date: 12/13/2006
Stuffy nose
How to ease the congestion
Are you confused about what cold medicines are best? ConsumerReportsHealth.org gives you the facts about nasal drops and sprays, oral decongestants, and older antihistamines, so you can talk to your doctor about the best treatment options.
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VAPOR CURE Inhaling steam, from a shower, for example, can help unclog your nose.
To keep people from using a common decongestant, pseudoephedrine, to make the illegal drug methamphetamine, federal law now requires that cold remedies such as Sudafed and Contac be moved from shelves to behind the counter. You have to show identification to buy them, and sign a logbook. Is it worth the hassle or should you try other options?
The drug choices

All decongestants reduce mucus production by constricting blood vessels in the nose. But some are safer or more effective than others.

Try nasal products first. Drops and sprays, such as Neo-Synephrine and Afrin 12-Hour, work faster than oral decongestants and are less likely to cause substantial side effects or drug interactions. But if used for more than about three days, they can cause rebound congestion, or renewed stuffiness that's worse than the original problem. Switch to oral decongestants if the congestion lasts longer than a few days.

Opt for pseudoephedrine. To keep familiar brand names on the shelves, some manufacturers have substituted the decongestant phenylephrine for pseudoephedrine in their products. But a recent review of the evidence, published in the Journal of Allergy and Clinical Immunology, concluded that oral phenylephrine is unlikely to work. Our consultants say pseudoephedrine is clearly the better choice for most people who need an oral decongestant. Check with your doctor before taking either ingredient if you have hypertension, heart disease, diabetes, hyperthyroidism, or anxiety, or take other drugs.

A runny nose caused by a cold is best treated by an older antihistamine, such as chlorpheniramine (Chlor-Trimeton) or diphenhydramine (Benadryl Allergy). But those drugs can cause drowsiness, so they're useful mainly when you don't need to be alert. The newer, nondrowsy versions, such as loratadine (Claritin), won't relieve a cold-related runny nose, although all antihistamines can stem the drip from an allergy.
Relief without drugs

Whenever possible, try nondrug steps first for treating congestion caused by a cold:
  • Elevate your head when lying down.
  • Inhale steam from a hot shower, vaporizer, or kettle.
  • Drink plenty of fluids, including chicken soup, which may help fight inflammation and the cold virus itself. See chicken-soup taste tests (available to ConsumerReports.org subscribers).
  • Use a saline nasal rinse, sold in drugstores.
See your physician if symptoms last longer than two weeks or you have thick, colored mucus or more than a slight fever.

Getting a chill might lead to sniffles after all
Being cold might make you more susceptible to catching a cold, an idea long dismissed as folklore. In a 2005 study, Welsh scientists chilled half of the 180 volunteers by putting their feet in cold water for 20 minutes. Within days, 29 percent of them caught colds vs. 9 percent of the others. In theory getting chilled may lead to colds by hampering the body's immune response. While the study wasn't definitive, it adds a possible reason to stay warm in winter.

This article first appeared in the January 2007 issue of Consumer Reports magazine.


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