1. About one hour before expected descent, take a decongestant (such as Sudafed- 12hr). 2. About 30 minutes before the flight use a nasal spray (such as Afrin or Neo-Synephrine).

To prevent "ear barotrauma" or "airplane ear" in 2026, the most recommended oral decongestant is Pseudoephedrine (Sudafed), which works by shrinking swollen tissues in the Eustachian tubes to allow for easier pressure equalization. It is usually taken about one hour before takeoff, and for long-haul flights, another dose may be needed before the descent. However, because pseudoephedrine can increase heart rate and blood pressure, many travelers prefer a nasal decongestant spray like Oxymetazoline (Afrin). Doctors recommend using the spray approximately 30 minutes before both takeoff and the start of descent to provide immediate, localized relief. It is critical to use these sprays only for the flight itself, as using them for more than three consecutive days can cause "rebound congestion." For a non-medicated approach, Saline nasal sprays can keep passages moist in the dry cabin air. Always consult with a pharmacist or doctor before use, especially if you have high blood pressure, as some decongestants can interfere with other medications or medical conditions.