Q I know to avoid NSAIDs before racing, but what about decongestants to fight allergies?
A Decongestants and exercise do not always mix well. If you are truly fighting allergies, decongestants are not your drugs of choice. Decongestants are supposed to relieve nasal and sinus congestion from colds and flu, but have not been shown to change the course of the disease. Decongestants can elevate heart rate and blood pressure (not a good choice for runners with blood-pressure issues), interfere with heat balance, and potentially trigger heart rhythm problems. Many decongestants are on the World Anti-Doping Agency (WADA) banned list and can disqualify an athlete who tests positive. So it may be best to avoid these medications.
While decongestants are not good medicine for allergies, there are several good medications available to reduce allergy symptoms and allow continued performance. Antihistamines are the mainstay of allergy control. It is best to pick a non-sedating antihistamine like loratadine, cetirizine, or fexofenadine, which can be purchased over the counter at pharmacies. You may find one works better for you than another so try all three before you give up on them. There are prescription medications that can improve your symptom profile with little, if any, effect on your performance (other than reducing your symptoms); this group includes intranasal steroid sprays and montelukast sodium. For those with severe allergies, allergy desensitisation shots can provide relief.
Some runners with allergies also have asthma or exercise asthma. If you cough after running or notice that you are wheezing you should check with your physician for testing to see if your lung function is normal.