| Drug | Type | Onset | Duration | Common Brands | Mechanism | Pros | Cons / Risks |
|---|---|---|---|---|---|---|---|
| Oxymetazoline | Topical spray | Within minutes | 10–12 hours | Afrin, Dristan | Alpha-1 agonist (vasoconstriction) | Fast, long-lasting relief | Risk of rebound congestion if used >3 days |
| Phenylephrine | Oral | 15–30 min | ~4 hours | Sudafed PE, Neo-Synephrine | Alpha-1 agonist | Widely available, safer for some users | Weak efficacy vs. placebo (per some studies) |
| Pseudoephedrine | Oral | 30–60 min | 6–12 hours | Sudafed (behind counter) | Alpha & beta agonist (vasoconstriction) | Effective, long-lasting relief | Can cause insomnia, anxiety; restricted sales |
| Xylometazoline | Topical spray | 5–10 min | 8–10 hours | Otrivin, Triaminic | Alpha agonist | Fast relief, less rebound than oxymetazoline | Still risk of rebound congestion |
| Naphazoline | Topical spray | Within minutes | 3–6 hours | Privine | Alpha-1 agonist | Quick relief | Shorter acting; rebound with overuse |
| Levmetamfetamine | Inhaler | <5 min | Short (~2 hours) | Vicks Inhaler | Indirect sympathomimetic | Portable, OTC | Less potent; short-lived effect |
| Phenylpropanolamine | Oral (obsolete) | 30–60 min | ~6 hours | Various (withdrawn in US) | Alpha agonist | Was effective | Withdrawn due to stroke risk |
⚠️ Note: Rebound congestion is a known risk with topical sprays (e.g., oxymetazoline) when used for more than 3 consecutive days.