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Principal components of sinus decongestants

Sinus decongestants mainly contain the following ingredients:

Pseudoephedrine

The most commonly used ingredient of the sinus decongestants is pseudoephedrine, an oral medication. For instance, pseudoephedrine is the principal component of several popular sinus decongestant brands, including Drixoral, Nasofed, Trimeton, Contac and Sudafed. Although pseudoephedrine does not need prescription but it is misused so you will find it behind the pharmacy counter. The drug is stronger than phenylephrine.

 

 The drug shrinks the mucous membranes of the nose (vasoconstriction), promoting sinus drainage and improving airflow. Pseudoephedrine reduces nasal mucus, relieving nasal congestion associated with sinusitis and allergic rhinitis temporarily. The drug is quickly absorbed and acts within 4-6 hours / 8-12 hours depending on the formulation. The liver metabolizes the drug. 
The drug may adversely affect pregnant patients and the patients suffering from diabetes, coronary artery disorder, sever hypertension, thyrotoxicosis and some other diseases.  The drug has some grave side effects, including nervousness, palpitation and tachycardia. Consult the physician before administering the medicine.

Phenylephrine

The drug, a strong alpha-adrenergic stimulant, reduces nasal, nasopharyngeal and sinus congestion. Phenylephrine is sold in three different formulations: drop, oral and spray. Rhinall, Neo-Synephrine and Sudafed PE brand tablets contain phenylephrine. Since the drug absorption is poor when administered orally, the drug is given topically or parenterally. The drug stimulates alpha-1 vascular receptors and plays the role of a vasopressor, causing vasoconstriction.
The drug should be avoided if the nasal membranes are abraded, as its systemic absorption may affect urinary, cardiac and central nervous systems. Overuse of the drug may lead to rebound congestion. The drug may also cause reflex bradycardia, excitability, restlessness and headaches.

Phenylpropanolamine (PPA)


The drug, a non-amphetamine stimulant,is another preferred component of the decongestants. Propagest, Empro and Acutrim decongestant brands contain the drug. PPA absorption is quick and complete. The drug acts like a vasoconstrictor to clear the congestion.  The function and structure of PPA resemble that of ephedrine. All three drugs are excreted in urine.
However, the U.S. Food and Drug Administration (FDA) advises that PPA is unsafe as over-the-counter (OTC) medicine because it increases chances of haemorrhagic stroke in women. Thus, it is a prescription drug in the country. So consult your doctor before taking the medicine. In some countries, like India, the drug is banned. On the other hand, in some parts of Europe, it is still available.