Rise and fall of decongestants in treating nasal congestion related diseases.

Introduction: Decongestants are commonly used drugs in clinical practice, and they can relieve nasal congestion caused by factors like influenza, rhinitis, and acute upper respiratory tract infection.

Areas covered: In this article, we review the research outcomes about decongestants, which aim to provide beneficial information that can guide the clinical application of decongestants for clinicians.

Expert opinion: Although the use of nasal decongestants is increasingly limited, caution rather than prohibition is now advocated. Scientific and accurate use of nasal decongestants can achieve satisfactory clinical effectiveness on nasal congestion, and it is not easy to produce adverse reactions. Patients with severe nasal congestion may use nasal decongestants solely or in combination with nasal corticosteroids or nasal antihistamines to exert a synergistic effect. The concentration, dose, frequency, and time of nasal decongestants determine whether drug-induced rhinitis will occur. Additionally, we recommend patients not to buy nasal sprays with unknown ingredients on the internet or in pharmacy, so as to avoid the risk of rhinitis medicamentosa. For patients with rhinitis medicamentosa, the use of nasal decongestants should be stopped immediately. However, more evidence is still needed to standardize the clinical use of nasal decongestants.