What is the best decongestant for ears?

Congestion causes | Common decongestants | Best decongestants for ears | Side effects | Other treatment options | When to see a doctor

If you’re experiencing ear congestion while sick with the common cold or the flu, you might be looking for the best decongestant for the ears. The best decongestant will depend on the underlying cause and the type of symptoms present. For example, some decongestants may be better for congestion caused by allergies, while others may be better for congestion caused by a sinus infection. 

Certain ear decongestants may come in different forms for adults and children. Young children are especially prone to experiencing ear congestion due to having shorter and narrower eustachian tubes than adults. Home remedies and other self-care methods can sometimes relieve mild or temporary congestion, such as congestion caused by high altitudes.

Continue reading to learn about the best decongestants for ears.

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Why are my ears congested? 

When deciding which decongestant is best for your symptoms, it’s important to know what could be causing the congestion in the first place. Ear congestion is typically a sign of eustachian tube dysfunction (ETD). It is caused by various problems with the tube that connects the middle ear to the back of the upper throat. 

The most common causes of ETD include bacterial infections of the ear and sinuses that can cause inflammation and mucus buildup in the eustachian tubes. Other symptoms can accompany ear congestion, such as a feeling of pressure in the ears, ear pain, and nasal congestion. 

Many cases of ETD are mild and temporary. For example, if you’ve ever traveled in an airplane, you may have experienced certain ETD symptoms like ear discomfort or a feeling of pressure in the ears. However, some cases of ETD can be more serious, requiring over-the-counter (OTC) medications or even prescription drugs. Congestion caused by sinusitis or allergies can easily be treated with OTC decongestants. 

Common decongestants

Decongestants help relieve congestion in the nasal passages and sinuses. However, they can also be useful for treating congestion in the ears. Drugs for congestion can work in different ways to reduce inflammation. They can also come in different forms, such as oral tablets and nasal sprays. 

Here are the most common decongestants used:

Oral decongestants

Oral decongestants come as tablets, capsules, and liquids. Sudafed (pseudoephedrine) and Sudafed (PE) are the most common oral decongestants. They work to relieve nasal and sinus congestion, which may help relieve discomfort in the ears. They generally start working within 15 to 30 minutes. Their effects last for around four to six hours. However, 24-hour formulations are also available. 

Nasal decongestant sprays

Nasal decongestant sprays work directly on the nasal passages. They help narrow the blood vessels to reduce inflammation and congestion. Afrin (oxymetazoline) and NeoSynephrine (phenylephrine nasal) are examples of nasal decongestant sprays. 

Decongestant sprays generally start working quickly to relieve symptoms. However, decongestant sprays should not be used for longer than three consecutive days due to the risk of rebound congestion. 

Saline spray

Nasal saline sprays contain a mixture of salt (sodium) and water. They work by clearing excess mucus, bacteria, and other debris in the nasal passages that may contribute to ETD. They are especially useful in children for gently clearing nasal mucus and reducing inflammation. 

Antihistamines

Antihistamines contain active ingredients that block the effects of histamine. These OTC drugs are useful for treating allergic rhinitis (hay fever) symptoms, such as runny nose and congestion, caused by exposure to allergens like pollen and dust. 

Antihistamines come as oral tablets, capsules, and liquids, and they start working within 30 minutes with effects that last up to 24 hours. Antihistamines include Claritin (loratadine), Allegra (fexofenadine), and Zyrtec (cetirizine). 

Nasal steroid sprays

Nasal steroid sprays reduce inflammation in the nasal passages. Like antihistamines, they can help relieve sinus congestion caused by allergies. As allergies can also cause ETD, nasal steroid sprays can effectively treat congestion in the ears. 

They are typically used one to two times per day. However, nasal steroids can take up to a week or longer to provide maximum benefits. Examples of nasal steroid sprays include Flonase (fluticasone), Nasonex (mometasone), Nasacort (triamcinolone), and Rhinocort (budesonide). 

The best decongestants for ears 

The best decongestant for ears depends on the individual, the cause of the symptoms, and other factors like cost and generic availability. Although most OTC decongestants can be affordable, some may be more expensive. 

Unfortunately, OTC decongestants are rarely covered by insurance due to their widespread availability. However, using a SingleCare discount card or coupon may help you save on the drug’s retail price. 

Sudafed (pseudoephedrine)30-60 mg every 4-6 hoursSudafed coupon
Sudafed PE (phenylephrine)10 mg every 4 hoursSudafed PE coupon
Afrin (oxymetazoline)2-3 sprays in each nostril every 10-12 hoursAfrin coupon
Deep Sea Nasal Spray (saline spray)2-3 sprays in each nostril every 10-12 hoursSaline spray coupon
Claritin (loratadine)10 mg once dailyClaritin coupon
Zyrtec (cetirizine)10 mg once dailyZyrtec coupon
Flonase (fluticasone)2 sprays in each nostril once daily for 1 week then 1-2 sprays in each nostril once daily as neededFlonase coupon
Nasonex (mometasone)2 sprays in each nostril once dailyNasonex coupon
Nasacort (triamcinolone)2 sprays in each nostril once dailyNasacort coupon

Decongestants are similarly effective for treating congestion. There is a lack of data directly comparing the effectiveness of decongestants. However, one study found phenylephrine is no more effective than a placebo. The study also found that pseudoephedrine is a more effective oral decongestant than phenylephrine. 

