Decongestants – Effect, Application & Risks


Decongestants are drugs that have a decongestant effect and are used to support the treatment of allergic diseases. They are not a uniform group of active ingredients. The individual substances work according to different mechanisms, but with the same result in reducing the swelling of the mucous membranes.

What are decongestants?

The term decongestants summarizes active ingredients whose only common feature is their decongestant effect. Chemically, these substances often have nothing to do with each other.

The decongestants also do not have a common mechanism of action. However, they are always used together with antiallergic drugs or other active ingredients for the symptomatic treatment of swollen mucous membranes. While the main active ingredient in these drugs combats the allergy , the decongestants only relieve the swelling and have a temporary effect.

Decongestants are most commonly used topically, but they can also be given orally. Its main area of ​​application is allergic rhinitis ( hay fever ).

Medical application & effect

Depending on the mechanism of action, decongestants can be divided into different classes of active substances. The first are the sympathomimetics. These act directly or indirectly via the sympathetic receptors. The sympathetic nervous system is part of the autonomic nervous system and primarily controls the smooth muscles of the glands and blood vessels.It increases the tone of the heart and skeletal muscles, heart activity, blood pressure and metabolism . It also expands the bronchi and has a decongestant effect on the mucous membranes. Another group of active ingredients in the decongestants are the corticosteroids . The corticosteroids have an antiallergic effect by suppressing the immune system and thus decongest the mucous membrane. Other non-decongestant anti-allergic drugs (e.g. cromoglicic acid ) inhibit the release of inflammatory mediators such as histamine from mast cells after long-term use, so long-term use is necessary for treatment.

In connection with cromoglicic acid, reproterol is always used to support the rapid decongestion of the mucous membrane. Reproterol is a sympathomimetic and can be called a decongestant. Other decongestants have a homeopathic effect, such as B. Luffa operculata, an active ingredient from the dried pumpkin fruit. Essential oils also have a decongestant effect and are used as decongestants. They often have an anti-inflammatory effect. There are also special active ingredients that act as decongestants.

Herbal, natural, homeopathic & pharmaceutical decongestants

Various decongestants from the active substance group of sympathomimetics are very often used topically in nasal sprays to treat swelling of the nasal mucosa in allergic rhinitis.

This includes e.g. ephedrine , phenylephrine, tetryzoline , xylometazoline, naphazoline, tramazoline or epinephrine. These active ingredients are chemically synthesized and, in addition to their use as decongestants, are also used in other areas. The other important group of active ingredients in decongestants are the cordicosteroids. Such important representatives should be mentioned here, such as beclometasone , prednisolone , dexamethasone , flunisolide, budesonide, betamethasone, tixocortol, fluticasone, mometasone or triamcinolone.

This group of active ingredients also mainly contains representatives that are produced synthetically. The active ingredients of the group of cordicosteroids are often applied orally for the systemic treatment of allergies. In addition, combinations of decongestants within one drug group are also used. Essential oils are often used as decongestants of plant origin. Chamomile and menthol should be mentioned as examples . The homeopathic active ingredient Luffa operculata, which comes from the dried pumpkin fruit, is also of plant origin.

Some special representatives of the decongestants cannot be assigned to any specific group of active ingredients. They are individual active ingredients of different chemical composition and with different mechanisms of action. These special substances include retinol , ipratropium bromide, hyaluronic acid and hypromellose, among others.

Risks & side effects

The side effects are as varied as the group of decongestants . It should be noted that every active ingredient can lead to side effects. These can occur, but do not have to.In principle, it can be assumed that there is also a corresponding hypersensitivity reaction to each individual active ingredient, which can sometimes also manifest itself in an allergic shock . Furthermore, the active ingredients of the group of sympathomimetics cause side effects resulting from the increased activity of the sympathetic nervous system.

These include increased blood pressure, increased cardiac activity, constipation , dry mouth , reduced secretion and much more. Cordicosteroids, in turn, have an immunosuppressive effect and, in extreme cases, can cause diabetes or osteoporosis. However, the application amounts are usually so small that the side effects are usually negligible.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.