What to Know About Using a Nasal Spray

Nasal sprays are used to deliver medications into your nostrils. Most often, they are used to treat allergy or cold symptoms, such as itching, sneezing, or nasal congestion. Some nasal sprays, however, deliver medications that act elsewhere in the body. The lining of your nose is rich in blood vessels, and medications can be absorbed easily into your bloodstream.

Nasal sprays are available by prescription and over the counter, depending on the medication.

Most nasal sprays work by introducing a fine mist of the medication into your nostrils by the action of a hand-operated pump bottle.

A variety of medications come as nasal sprays, and instructions for how to use them may vary. Your nasal spray should come with a specific set of instructions. If you are not sure, ask your pharmacist to show you the proper use of your nasal spray. The following is an example of how to use a nasal spray and should work for most nasal medications:

Quick Tip #1: Some nasal sprays need to be primed each day before use. If your nasal spray needs to be primed before using, squirt it a few times into the air until a fine mist comes out. Make sure to keep it away from your eyes.

Quick Tip #2: Sniff gently as you spray the medication as if smelling your favorite food or a flower. Don’t snort the spray, which can cause the medication to go into your throat.

1. Blow your nose gently to remove mucus from your nasal passages.
2. Wash your hands with soap and water.
3. Gently shake the bottle of nasal spray and remove the cap or lid from the bottle. If needed, “prime” before using.
4. Tilt your head slightly forward and close one nostril by gently pressing against the side of your nose with your finger.
5. Insert the tip of the nasal spray into the other nostril. Point the tip toward the back and outer side of your nose. Make sure to direct the spray straight back, not up into the tip of your nose.
6. Squeeze the nasal spray bottle as you begin to slowly breathe in through your nose.
7. Remove the tip of the nasal spray from your nostril and breath out through your mouth.
8. Repeat this procedure for your other nostril if you have been told to do so by your doctor or pharmacist. If you are using an over-the-counter nasal spray, make sure to follow the directions and use only the amount of medication recommended.
9. Replace the lid on the nasal spray bottle.
10. Try to avoid sneezing or blowing your nose immediately after using the nasal spray.

1. Some nasal sprays may induce an unpleasant taste in your mouth. A drink of water or juice should help eliminate the taste.
2. You should not use decongestant nasal sprays (such as Afrin) for longer than one week. This can cause your nasal congestion to return, an occurrence called rebound congestion.
3. Make sure that you can breathe through each nostril before using your nasal spray. If your nostril is blocked, the medication will not go deep enough into the inside of your nose, and hence, will be wasted.
4. If you are using your nasal spray correctly, the medication should not drip from your nose or down the back of your throat.
5. Your nasal spray is only intended for use in your nose and you must not take it by mouth.
6. If you have any side effects of the nasal spray, such as pain in your nose, stinging in your nose when you spray, or nosebleeds, then stop using the medication for one to two days. Your doctor or pharmacist may recommend that you use a saline (saltwater) nose spray just before you use your nasal spray. Several brands of saline nasal spray are available at most drugstores and many supermarkets.

• Afrin Nasal Spray (phenylephrine): Acts as a decongestant to relieve nasal congestion in people with colds and sinus problems
• Nasalcrom (cromolyn): Helps to relieve and prevent symptoms of allergic rhinitis, such as sneezing, runny nose or itching
• Neo-Synephrine Nasal Spray (phenylephrine): Acts as a decongestant to relieve nasal congestion in people with colds and sinus problems

• Astelin NS (azelastine): An antihistamine that reduces nasal allergy symptoms, such as a runny nose, hay fever or other allergies
• Nasarel (flunisolide): Helps to shrink nasal polyps and relieve allergy symptoms, such as runny or stuffy nose, sneezing, and itching of the nose
• Rhinocort Aqua (budesonide): Relieves inflammation and congestion of a stuffy nose caused by hay fever and other allergies

• FluMist (intranasal influenza vaccine): Given by a healthcare professional, it helps to reduce the risk of getting influenza (the ‘flu’).
• Fortical (calcitonin): Controls the amount of calcium in your body and helps maintain proper bone density (Fortical Nasal Spray is used to treat osteoporosis)
• Imitrex (sumatriptan): Helps to relieve a migraine attack that starts with or without an aura (a peculiar feeling or visual disturbance that warns you of an attack)

Rhinitis medicamentosa, or rebound congestion, can result from the overuse of over-the-counter vasoconstrictive nasal sprays, such as Afrin. Vasoconstriction refers to the constriction of blood vessels in the nose, which helps decrease congestion and fluid release.

Over time, sometimes years, a person will use increasing dosages of nasal spray to relieve obstruction, a phenomenon called tachyphylaxis.  The overuse of such sprays decreases their efficacy and can make nasal obstruction worse. Ultimately, these medications should be used for the shortest time period that is required. Treatment for this condition is to stop using nasal sprays altogether. If you suspect that you're experiencing rebound congestion, please make an appointment to see your physician.