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 (OTC), depending on the medication. Most work by introducing a fine mist of the medication into your nostrils by the action of a hand-operated pump bottle.

Many different medications come as nasal sprays, and instructions for how to use them can vary. If you don't understand the instructions, ask your pharmacist to walk you through them. Before starting, there are a few things you should know.

First, make sure that you are able to breathe through each nostril before using your nasal spray. If your nostril is blocked, the medication will not go deep enough into the nasal passage and will be wasted.

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.

Always store your nasal spray as directed and keep the body away from direct sunlight. Do not share your nasal spray with other people. And, most important, keep your nasal spray out of the reach of children.

To use a pump bottle nasal spray correctly:

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.

If you are using your nasal spray correctly, the medication should not drip from your nose or down the back of your throat. Some nasal sprays leave an unpleasant taste in your mouth. A drink of water or juice should help eliminate the aftertaste.

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, stop using the medication for three to five days. If you have continued nosebleeds, stop the nose spray completely until advised by a doctor or pharmacist. 

Never use your nasal spray after the expiration date on the bottle. Since your nasal spray is a liquid medication, it is easily contaminated with dirt or bacteria. Use a marking pen to write the date you open your nasal spray on the bottle. This way, you will know when to throw it away.

The array of nasal sprays on the market is vast, some of which treat nasal congestion and allergy, while others deliver systemic medications and vaccines to manage or prevent illness.

OTC Cold and Allergy Nasal Sprays

• Afrin (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 (phenylephrine): Acts as a decongestant to relieve nasal congestion in people with colds and sinus problems
• Flonase (Fluticasone Propionate): Treats sneezing and symptoms of hay fever
• Nasacort (Triamcinolone): Treats itchy and runny nose
• Rhinocort (Budesonide): Treats runny and itchy nose. This is a steroid that prevents inflammation. 

Prescription Allergy Nasal Sprays

• 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 a runny or stuffy nose, sneezing, and itching of the nose
• Nasonex (mometasone): Used to prevent and treat stuffy nose and other allergy symptoms.
• QNASL (beclomethasone): Used to treat allergy symptoms, such as sneezing
• Zetonna/Omnaris (ciclesonide): Used to treat itchy and runny nose, as well as sneezing
• Xhance (fluticasone): Can be prescribed to treat nasal polyps, as well as allergy symptoms
• Dymista (fluticasone/azelastine combination): Treats allergy symptoms, such as runny and itchy nose.
• Patanase (olopatadine): Used to treat allergy symptoms, such as itchy nose and eyes

Other Nasal Sprays

• 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)
• Nicotine nasal sprays: A smoking cessation device used to wean you off cigarettes

Rhinitis medicamentosa, or rebound congestion, can result from the overuse of over-the-counter vasoconstrictive nasal sprays, such as Afrin. Vasoconstriction refers to the narrowing 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 the obstruction. The overuse of such sprays decreases their efficacy and can actually make nasal obstruction worse.