Do oral decongestants and anti-histamines cause rebound nasal congestion

I have read it is a bad idea to take nasal spray decongestants for several days in a row because you can become accustomed to them and suffer a rebound effect where your nose is more clogged than it was before, at least for a few days.

Does the same rule apply to medications taken orally (would sudafed taken for several days via pill cause rebound nasal problems)?

What about sprays like nasonex or flonase? The info I’ve seen on rebound seems to talk about alpha agonists, not so much corticosteroids.

Oxymetazoline, which is the active ingredients in almost all OTC nasal decongestants (such as Afrin, Dristan, Mucinex Nasal, and others) will cause rebound nasal congestion after multi day use…

Psudoephedrine (Sudefed) which is taken orally doesn’t cause this same problem. Neither does Phenylephrine.

Nasonex and Flonase are steroid based nasal sprays, they haven’t been linked to rebound congestion either…

Basically, it is only Oxymetazoline, which is the ONLY OTC nasal decongestant spray. When you are looking for nasal sprays, there are only two options, Oxymetazoline, or saline. Both come in a million different brands, but they are all the same, and have the same problems. The Rx only sprays (Nasonex, Flonase, etc), are different, and they don’t have rebound problems.

Phenylephrine is another US OTC nasal decongestant spray. Neosynephrin (and generics), some varieties of Sinex, etc.

Too late to edit: you did acknowledge phenylephrine in your post, but it should be noted that it is used as a nasal spray decongestant. It’s not just oxymetazoline as a nasal spray out there. (If you want to go further afield, the levmetamfetamine ahem in Vicks Inhalers is an effective OTC decongestant in a form that is amenable to those using nasal sprays.)

Many people may find oral decongestants fine to clear their noses, but also find their blood pressure, heart rate, and sleeping patterns are adversely affected. I think that is a primary reason why prescription nasal sprays are so attractive.

I’ve used Flonase off and on for years. It does work…but after a couple of months, I get nose bleeds. And then I find my breathing REALLY restricted by the clots in my nose. So, I’d lay off the Flonase for a while, until I couldn’t stand NOT breathing a single second longer.

My doctor recently switched me to ASTEPRO. This is NOT a corticosteroid like Flonase. It is a nasal spray antihistamine. Son of a gun! I found it to work even BETTER than Flonase, and so far (knock on wood) no nose bleeds.

I do have occasions with stuffiness. But the once in a while dose of Sudafed doesn’t drastically impact me in negative ways.