What to take for a cold before flying? Medications, methods, and precautions

October 13, 2025 •

4 min read

Flying with a head cold can transform a routine trip into a miserable experience due to painful ear pressure, a phenomenon medically known as barotrauma. Knowing what to take for a cold before flying can make all the difference by helping to equalize pressure in your ears and sinuses. This guide covers effective over-the-counter (OTC) options, safety precautions, and non-medicated strategies to help you fly more comfortably.

Quick Summary

This guide provides expert information on managing cold symptoms during air travel. It covers effective over-the-counter medications like oral and nasal decongestants, emphasizing timing and important contraindications for certain health conditions. Also included are alternative strategies, such as saline sprays and chewing gum, to help relieve ear and sinus pressure. Specific considerations for children are also detailed, along with tips for when it might be best to reschedule your trip entirely.

Key Points

Oral Decongestants: Adults can take medications with pseudoephedrine about 30-60 minutes before takeoff and landing to help equalize ear pressure.
Medicated Nasal Sprays: Fast-acting nasal sprays like oxymetazoline can be used before takeoff and landing but should not be used for more than three days to avoid rebound congestion.
Non-Medicated Techniques: Chew gum, suck on candy, and use the Valsalva maneuver (pinching your nose and blowing gently) during ascent and descent to help open Eustachian tubes.
Children's Safety: Avoid decongestants for young children; instead, use a saline nasal spray, a bottle, or a pacifier to encourage swallowing during pressure changes.
Pre-Flight Hydration: Drink plenty of water and avoid dehydrating beverages like alcohol and caffeine to keep mucus thin and easier to clear.
Consult a Doctor: If you have high blood pressure, a heart condition, or a severe infection, speak with a healthcare provider before using decongestants or flying.

The sudden pressure changes experienced during airplane takeoff and landing can cause significant discomfort when you have a cold or sinus congestion. The Eustachian tubes, which connect your middle ear to the back of your throat, can become blocked with mucus, preventing them from equalizing pressure effectively. This can lead to painful ear pressure, a plugged-up feeling, or even temporary hearing loss. Preparing with the right medication and techniques can prevent these issues.

Understanding Your Medication Options for Flying with a Cold

When you're dealing with a cold before a flight, the primary goal is to reduce nasal and sinus congestion to allow your Eustachian tubes to function correctly. Various over-the-counter (OTC) medications can help, each with different considerations.

Oral Decongestants (e.g., Pseudoephedrine)

Oral decongestants like pseudoephedrine (found in behind-the-counter Sudafed) are a common choice for adults. They work by shrinking the swollen blood vessels and tissues in your nose and sinuses, which helps to relieve congestion and open up the Eustachian tubes.

Timing: For best results, take a dose about 30 to 60 minutes before takeoff and again before landing on long flights.
Side Effects: Can cause jitteriness, insomnia, and an increased heart rate.
Contraindications: Individuals with high blood pressure, heart conditions, or enlarged prostates should consult a doctor before use, as these medications can worsen these conditions.

Nasal Decongestant Sprays (e.g., Oxymetazoline)

Medicated nasal sprays containing oxymetazoline (like Afrin or Sinex) provide targeted relief by shrinking the nasal tissues directly. They offer fast, powerful relief but come with a significant caution.

Timing: Apply the spray about 30 minutes to an hour before takeoff and again before landing.
Rebound Congestion: Do not use for more than three consecutive days. Overuse can cause rebound congestion, where nasal swelling returns and becomes worse, making future congestion more severe.

Saline Nasal Sprays and Rinses

For a gentler, drug-free option, saline nasal sprays or rinses are highly effective. They moisturize the nasal passages and help clear out mucus and irritants.

Benefits: Safe for all ages, including young children, and can be used as often as needed without the risk of rebound congestion.
Preparation: Use a saline spray regularly in the days leading up to your flight and during the flight to combat the dry cabin air.

Multi-Symptom Cold Medications

Many all-in-one cold and flu products contain a mixture of medications, including decongestants, pain relievers, and antihistamines. It is critical to check the ingredients carefully.

Avoid Sedating Antihistamines: Certain antihistamines, such as diphenhydramine (often found in “PM” formulas like NyQuil and Benadryl), cause drowsiness and can impair judgment. These should be avoided, especially by pilots, but are also not recommended for general travelers who need to stay alert.

