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Q: I used to take pseudoephedrine (standard Sudafed) for nasal congestion. But I have an enlarged prostate and find that it restricts my urine flow. Is there an alternative over-the-counter decongestant that will not affect the prostate and restrict urine flow?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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March 30, 2012
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A:

The other oral non-prescription decongestant available is phenylephrine. It has replaced pseudoephedrine in many products. The reason: pseudoephedrine can be illegally used to make methamphetamine (crystal meth).

But phenlyephrine is not a good choice for you either. It can also affect the prostate and restrict urine flow.

Is your nasal congestion caused by allergies? Then you might consider one of the newer antihistamines. These include plain loratadine (Claritin) and fexofenadine (Allegra). Be careful that they do not contain a decongestant. There should not be a letter “D” after the name of the product.

Stay away from the older antihistamines, such as diphenydramine (Benadryl). This can cause problems in men with enlarged prostates.

Another option is to use a decongestant nasal spray. You are less likely to have a urine problem because only a small amount is needed when sprayed directly into the nose. But decongestant nasal sprays should only be used for a few days at a time. Your nose can quickly rely on the nasal spray to stay dry if you use it too often.

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