The Girl in the Red Sweater

There are different kinds of allergy sinus medicine — do you know which one to take? It depends on your symptoms.

My grandfather was a pharmacist, and most of my family (including me) have experienced severe allergy and sinus problems over the years. So I learned from an early age what types of medicine were available and when to use each kind. The last time I helped a friend figure out what kind of medicine she needed, it really struck me how much of a pain it must be for most people who just have an occasional cold and don’t know which medicine will work best or why. So I’d like to share my usual recommendations (and why they work), and then I’ll go into a deeper explanation so you can compare all those different bottles on the shelf and pick the right medicine for you.

My top allergy sinus medicine recommendations

If you are having sinus problems, pseudoephedrine is one of the best medicines you can take. It is a decongestant, which means it helps relieve the pressure. Unfortunately, it can be used to make illegal drugs, so even though it is available with no prescription, you have to go to the pharmacy counter to ask for any medicine that contains pseudoephedrine.

I usually keep a box of plain Sudafed-D at the house. It only contains pseudoephedrine, so it only decongests. If I know I’ve got a sinus infection or a cold that is not due to allergies, it’s nice to just be able to take the one medicine I need.

If you are also having allergy problems, plain old diphenhydramine (Benadryl) is good. You can buy the pink Benadryl which only contains an antihistamine — which helps your body stop reacting to the allergens — and take it at the same time as Sudafed-D, or you can buy Benadryl which contains both medicines together.

If you have any postnasal drip (mucus draining down your throat) or are coughing up mucus, guaifenesin is a lifesaver. It is the main ingredient in Mucinex. I usually buy the Mucinex-D, which also contains pseudoephedrine, because most times if I’m coughing up mucus I also need sinus medicine.

For bedtime, NyQuil is no longer my medicine of choice. They changed the formula so it would not include pseudoephedrine anymore, and it just doesn’t work for me. Instead, I buy Walgreens’ store brand “Nighttime-D” which is the same formula NyQuil used to use.

Nighttime-D contains a fever and pain reducer, an antihistamine (a different one than what Benadryl contains, but it does the same thing), medicine to help you stop coughing, and best of all, pseudoephedrine to clear your sinuses. It also has alcohol which helps you sleep. I try to take this medicine the first night I am sick and either take a smaller dose the second night or alternate days. If you use the same allergy sinus medicine more than a couple of days in a row, it starts being less effective.

When you’re sick longer than a couple of days, I also recommend taking TheraFlu. You can do Mucinex-D one day (it lasts 12 hours), Sudafed or Benadryl the next day, and TheraFlu the next day — then rotate all over again.

Now that you have my main recommendations, here is a more detailed look at the different categories of allergy sinus medicine:

Allergy sinus medicine #1: Antihistamines

An antihistamine is an allergy medicine that helps stop your body from reacting to an allergy. Antihistamines try to stop your body from creating symptoms like runny nose and hives.

Benadryl is one of the best-known antihistamines. Claritin, Zyrtec, Allegra, and Dimetapp also contain antihistamines for allergies.

You should take an antihistamine if you know your sinus problems are being caused by allergies. If you only take a decongestant like Sudafed-D, you’re treating the sinus symptoms without relieving your body’s other allergic reactions.

If you’re itchy, have hives, or get a runny nose after being outside, those are good clues that allergies are troubling you and an antihistamine may help.

Allergy sinus medicine #2: Decongestants

If you have lots of pressure in your head, especially around your eyebrows or nose, you probably have a sinus headache. This is where decongestants come in. Antihistamines help your body stop reacting to allergies — so you make less mucus and inflammation goes down — but decongestants work to help the mucus that’s already there get out of your body.

The best decongestant for sinus pain is pseudoephedrine, the drug that’s found in the original Sudafed and in almost anything that ends in D. These are drugs you can buy without a prescription, but you have to go to the pharmacy counter and provide your ID. It’s well worth the effort; other common decongestants such as phenylephrine (found in Sudafed PE and many others) are nowhere near as effective.

Allergy sinus medicine #3: Expectorants

If you’ve also got mucus running down your throat or are coughing up mucus, an expectorant can help break it up so it can leave your body. Mucinex has a very powerful expectorant called guaifenisin. This ingredient is also in a lot of other remedies.

Other tips for allergy sinus problems

It’s often possible to take more than one medicine at a time. For example, pink Benadryl plus Sudafed-D work fine together. But always check to make sure you’re not doubling up. You would not want to take Mucinex-D plus Sudafed-D, since they both contain pseudoephedrine. You also wouldn’t need to take Benadryl with Claritin. Even though they contain different ingredients, they are both antihistamines.

Allergy sinus medicines are required to say the purpose of each ingredient, so just check to make sure the two medicines you’re considering taking together do not have any medicine from the same category (antihistamine, decongestant, expectorant, cough suppressant, etc.)

Make sure you drink a lot of liquid, especially water and juice. This will help your body make thinner mucus that will leave faster, and this in turn flushes out the germs. If you’re dehydrated, the mucus gets thicker and sits in your body. It’s a great breeding ground for germs, and even if you’re only having allergy problems, it keeps the allergens trapped in your body. Also, when you take decongestants, they tend to dehydrate you and you’ll need to drink more than usual to make up for that.

Traditional Medicinals makes a special herbal tea called Cold Care P.M. It is not as strong of a remedy as medicine, but when I’m suffering from allergy sinus problems, it helps relieve some of the sinus pressure.

If you’re suffering from the flu or a bad cold, zinc lozenges can help you get better faster. And whether you are suffering from allergies or germs, vitamin C can help boost your immune system. I like to buy Emergen-C packets and drink one a day. I also love gummy Vitamin C that you can find in the vitamin section at almost any grocery store — it’s less acidic than chewable tablets.

This may sound gross to you, but if you have ongoing allergy sinus problems, buying a nasal rinse may be the best thing you ever do. NeilMed brand makes a sinus rinse kit that you can buy at most groceries and pharmacies — it’s a little squeeze bottle with packets of salt. You mix the salt into warm water and squeeze it up your nose to flush out the mucus.

It’s not all that uncomfortable, and it really does wonders, because the salt not only flushes out the mucus, it also kills the germs that are there. It’s definitely worth a try if you have chronic allergy or sinus problems like I used to. (Now that we’re no longer in the mold capital of the U.S., it’s not a big issue anymore.)

If you have any other allergy sinus medicines or remedies, I’d love to hear your comments. I am always interested in herbal or nutritional remedies because they often have less side effects than medicines.

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