Comparative Look at Cold Relief for Flying


Feature	Oral Decongestants (e.g., Pseudoephedrine)	Medicated Nasal Sprays (e.g., Oxymetazoline)	Saline Sprays & Rinses
Mode of Action	Reduces overall sinus and nasal swelling.	Shrinks nasal passage tissues directly.	Moisturizes nasal passages and clears mucus.
Effectiveness	Highly effective for relieving Eustachian tube pressure in adults.	Very effective for immediate congestion relief.	Effective for moisturizing and clearing but not as powerful for severe blockage.
Speed of Action	Takes about 30-60 minutes to take effect.	Fast-acting, with effects felt within minutes.	Provides immediate moisture; cleansing effects are gradual.
Duration	Lasts for several hours depending on formulation.	Effects are temporary; overuse leads to rebound congestion.	Effects last as long as moisture is present; can be reapplied.
Safety Concerns	Potential side effects include increased heart rate and insomnia; caution for those with heart conditions or high blood pressure.	Risk of rebound congestion if used for more than 3 days.	Very safe, drug-free option with minimal side effects.

Non-Medicated Techniques to Alleviate Pressure

In addition to medication, several simple, non-invasive techniques can help equalize the pressure in your ears during your flight.

Valsalva Maneuver: Pinch your nostrils shut and gently blow through your nose with your mouth closed. This pushes air into the Eustachian tubes. Use this during takeoff and descent.
Chew Gum or Suck on Candy: The act of chewing and swallowing helps to open the Eustachian tubes.
Stay Hydrated: Drink plenty of water throughout your flight. The dry cabin air can thicken mucus, making it harder to clear. Avoid alcohol and caffeine, which can cause dehydration.
Stay Awake During Takeoff and Landing: Consciously staying awake allows you to perform pressure-equalizing maneuvers, unlike sleeping, when you are not actively swallowing.
Use Filtered Earplugs: Products like EarPlanes are designed to regulate air pressure changes gradually, reducing the shock to your eardrums.

Advice for Children and When to Avoid Flying

When traveling with children, caution is key, as decongestants are not recommended for young kids.

For Infants: Encourage swallowing with a bottle or pacifier during ascent and descent.
For Older Children: Chewing gum or sipping from a drink can help. A nasal saline spray is a safe, effective option for clearing congestion.
When to Postpone: If you have a severe sinus infection, significant ear pain before flying, or a fever, consider rescheduling your trip. The rapid pressure changes could worsen the infection or lead to more serious issues like a ruptured eardrum. Always consult a healthcare professional if you are concerned.

Conclusion

Dealing with a cold while flying requires proactive management to ensure a comfortable journey. By choosing the right medication, such as a targeted decongestant for adults or a safe saline spray for children, and combining it with proven non-medicated techniques, you can effectively manage ear and sinus pressure. Proper timing, careful attention to contraindications, and consulting a doctor when in doubt are crucial steps for safe travel. For more detailed information on various travel-related health topics, refer to resources like the CDC's travel health guidance.

Frequently Asked Questions

For adults, an oral decongestant containing pseudoephedrine (e.g., behind-the-counter Sudafed) or a topical nasal spray like oxymetazoline (Afrin) can be very effective. A saline nasal spray is a safe, drug-free alternative for all ages.

No, you should avoid taking sedating antihistamines like diphenhydramine (found in Benadryl and NyQuil) before flying, as they can cause drowsiness and impair judgment. This is particularly important for pilots but also a safety consideration for all travelers.

For maximum effectiveness, take an oral decongestant about 30 to 60 minutes before takeoff. For nasal sprays, apply them 30 minutes before both takeoff and landing.

If your cold is severe or you have a sinus infection, it's best to reconsider your travel plans. The risk of painful ear barotrauma is much higher, and in some cases, it could lead to a burst eardrum. Consult a doctor for advice.

Do not give decongestants to young children. Instead, use a saline nasal spray and encourage swallowing with a bottle, pacifier, or cup during takeoff and landing. Keeping them awake during these times also helps.

To prevent rebound congestion, limit the use of medicated nasal sprays containing oxymetazoline to no more than three consecutive days.

The Valsalva maneuver is a technique to equalize pressure in your ears. Pinch your nose shut, close your mouth, and gently try to blow air out through your nose. It is most effective when done during descent.

Besides the Valsalva maneuver, chewing gum, sucking on candy, staying hydrated, and using filtered earplugs like EarPlanes can help relieve ear pressure during a flight.

Yes, even minor congestion can increase the risk of ear pain and pressure issues during flight. Using a saline spray and practicing pressure-equalizing techniques is a good idea.