Afrin vs. Sudafed: 6 Differences Between These 2 Nasal Decongestants
Key takeaways:
Afrin (oxymetazoline) and Sudafed (pseudoephedrine) are nasal decongestants used to relieve congestion from the common cold or allergies. Both are available without a prescription.
Afrin is available over the counter and is safe for most adults and children ages 6 years and older. You shouldn’t use it for more than 3 days in a row. Overusing Afrin can cause rebound (returning) congestion.
Sudafed is taken by mouth, as either a tablet or liquid. It’s generally safe for short-term use in adults and children as young as 4 years old. Sudafed is kept behind the pharmacy counter to help prevent misuse.
Table of contents
Afrin (oxymetazoline) and Sudafed (pseudoephedrine) are two popular decongestants. They help relieve sinus and nasal congestion from the common cold or allergies. Both are available without a prescription.
At first glance, Afrin and Sudafed may seem similar. But there are several distinctions to be aware of when deciding between them. Here, we’ll dive into six differences between Afrin and Sudafed, so you can be confident when choosing one to purchase.
1. Afrin is a nasal spray, while Sudafed is an oral medication
This is likely the most obvious difference between Afrin and Sudafed. Afrin is available as a nasal spray. It relieves congestion and swelling by tightening the blood vessels in and around your nose.
Sudafed is available as an oral medication. It also causes the blood vessels in your nasal passages to tighten, giving you short-term congestion relief. It comes as immediate-release (IR) tablets, extended-release (ER) tablets, and an oral liquid for children.
The active ingredient in Sudafed is also available in many combination products. Sudafed Sinus Pressure and Pain (naproxen / pseudoephedrine) and Allegra-D (fexofenadine / pseudoephedrine) are two examples.
Good to know: Neither Afrin nor Sudafed is recommended for people with high blood pressure. Both medications may worsen existing blood pressure problems. However, Sudafed has a higher risk of this.
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2. They have different active ingredients
Afrin and Sudafed each have a different active ingredient. Afrin contains oxymetazoline. It activates receptors (binding sites) in your blood vessels. When activated, these receptors trigger your blood vessels to constrict. Afrin is applied directly to your nose and begins working in as little as 5 to 10 minutes.
The active ingredient in Sudafed is pseudoephedrine. Sudafed works similarly to Afrin, activating the same receptors in your blood vessels. But because you take Sudafed by mouth, your body needs to absorb it before it reaches the vessels in your nose. This means it takes longer to kick in — about 30 to 60 minutes.
Good to know: The FDA recently determined that Sudafed PE (phenylephrine) is an ineffective oral decongestant. But this is a different medication than the Sudafed discussed here. Sudafed containing pseudoephedrine is still considered effective for nasal congestion.
3. Their typical dosages are different
Recommended dosages of Afrin and Sudafed vary because they’re different medications that also come in different dosage forms. It’s important to read the “drug facts” label on your medication before taking it.
The typical Afrin dosage is 2 to 3 sprays in each nostril every 10 to 12 hours. Don’t use more than 2 doses in 24 hours. And don’t use Afrin for more than 3 days in a row.
Sudafed comes as an oral liquid, as well as IR and ER tablets. Your sudafed dosage depends on which product you’re using and your age. Sudafed IR tablets and oral liquid can usually be taken every 4 to 6 hours as needed. Sudafed ER tablets can be taken every 12 or 24 hours, depending on the product. Make sure to stay within the maximum dosage listed on the product’s package.
If you’re unsure about how much Sudafed you or your child should take, talk with your healthcare provider or pharmacist first. If you take other medications or have a chronic health condition, you should also check with them first. They can recommend a different medication if Sudafed isn’t safe for you or interacts with something else you’re taking.
4. Afrin can cause rebound congestion if used too much
Afrin is notorious for causing rebound (worsening or returning) congestion. Rebound congestion happens when you overuse nasal spray decongestants and your nose becomes dependent on them. Rebound congestion can cause worse congestion than you had before you started the nasal spray. It can also be difficult to treat and may take months to go away.
The easiest way to prevent rebound congestion from happening is to limit how often you use Afrin. This is why it’s recommended that you stop using Afrin after 3 consecutive days. If you’re still having congestion after 3 days of using Afrin, ask your healthcare provider or pharmacist for other solutions.
Oral decongestants, such as Sudafed, aren’t known to cause rebound congestion. But they have their own risks when you take them long-term, such as raised blood pressure and heart rate. So it’s best to limit Sudafed to no more than 7 days in a row.
5. Sudafed has dosage information for kids as young as 4 years old
Certain Sudafed products are safe for children as young as 4 years old. As mentioned above, Sudafed comes as an oral liquid. This is often the preferred dosage form for kids. But if your child can safely swallow tablets, the IR tablets are safe for kids 6 years and older. Keep in mind that the ER tablets aren’t recommended for children under 12 years old.
Afrin has dosage information for kids as well, but only for children ages 6 years and older. Follow the directions carefully and only give Afrin to a child under adult supervision.
6. Sudafed is kept behind the pharmacy counter
Both Afrin and Sudafed are available without a prescription, but you won’t find them sitting next to each other on the shelves. Afrin is available over the counter, and is typically found in pharmacy aisles alongside other cold medications.
Sudafed, however, is kept behind the pharmacy counter. You’re also limited in how much you can buy per day and per month. This is because Sudafed carries a risk of misuse. To purchase it, you’ll have to present valid federal or state photo identification at the pharmacy counter. A passport or driver’s license are examples of accepted identification.
Specific regulations can vary, depending on where you live. Some cities and states may have stricter restrictions. It’s best to check with your pharmacist if you’re unsure of your location's Sudafed laws.
The bottom line
Afrin (oxymetazoline) and Sudafed (pseudoephedrine) are nasal decongestants that help relieve congestion caused by the common cold and allergies. There are several differences to note when comparing Afrin and Sudafed.
Afrin is an over-the-counter nasal spray that’s safe for most adults and children ages 6 years and older. Because it can cause rebound congestion, you should only use Afrin for up to 3 days in a row.
Sudafed comes in several different oral dosage forms. It’s available without a prescription, but is kept behind the pharmacy counter. Sudafed provides dosage information for adults and children as young as 4 years old. You shouldn’t take it for more than 7 days in a row to limit your risk of side effects.
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References
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