Javascript is not enabled.

Javascript must be enabled to use this site. Please enable Javascript in your browser and try again.

Skip to content
Content starts here
Leaving Website

You are now leaving and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.

Common Decongestants That Don’t Actually Work

An ingredient found in many cold and flu products won’t relieve your stuffy nose

spinner image sudafed PE nasal decongestant is displayed on a shelf
Tim Boyle / Getty Images

With cold and flu season upon us, it’s time to take stock of what’s in the medicine cabinet. This year, that process may involve not only getting rid of any expired boxes and bottles but also rethinking certain remedies that never worked in the first place. 

A U.S. Food and Drug Administration (FDA) advisory panel recently concluded that a common decongestant found in many over-the-counter cold medications is ineffective at relieving nasal congestion when taken by mouth.

spinner image Image Alt Attribute

AARP Membership— $12 for your first year when you sign up for Automatic Renewal

Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine.

Join Now

The ingredient, phenylephrine, is supposed to work by reducing swelling of the blood vessels in the nasal passages, making it easier to breathe. But when taken orally, “it basically becomes deactivated before it enters your bloodstream,” says Stefanie Ferreri, a professor of pharmacy at the University of North Carolina Eshelman School of Pharmacy. “It’s almost like a placebo, a sugar pill, when it’s taken orally.”  

Experts stress that phenylephrine, which has been sold for decades, isn’t dangerous, and it is still effective when used as a nasal spray or as drops to dilate the eyes.

But it can be harmful to your wallet if you’re buying a pill that’s ineffective to relieve congestion, Ferreri says. Products containing phenylephrine — including those sold by big brands such as Tylenol, Advil, Sudafed and Mucinex — generated nearly $1.8 billion in sales in 2022, according to data presented by the advisory panel. 

What works and what doesn’t for a stuffy nose

Common Decongestants That Won’t Work

Here are examples of oral medications that may help your headache or sore throat, but they won’t relieve your stuffy nose.

  1. Advil Sinus Congestion & Pain
  2. Tylenol Cold + Head Congestion Severe
  3. Mucinex Sinus-Max Severe Congestion & Pain Relief
  4. Benadryl Allergy Plus Congestion
  5. DayQuil Cold + Flu
  6. Sudafed PE
  7. Theraflu Severe Cold Relief Daytime
  8. Vicks Sinex Severe

This list is not exhaustive. Phenylephrine is found in a number of oral over-the-counter products.

Phenylephrine, sometimes labeled PE on packaging, is sold on its own but is often found in combination products that contain ingredients meant to knock out a range of symptoms that can accompany congestion — sore throat, fever, body aches and so on.

Because of this, you may not want to toss out everything containing phenylephrine, says Sarah Westberg, a professor at the University of Minnesota College of Pharmacy. That box of cold and flu medication could help with your other symptoms, it just won’t unclog your nose.

If you’re looking for a decongestant that will work, there are options — just be sure to talk to your doctor or pharmacist before taking one, especially if you take other medications, experts stress. Nearly half of older adults take at least five drugs daily.

Pseudoephedrine is an effective oral alternative, Westberg says. It’s available without a prescription, but it’s not as easy to buy as phenylephrine since pseudoephedrine can be used to illegally make methamphetamine, a stimulant that can be highly addictive. It’s technically behind the counter, so you’ll need to ask the pharmacist for a product containing pseudoephedrine and will only be able to purchase a limited amount at one time. “You can still get enough to treat your cough and cold,” Ferreri says.

Just know that pseudoephedrine can cause an increase in blood pressure, so it’s important to talk to your doctor before taking it if you have high blood pressure or heart disease. About 70 percent of adults 65 and older have high blood pressure.


AARP® Vision Plans from VSP™

Exclusive vision insurance plans designed for members and their families

See more Insurance offers >

Another option: “Go straight to the source” and consider a nasal spray, Ferreri says. A spray product containing phenylephrine will work fine when it comes to relieving congestion, though this can similarly affect your blood pressure. Saline nasal sprays that don’t contain medication can also provide relief.

The decongestant aisle could shrink

Until the FDA acts on its panel’s vote, pills and liquids containing phenylephrine — more than 250 oral products in all, according to The New York Times — will remain available.

If the agency follows through on the panel’s recommendations and removes phenylephrine from over-the-counter medications, it could “have a big impact on the market,” Westberg says. “There are a lot of products that will need to be reformulated.”

That’s not a bad thing, though, Ferreri says. “Right now, I think we have way too many [options] on the market, and it’s almost confusing. You want to have things on the market that are safe and effective, and [we need to] narrow it down so you know what you’re buying is going to work,” she says.

Discover AARP Members Only Access

Join AARP to Continue

Already a Member?