Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Pseudoephedrine (Sudafed), naphazoline (4-Way Fast-Acting Nasal Spray), and oxymetazoline (Afrin Nasal Spray) are examples of decongestants. Due to increasing abuse of pseudoephedrine (as a stimulant in athletics and in the illegal production of methamphetamines), phenylephrine has been substituted for pseudoephedrine in many over-the-counter preparations. Phenylephrine is less effective than pseudoephedrine for the treatment of rhinitis symptoms. Many over-the-counter products are available for purchase at the pharmacy counter that contain pseudoephedrine (rather than being freely available on store shelves).
How decongestants work: These drugs decrease nasal congestion by causing blood vessel constriction (narrowing) and reduced blood flow to the nasal passage.
Who should not use these medications: These medications should not be used in those who are allergic to them. They may cause unwanted side effects in individuals with the following conditions:
Use: Decongestants are available over the counter in oral (tablets, capsules, liquids) and nasal-spray forms. Many combination preparations are available that combine decongestants with first- or second-generation antihistamines. The individual preparations vary in regard to how often the drug should be taken each day. Use of nasal sprays as directed should be for temporary relief only (no longer than
three to five days). Prolonged use can cause worsening congestion.
Drug or food interactions:
Avoid within two weeks of taking MAOIs (for example, isocarboxazid [Marplan], pargyline [Eutonyl], procarbazine [Matulane], and tranylcypromine [Parnate]).
Use caution with herbal drug preparations that also increase blood pressure, such as ephedra (Ma Huang).
Illicit drugs (such as cocaine) may also cause increased blood pressure.
Side effects: Do not use decongestant nasal sprays for more than
three to five days. Use beyond three to five days causes swelling in the nasal passages and aggravates allergic symptoms. Oral decongestants may increase blood pressure, cause or aggravate existing heart rhythm abnormalities, and/or cause wakefulness and difficulty falling asleep.