OVER THE COUNTER NASAL SPRAYS

Survey
Is your nose frequently stuffy?
Do you have difficulty breathing through your nose?
Do you have to sleep with your mouth open?
Are you unable to get enough air through your nose during exercise?
Have you experienced 4 or more nasal or sinus infections in the past year?
Do you notice alot of snot to blow out of your nose?
Do  you have constant phlegm or postnasal drip to snort or spit?
Is your sense of smell less than you wish it was?
Does your voice sound like you always have a cold?
Do you know someone who answers YES to these questions?

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Information
-  There are many different kinds of nasal sprays available over the counter (OTC).  But just because they are over the counter does not mean they are safe to use any way you like.

-      OTC saline nasal sprays can be used as often as needed.  Your nose and sinuses need moisture to heal and improve.  You can use saline washings numerous times each day.  In addition to keeping your nose moist, these sprays wash your nose, loosen thick mucous, and clean out any crusts or drainage.  Point the spray in all different directions in your nose and then, blow it out.  You cannot use this too much.  There are higher volume and pressure versions of saline irrigations including NeilMed’s Sinus Rinse or the Nettipot.  For these, please use only distilled, boiled water or filtered water (not tap water).  With these you should clean the bottle weekly with iodine, vinegar or alcohol.  It is also important to always take off the cap and allow the bottle to dry out in between uses.

-      OTC decongestant nasal sprays such as Afrin, Oxymetazoline, and Neosynephrine provide powerful nasal decongestion.  These sprays are helpful for a common cold or airplane flight when used for no more than a few days. However, they should never be used longer than that. 

When you use them for weeks, months or years, your nose develops a tolerance, and then a dependence on the medication.  When the effect of the spray wears off, your nasal passages become more congested and swollen.  This tolerance forces you to keep using the medication again and again simply to breathe. Frequently, it can become impossible to breathe through your nose without the spray!  When this occurs, our ENT specialists can help you overcome your dependence on the nasal decongestant spray.

-      OTC Zinc-based nasal sprays such as Zicam can cause permanent loss of smell that cannot be reversed.  These sprays are generally advertised as helping to stop the common cold, but we strongly recommend against using them under any circumstances.  We have seen patients lose their ability to smell permanently.  

-      OTC steroid nasal sprays include Fluticasone, Flonase, Nasonex, Nasacort, Rhinocort, and Qnasl.  These sprays decrease swelling in your nose and sinuses to help the sinuses improve their ventilation.  Nasal steroid sprays must be used every day to be effective and often take 5-7 days before you will notice their benefit.  They only work on the areas they touch.  They must be primed before you begin using them to ensure that you get the medicine.  To use them properly, point the spray toward the same eye or ear as the side of the nose you spray.  Spray 2 puffs into each nostril once a day every day until your doctor instructs you to stop, even if you feel better.  You can sniff in the medicine but do not need to inhale it.  The object is to line the nasal cavity with medicine.  These sprays should not burn or cause bleeding and if they do, please stop and notify your doctor.   Also, if you have eye problems such as cataracts or glaucoma, please discuss their use with your ophthalmologist.