Phenylephrine vs. Afrin

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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Sudafed Pe


Clears your sinuses. Sudafed Pe (Phenylephrine) is a good medication for relieving stuffy nose. It doesn't work as well as pseudoephedrine (Sudafed), but it has fewer side effects.Clears your sinuses. Afrin (Oxymetazoline) clears stuffy noses well, but don't use it for more than 3 days in a row or your congestion could get worse.
How it works
Sudafed Pe (Phenylephrine) is a decongestant. It narrows blood vessels and reduces swelling in your nasal passages to make breathing easier.Afrin (Oxymetazoline) is a nasal decongestant. It reduces swelling in your nose to make breathing easier.
Type of medication
DecongestantPrescription or OTC
DecongestantPrescription or OTC
Available as
  • Pill
  • Nasal spray
  • Eye drops
  • Suppository
  • Nasal spray
Used for (click to learn more)
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
Reviews for Sudafed Pe (Phenylephrine)
of people say Sudafed Pe (Phenylephrine) is worth it
say it works well
say it's a big hassle
Reviews for Afrin (Oxymetazoline)
+27% vs. Sudafed Pe (Phenylephrine)
+23% vs. Sudafed Pe (Phenylephrine)
-2% vs. Sudafed Pe (Phenylephrine)
Side effects

We haven’t found good data for Phenylephrine side effects.

FDA side effect reports for Phenylephrine »

We haven’t found good data for Afrin side effects.

FDA side effect reports for Afrin »
Risk factors for serious side effects
  • History of high blood pressure
  • Taking MAO inhibitors
  • History of heart problems
  • Age 65 years or older
  • Women of childbearing age
Detailed Sudafed Pe (Phenylephrine) risks & warnings »
  • Using Afrin (Oxymetazoline) for more than 3 days
  • Women of childbearing age
Detailed Afrin (Oxymetazoline) risks & warnings »
Pregnancy category
CFDA pregnancy category (Weigh risks vs. benefits)

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

See the FDA package insert
NFDA pregnancy category (Unknown)

The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

See the FDA package insert
No specific alcohol-related info.No specific alcohol-related info.
No specific food-related info.No specific food-related info.
Kidneys and liver
No specific kidneys and liver-related info.No specific kidneys and liver-related info.
No specific sex-related info.No specific sex-related info.
  • Shouldn't use it before you want to sleep.
No specific sleep-related info.
No specific weight-related info.No specific weight-related info.
Upsides and benefits
  • Works to clear nasal congestion and helps you breathe better.
  • Helpful in relieving congestion-related headaches.
  • Has fewer side effects than other decongestants like pseudoephedrine.
  • It doesn't raise your blood pressure and heart rate as much, or cause as much trouble falling asleep.
  • Doesn't give you rebound congestion (worse symptoms when you stop taking it) like nasal spray decongestants do.
  • It works right away and each dose provides relief for up to 12 hours.
  • Can use for nasal congestion caused by colds and allergies.
  • It only affects your nose, so there aren't too many other side effects.
  • Available as a nasal spray and a nasal mist.
Downsides and risks
  • Phenylephrine doesn't last as long as other decongestants like pseudoephedrine (Sudafed).
  • You shouldn't use it if you have high blood pressure.
  • Can make your heart race or make you feel anxious and restless.
  • Shouldn't use it before you want to sleep.
  • Not as effective after using it for 4 days in a row.
  • Afrin (Oxymetazoline), like all other sprays used for stuffy noses, can make your congestion worse if you use it for more than 3 or 4 days in a row (called rebound-congestion).
  • Can cause temporary stinging, burning, or dryness in your nose.
  • Can't be used for kids younger than 6 years old.
Tips from our pharmacists for people taking the medication
  • Starts working in 30 minutes.
  • Phenylephrine can make you restless, so don't take it too close to bedtime.
  • It's in other cold and flu combination medicines. Read labels closely so you don't accidentally double up and take too much of it in a day.
  • Follow age-specific dosing instructions on how much to take.
  • Let your doctor know if your symptoms don't improve in a few days.
  • Use 2 to 3 sprays in each nostril every 10 to 12 hours. Don't use Afrin (Oxymetazoline) more than two times a day.
  • Keep your head upright and don't tilt it back when spraying Afrin (Oxymetazoline) into your nose.
  • Breathe in with quick sniffs while spraying and wait a few minutes before blowing your nose.
  • Don't use Afrin (Oxymetazoline) for more than 3 days in a row since it can worsen your congestion after a few days of use.
Learn more
More about PhenylephrineSide effectsReviews & ratingsAlternativesFDA package insert
More about AfrinSide effectsReviews & ratingsAlternativesFDA package insert