What to Know About Using a Nasal Spray

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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, which means it can easily absorb medications 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 or squeeze bottle.

Basics of Nasal Spray Use

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, you need to know a few things:

  • First, make sure you can breathe through each nostril before using a nasal spray. If your nostril is blocked, the medication won't go deep enough into the nasal passage to be effective.
  • Some nasal sprays need to be primed each day before use. To prime it, 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 bottle away from direct sunlight. Don't share your nasal spray with other people, and, most importantly, keep it where children can't get to it.

When you're ready to use the spray, remember to sniff gently as if smelling your favorite food or a flower. Do not snort the spray, which can cause the medication to bypass your nasal passage and go straight into your throat.

Step-by-Step Instructions

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 slowly breathe in through your nose.
  7. Remove the tip of the nasal spray from your nostril and breathe 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're using an over-the-counter nasal spray, make sure to follow the directions and use only the recommended amount of medication.
  9. Wipe the tip with a tissue and put the lid back on.
  10. Try to avoid sneezing or blowing your nose immediately after using the nasal spray.

If you're 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.

Precautions

Nasal sprays can cause side effects. If you have side effects that are severe or persistent, you should let your doctor know.

Common side effects of nasal spray may include:

  • Burning
  • Stinging
  • Increased runny nose
  • Dryness in the nose
  • Sneezing
  • Nervousness
  • Nausea
  • Headache

Call your doctor if you experience nasal spray side effects including:

  • Dizziness
  • Insomnia
  • Tremors
  • Vision changes
  • Weakness
  • Shortness of breath
  • Irregular or rapid heartbeat

Never use your nasal spray after the expiration date on the bottle. Liquid medication can easily be contaminated with dirt or bacteria.

Types of Nasal Sprays

The array of nasal sprays on the market is vast. Some treat nasal congestion and allergies 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): steroid that prevents inflammation, and treats runny and itchy nose

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 to help 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

Avoiding Rebound Congestion

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

With regular use over time, though, you'll need increasing dosages of nasal spray to relieve the obstruction. The overuse of such sprays decreases their effectiveness and can actually make nasal obstruction worse.

As a rule, never use a decongestant nasal spray for longer than three days. Overuse can lead to dependence and require you to use a metered-dose device called a Rhinostat to gradually wean you off the medication.

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Article Sources

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  1. MedlinePlus. Oxymetazoline Nasal Spray. Updated February 18, 2020.

  2. Mortuaire G, De Gabory L, François M, et al. Rebound congestion and rhinitis medicamentosa: nasal decongestants in clinical practice. Critical review of the literature by a medical panel. Eur Ann Otorhinolaryngol Head Neck Dis. 2013;130(3):137-144. doi:10.1016/j.anorl.2012.09.005

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