The day before I flew from Europe to South America a few weeks ago I had a completely stopped nose. Solid brick. I was terrified of damaging my ears. I took Afrin and some real Sudafed, starting about six hours before flying, and was careful to start balancing my ear pressure as soon as the plane started to descend (which was about 25 minutes before landing and 10 minutes before they announced descent). Zero problems. One or both of those two drugs is a miracle.

(It probably helped that the second leg of the flight landed in Bogota, where air pressure is less than it is in a commercial jet. But the first leg landed near sea level.)

Works great, BUT easily habit forming. Beware.

My doc gave me a trick that prevents the rebound effect of Afrin (and other addictive vasoconstricting sprays). When you start the Afrin, or about a week before you want to stop it, start using a nasal steroid spray (nasalcort or whatever you prefer). The steroid will prevent the swelling and itself has no rebound period. After a week after stopping the Afrin, stop the steroid as well, and you will successfully be congestion free the entire time.

I prefer this to pseudoephedrine as it’s not a systemic solution to a local problem in the nasal cavity.

I made this comment elsewhere but I do a sinus rinse in the morning with Xylitol, and do Afrin at night. Rinsing it out helps with dependence and Xylitol helps with congestion too.

I use xylitol rinse daily anyways ;-) helps keep sinus infections at bay.

Why not just use the steroid spray, then?

Cool hack to get off it, but I would still be wary of being on it too long.

Because the congestion usually starts quickly and there isn’t time to build up the steroid response, which can take a week or more. People with allergies use steroids chronically, so they’re generally considered safe for long term use.

What do you mean by this? I’ve been using Afrin to deal with nasal congestion when I get a cold for 10+ years now.

Do people continue to use the stuff once they have recovered or something?

Yes. It can fairly quickly feel like you can’t breathe without it.

I feel like @theRealSudafed needs its own ironic Twitter account at this point if the Marvelous Mister Musk wasn't such a glorified shithead