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Oral vasoconstrictors: how dangerous are they?

Published Feb 9, 2024 • By Emma Zylbermine

Oral vasoconstrictors have received a great deal of attention in recent months.

This increased attention is due to an opinion issued by the ANSM (The French national agency for the safety of medicines and health products) last October (2023), recommending that these treatments should not be used in the case of viral rhinopharyngitis, given that recovery is generally spontaneous within 7 to 10 days.

In December, the European Medicines Agency proposed measures to limit the risk of rare but serious side effects from these drugs.

So what exactly are oral vasoconstrictors? How do they work? What are they used for?

We explain it all in our article!

Oral vasoconstrictors: how dangerous are they?

Oral vasoconstrictors: what are they? 

In the US, oral vasoconstrictors are found in a lot of medicines, such as Actifed®, Advil®, Sudafed®, Vanacof®, Drixoral®, etc.  

They consist of a vasoconstrictor designed to relieve nasal congestion (generally pseudoephedrine) combined with an analgesic (paracetamol or ibuprofen) and/or an antihistamine (anti-allergic).

Oral vasoconstrictors: how do they work? 

Oral vasoconstrictors reduce the sensation of a blocked nose by narrowing the diameter of the blood vessels, causing the nasal mucosa to swell less. It is important to know that they only act on the symptoms and do not reduce the duration of the cold, which is generally 7 to 10 days without treatment. 

These drugs are therefore used to relieve the symptoms of a cold. They should not be used as a first line of defense. There are other things you can do to reduce your symptoms before trying vasoconstrictors: using physiological saline solution to clean your nose, or a spray of seawater or thermal spring water, drinking enough fluids, adding another pillow to elevate your head and airing your house regularly.

Recommendations for use: 

Taking oral vasoconstrictors to relieve the symptoms of a cold is still possible, even though they are not exactly recommended by health authorities. However, if you take vasoconstrictors you run certain risks:

  • risk of cerebrovascular accident (CVA). This condition is characterized by poor blood flow to or within the brain due to a blocked blood vessel. The most characteristic symptoms are a deformed mouth, abnormal speech and weakness on one side of the body, accompanied by very intense headaches,
  • risk of heart problems leading to myocardial infarction, a type of very severe chest pain accompanied by shortness of breath and unexplained fatigue,
  • increased blood pressure,
  • suddenly worsening eyesight due to narrowing of the blood flow to the eyes,
  • convulsions,
  • more or less generalized redness of skin
  • mental disorders (agitation, anxiety, etc.).

In view of the potential side-effects, the are certain recommendations you should follow if you decide to take vasoconstrictor drugs:

  • these medicines should not be used: by pregnant or breast-feeding women, by children under 15 years of age, in the case of a history of stroke, convulsions or risk factors for stroke, glaucoma or urinary retention linked to urethro-prostatic disorders, or in the case of arterial hypertension (severe, poorly balanced), 
  • they should not be taken for more than 5 days. If symptoms persist, see a doctor. 
  • several vasoconstrictor drugs should not be taken at the same time, nor should they be combined with another analgesic containing ibuprofen or paracetamol.

Oral vasoconstrictors are over the counter medicines, but if you have a cold and are thinking of taking them, make sure to ask your pharmacist for advice.


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