How Drugs Work: Nasal Decongestant Sprays

Today, I am very much enjoying the effects of oxymetazoline.

In fact, without it, I wouldn’t have taken a clear breath through my nose for the past three days. My nose is bunged up, you see. My body is playing host to a virus that is causing me to produce more mucus than I really would have believed possible for a person my size. More importantly, the blood vessels in my nasal passage are swollen up; making me feel very much like someone poured concrete in my sinuses while I was napping during Harry Potter and the Goblet of Fire yesterday. In short, I have a cold.

I am impatient with my body when I’m ill, I’m a rubbish patient, and I get particularly grumpy and annoying when I can’t breathe through my nose. It just makes me stroppy, and as a result I’m a pretty big fan of decongestants. And, of course, whenever I take or use a drug, to help me breathe through my nose or for any other reason really, I get all nerdy and like to look up how it works.

So, as I said, the feeling of being stuffed up comes mainly from the swelling of your blood vessels. Cold viruses don’t actually make you feel ill, particularly. Most of the symptoms come from the response of your immune system to the invader; as soon as a cold virus is detected launching an attack on your nose and the back of your throat, an alarm sounds. White blood cells charge to the field of battle, probably on white horses. Chemical messengers dash around. Battle stations are armed and all systems are go.

An adorable cuddly common cold virus, ready to do battle with your immune system. And lose.
Image credit.

All this activity requires your body to do something; a lot of immune cells and molecules need to get to your nasal area, in order to fight, and to get them all there access needs to be improved. Luckily, the lining of your nose is designed to allow this to happen; it is made from erectile tissue, which means that it has plenty of vascular space, to allow the blood vessels to dilate, thus increasing blood flow to the area. This dilating of the blood vessels allows the soldier cells and chemical weaponry of the immune system to get onto the battlefield faster. On the downside, flooding erectile tissue with lots of blood and immune cells causes it to swell; and this has the effect of narrowing the passageway that air usually comes in through. Great news for the viral battlefield, not such great news for your ability to sleep.

What you need, then, if you want to be able to breathe in properly for an hour or so, is to call a halt to the dilation of your blood vessels. This is where oxymetazoline comes in. It binds to the alpha-1 adrenergic receptor, which then gives a signal for the blood vessels to constrict. This vasoconstriction shrinks down the erectile tissue of your nose, and opens the airways back up, so you can take big deep breaths once again.  Obviously, this makes you feel a lot better; breathing is always a nice thing to be involved in.

However, despite the fact that it makes you FEEL better, taking a decongestant doesn’t really do anything to help you actually GET better. In fact, the blocked up nose was actually your body opening up supply lines for an infection battle in the first place, and while immune cells can make it through constricted blood vessels, a lot more can make it through when they’re dilated. This doesn’t mean you shouldn’t use a decongestant, if you feel the need, I know I can’t sleep when my nose is blocked up, because I’m a stroppy little so-and-so, but it does mean you’re better off not taking it constantly. After all, it may be uncomfortable, but then battles usually are, and your immune system is fighting a full-on battle with a cold virus in your nose. Luckily, your immune system is pretty good in a fight.


7 thoughts on “How Drugs Work: Nasal Decongestant Sprays

  1. I had always wondered whether there was something about the magic sprays that stopped your body doing its job! Amazing. Hope you feel better soon Katie. The worst thing for me about a bunged up nose is not being able to taste food – DEPRESSION.


    • Yep, researching this has stopped me using my nasal spray so often! And you’re SO right, just when you’re all poorly and you think “oh, go on, I could have a tasty treat”, you can’t taste the tasty. Most unfair!

      K x

    • I just had to google ‘Nose Penis Correlation’ to check what they do actually say about this matter. I had seriously never heard that before! Now I want to know if it IS true.

      K x

  2. Thanks for this – I try with most colds to stick it out – even with sinusitis as I get it so often and now I feel okay for that (if I get sinusitis for more than three days I do get a decongestant and if it lasts past then do see the doctor but I try to avoid antibiotics except as a last resort)

  3. Pingback: The Week In Science (Feb 23 – Mar 3) | Science Communication Blog Network

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