Nasal Sprays: How Do I Use One?

A question from a reader: Dr. Mike, I've read the directions for my medication Fortical used as a nose spray, but I’m not sure I’m using it right. This feels like a dumb question, but am I supposed to inhale as I spray or just let the spray absorb?

You’re not alone, many people are concerned about how to properly use nasal sprays when they are prescribed. The lining of your nose is rich in blood vessels, and medications can easily be absorbed into your bloodstream with just a quick spray.

Your Fortical has most likely been prescribed to treat your osteoporosis, and it is important that you use this medication exactly as prescribed for you by your doctor. Read the package insert and instructions that came with the medication to make sure that you understand Fortical’s adverse effects and how to store and use the medication.

According to the pharmaceutical company that sells Fortical Nasal Spray:

  • You can spray Fortical Nasal Spray into either nostril.
  • Simply hold your head and the unit in an upright, vertical position, and place the spray tip into your nostril at the same angle as your nasal passage then press the pump all the way down one time.
  • If the unit is not held upright during use, the pump may not be able to deliver an accurate dose.
  • You may not feel the spray because the mist is so fine.
  • Do not waste medication by testing the sprayer.
  • It is all right if some of the spray drips out of your nostril. Just one spray will give you the correct dose.

You do not need to inhale –- just let the medication be absorbed!

More Information about Fortical

Fortical (calcitonin) spray is composed of calcitonin, a polypeptide hormone typically produced by the thyroid. Calcitonin works to increase bone build-up (osteoblast activity) and inhibits bone breakdown (osteoclast activity). Calcitonin also inhibits calcium reabsorption in the intestines. Interestingly, calcitonin has also been shown to have an analgesic or pan-reducing effect, which helps soothe the pain of people with vertebral fractures.

Because calcitonin is broken down into inactive form during digestion, this agent must be administered as either an injection or nasal spray.

Studies have shown that in postmenopausal women taking calcitonin spray, the risk of vertebral fractures decreased by 33 percent.

Possible adverse effects of calcitonin nasal spray include tenderness at the site of injection and gastric discomfort. Additionally, a smaller number of people taking calcitonin spray experience rhinitis or stuffy nose. Fortunately, the adverse effects of calcitonin usually abate with continued use.

If you have any questions about Fortical, its uses, its administration and its risk of adverse effects, please contact your physician or pharmacist. Please remember that your pharmacist is a valuable and often underutilized resource who can help you better understand your prescription medications.

Edited by Naveed Saleh, MD, MS on 12/29/2015.

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Article Sources

  • Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham F, Calver LE. Chapter 22. The Mature Woman. In: Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham F, Calver LE. eds. Williams Gynecology, 2e. New York, NY: McGraw-Hill; 2012.  Accessed October 24, 2015.
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