The main side- effects of oral decongestants are irritability, nervousness, inability to sleep, heart racing and pounding, and headache. Since they work rapidly and effectively, they are ideal treatment for the occasional nasal congestion in anyone older than 6 years. Cromolyn works by inhibiting release of symptom-inducing chemicals from cells in our body that participate in allergic reactions. Recent studies suggest mometasone, fluticasone and budesonide have the greatest topical activity and might have the least systemic absorption. Hence, theoretically, they are safer.
Nothing is proven more effective in eliminating nasal symptoms in most patients than steroids.
Indeed, for severely affected patients, oral or injectible steroids are sometimes used. Steroid eye drops may be risky if there is a concurrent viral eye infection, so we generally avoid these unless he symptoms are severe or chronic. Their effectiveness in treating the symptoms of the common cold is a different matter. As mentioned above, an anti-histamine may make your child drowsy. Its expense limits its use.