Decongestant sprays may work more quickly than oral decongestants. However, they are limited by an increased risk of rebound congestion if used for more than a few days. For patients with ETD caused by allergic rhinitis, a nasal steroid spray, and antihistamine are better options than other drugs. 

Some medications may be found as combinations of drugs. For example, an antihistamine and decongestant combination can often be found over the counter. Combination drugs may provide more relief than single drugs. 

It’s important to note that nasal sprays should only be applied to the nose. They should not be used in the ears. It’s best to speak with a pharmacist for directions on how to use your medicine if you have concerns. 

Ear decongestant side effects 

As with other OTC drugs and prescription medications, decongestants can cause side effects. In most cases, side effects are mild and go away on their own. However, serious side effects are possible, especially in people with certain medical conditions.

The most common side effects of decongestants include:

  • Headache
  • Nervousness
  • Insomnia
  • Restlessness
  • Heart palpitations
  • High blood pressure
  • Nausea
  • Dry mouth
  • Dizziness

Nasal decongestants are also more likely to irritate, burn, or dry the nasal passages. 

Serious side effects of decongestants may include seizures, chest pain, heart attack, and stroke. Decongestants may worsen problems with glaucoma, prostate problems, and thyroid disorders. 

In addition, severe allergic reactions are possible while using a decongestant. Seek immediate medical attention if you experience signs or symptoms of an allergic reaction, such as hives, swelling of the throat or face, or difficulty breathing. 

Consult a healthcare provider before using a decongestant, especially if you have other medical conditions, including:

  • High blood pressure
  • Heart problems
  • Prostate problems
  • Diabetes
  • Thyroid disorders
  • Glaucoma
  • Gastrointestinal problems

Other treatment options for ear congestion

While over-the-counter decongestants and pain relievers can provide relief, not everyone wants to rely on these medications for every episode of ear congestion. Fortunately, several natural remedies and non-medical treatments may help alleviate ear congestion symptoms. In some cases, however, a prescription medication may be needed to resolve the underlying cause of the congestion, such as a bacterial infection. 

Prescription medications

Certain medications may be prescribed by a healthcare provider to treat the condition-causing symptoms. Antibiotics can help treat bacterial ear infections, while antivirals can help treat viral infections. Bacteria and viruses are common culprits of otitis media or a middle ear infection. 

The type and duration of the medication prescribed will depend on the cause and severity of the ear congestion. In some cases, over-the-counter decongestants and pain relievers can be used along with prescription medicines to alleviate symptoms and speed up recovery.

Home remedies

There are a variety of natural home remedies that can help alleviate the symptoms of ear congestion. From warm compresses to essential oils, these remedies are safe, inexpensive, and often just as effective as traditional treatments. If you are looking for alternative or supplementary treatments for ear congestion, consider giving some of these home remedies a try:

  • Nasal irrigation: Using a saline solution to rinse the nasal passages can help reduce sinus pressure, clear out mucus, and relieve pressure in the ear. 
  • Steam therapy: Inhaling steam from a hot shower or a bowl of hot water can help reduce congestion in the ear.
  • Salt rinse: Mixing half a teaspoon of salt with warm water and using a dropper to put a few drops in your ear can help to reduce swelling and pain. 
  • Warm compress: Applying a warm cloth or hot water bottle to the affected ear can help to relieve pain and pressure caused by ear congestion.
  • Ear drops: Applying over-the-counter ear drops, mineral oil, or baby oil can help to soften and remove earwax buildup, which can relieve ear congestion.
  • Staying hydrated: Drinking plenty of fluids can help to keep the mucus thin and prevent ear congestion from developing or worsening.

RELATED: Home remedies for ear infection

Valsalva maneuver

The Valsalva maneuver is a technique that involves holding your breath, closing your mouth and nose, and bearing down as if you were trying to have a bowel movement. This maneuver helps to equalize the pressure in your ears and can effectively relieve ear congestion caused by changes in air pressure, such as during air travel or diving.

Whether it’s staying hydrated, using essential oils, or performing the Valsalva maneuver, at-home options can provide relief without medication. While these remedies may be helpful, they may not be a substitute for medical treatment if congestion is due to a more serious underlying problem. If symptoms persist or worsen, it’s best to consult a healthcare professional for a proper diagnosis and personalized treatment plan.

When to see a doctor

Deciding when to see a doctor for ear congestion can be challenging. While minor ear congestion can often be treated with home remedies or OTC decongestants, there are certain circumstances where it is important to seek medical advice from a healthcare provider. 

You should seek help from a healthcare provider if you or your child experience severe pain in the inner ear or symptoms that don’t seem to go away after one to two weeks. Additionally, if you have tried different types of decongestants and home remedies and the symptoms persist, it is a good idea to consult a healthcare professional.

It’s also important to consult a healthcare provider or pharmacist for more information before using any treatments or products for the first time. You should tell your healthcare provider or pharmacist about any health conditions and other medications you may be taking. 



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