easier to choose the one that’s best for you.

Each over-the-counter (OTC) decongestant formula is different. Some target multiple symptoms and bring together several active ingredients. Others are designed simply to relieve a stuffy nose caused by allergies. Some can make you drowsy, while others can make it hard for you to sleep. Knowing the difference between these products will help you choose the best product for your symptoms and situation.

We’ve rounded up the best decongestants you can buy over the counter to make the decision making process easier.

  • Customer reviews. We have chosen products that have obtained high marks of trust with customers, based on hundreds of verified reviews.
  • Transparency. We have researched products and brands that make realistic and medically based claims on their products.
  • Clinical trials and peer-reviewed literature. We have read what doctors and researchers have observed about the different active ingredients available on the market.

Best over-the-counter sinus decongestant for allergies

Benadryl Allergy Plus Congestion Ultratabs

  • What we liked: These tablets contain diphenhydramine, an antihistamine ingredient that fights allergy symptoms, as well as phenylephrine, which reduces sinus congestion. You can take one of these tablets every 4 hours throughout the day, and reviewers note that they work relatively quickly.
  • What there is to know: These tablets are not intended to fight a flu or a cold, so they should only be taken if your sinus congestion is caused by allergies. You should also be aware that diphenhydramine can make you quite drowsy, so avoid this medicine on days when you need to be alert.

Best over-the-counter sinus decongestant for a headache

Advil Sinus Congestion and Pain

  • What we liked: These coated tablets contain phenylephrine, a proven decongestant ingredient, as well as ibuprofen, a pain reliever. You can take one tablet up to every four hours. The combination of nasal swelling relief and a pain reliever can provide quick relief from many sinus-related headaches. Many reviewers who get frequent sinus headaches swear by this product to be better than even some prescription drugs.
  • What there is to know: Be sure to keep track of how much ibuprofen you are taking if you are using this product. Do not take other pain relievers, such as acetaminophen or aspirin, with this product, unless your doctor tells you to. It’s easy to end up taking a higher than recommended dose of pain relievers when you mix drugs.

Best over-the-counter sinus decongestant nasal spray

Afrin No-Drip Severe congestion

  • What we liked: Nasal sprays like Afrin narrow swollen nasal passages by applying an active ingredient directly to your sinuses. The advantage of this may be that sprays tend to work faster than tablets or liquid decongestants. Afrin spray contains oxymetazoline hydrochloride as well as menthol, which relaxes and refreshes your nasal passages pretty much right away, according to reviews.
  • What there is to know: Afrin should only be used temporarily to relieve sinus congestion. Rebound congestion can occur in as little as 3 days.

Best over-the-counter sinus decongestant for kids

Little Remedies Decongestant Nasal Drops

  • What we liked: These dye-free drops contain phenylephrine in a safe dosage for children 2 years of age and older. The dropper formula can be applied 2 to 3 drops at a time directly to the nasal passages, resulting in quick relief. (No waiting for the tablets to go off at bedtime). This decongestant can work for cold or flu symptoms, or it can be used to help manage congestion caused by allergies.
  • What there is to know: It can be difficult to get toddlers to sit still and have the drops applied to their noses. You may have a better chance to put the preparation in a spray bottle or other mist-based bottle to get your child to cooperate.

Best OTC day / night decongestant duo

Sudafed PE Day and Night Tablets for Sinus Pressure

  • What we liked: These tablets contain phenylephrine to relieve sinus congestion during the day, as well as an additional antihistamine ingredient for nighttime use. These ingredients can treat environmental allergies as well as congestion caused by the common cold. There are 12 tablets meant for daytime use and 8 you can take at night, meaning you can take a few more tablets during the day if you need to, but stick to one just before bedtime once. that you are ready to sleep.
  • What there is to know: There are no pain relieving ingredients included in the day or night formulas of these tablets. This means that if you have a headache and treatment for sinus pressure does not provide relief, you could still find yourself taking acetaminophen at the end of the day.

Best OTC Sinus Decongestant on a Budget

Nasal Decongestant Tablets Cabinet

  • What we liked: This mega container of 225 tablets is a great solution if several people in your family are prone to allergies or sinus headaches. The no-frills phenylephrine formula is comparable to the dosage you’ll find in a brand, but at a fraction of the cost. There is nothing in the formula to make you drowsy, and you can take one pill every 4 hours on days when symptoms hit you hard.
  • What there is to know: Some customers have complained that the bottle is too big to fit in their medicine cabinet, which seems like a small complaint for a product if you use it often. This particular tablet alone targets sinus congestion, so it will not relieve symptoms like fever or cough.

Best over-the-counter bedtime medicine

Mucinex Nightshift Cold & Flu Liquid

  • What we liked: This liquid formula contains a pain reliever, a cough suppressant, and an antihistamine ingredient that work together to give you a good night’s sleep when you’re sick. However, it does not contain any decongestants, so keep that in mind when using this treatment. It’s great for bedtime because it tames coughing fits that can keep you awake at night. Although it does not contain a decongestant, the antihistamine ingredient can also reduce nasal congestion caused by seasonal allergies.
  • What there is to know: Unlike the other decongestants on this list, this product does not contain anything that will release mucus. Some reviewers note that they really don’t like the taste of this drug.

When determining which decongestant to buy, you’ll need to determine the cause of your congestion. If it’s allergies, you’ll probably want a product with an antihistamine ingredient like diphenhydramine.

If you have cold or flu symptoms, you may be looking for a product that contains phenylephrine or pseudoephedrine. Some over-the-counter sinus decongestant formulas include both antihistamines and decongestant ingredients, and some add pain relieving ingredients such as ibuprofen to their formula. Treat the symptoms you have, not the additional symptoms you don’t.

Can / should I take a sinus decongestant for a sinus infection?

You can take certain decongestants for a sinus infection. Decongestants that only contain pseudoephedrine or phenylephrine are more generally recommended for a sinus infection. Decongestants with additional ingredients like antihistamines can suppress your body’s immune response and interfere with your body’s ability to fight infection. If you have a severe sinus infection or are taking antibiotics, talk to your doctor about the best over-the-counter medication choice for you.

Do sinus decongestants work for ear congestion?

Sinus decongestants can relieve pressure in the upper sinus cavities. If you have ear congestion, relieving that pressure can help you manage your pain. But sinus decongestants can’t treat an underlying ear infection.

Is It Safe To Take Sinus Decongestants While Pregnant?

It depends on the active ingredient. Over-the-counter pseudoephedrine and phenylephrine should only be used during pregnancy under the supervision of your doctor. These are Category C drugs and should not be used during the first trimester, but only later on doctor’s recommendation.

Can You Take Sinus Decongestants With High Blood Pressure?

Phenylephrine is not considered safe if you have high blood pressure. Sinus decongestants that contain pseudoephedrine can actually raise your blood pressure and counteract the blood pressure medications you are taking. If you have high blood pressure, you should talk to your doctor about which decongestant they recommend.

The best way to choose an OTC decongestant is to look at the active ingredients. A good decongestant should only treat the symptoms you have, not the additional symptoms you don’t have. Over-the-counter decongestants are not a solution for severe, long-lasting sinus infections and chronic allergies. You may need to discuss a long-term strategy with your doctor if you find that over-the-counter decongestants are not effectively managing your symptoms.


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