Nasal sprays can be used to treat medical conditions from flu to migraine headaches to tobacco abuse. But by far the most common reason people reach for nasal sprays is to relieve nasal congestion. Adverse effects, though often affecting only a limited number of users, have been identified for all types of nasal sprays.
Saline Mist Sprays
Saline mist sprays, which are used to keep the nasal passages moist, can be purchased in most retail drug outlets. Their main active ingredient is sodium chloride--salt. However, many of these sprays include preservatives, such as phenylcarbinol and benzalkonium chloride. While saline is a common and safe moisturizer, according to Dr. Murray Grossan, some people find that the preservatives irritate their nasal passages. Grossan recommends patients seek out additive-free solutions or even make their own.
Over-The-Counter Nasal Decongestant Sprays
The main active ingredients in Afrin, Vicks Sinex 12-Hour, Neo-Synephrine and other OTC nasal decongestant sprays are oxymetazoline or phenylephrine. These drugs occasionally cause burning, dryness or stinging inside the nose and sneezing or a runny nose, though these symptoms often stop after a few uses of the spray. Other, more serious but less common adverse effects, according to Drugs.com, result from too high concentrations of oxymetazoline in the body and may require a call to the doctor. These include blurred vision, a pounding heartbeat, headache, dizziness or lightheadedness, nervousness or a wobbly feeling and difficulty with sleeping.
The most common adverse effect of nasal decongestant sprays, though, is the rebound effect. According to a 2003 article in "The New York Times", when OTC nasal decongestant sprays are used for more than three or four days at a time, their effectiveness wears off, the sinuses become more swollen and other symptoms of congestion tend to worsen, a condition called rhinitis medicamentosa. When that occurs, doctors recommend discontinuing use of the spray until the nasal passages can heal.
Some people also claim these types of sprays are addictive, but Dr. James T. Li of the Mayo Clinic says the sprays aren't physiologically addictive (Reference 4).
Prescription Nasal Decongestant Sprays
Corticosteroids are the main active ingredient in prescription nasal sprays, such as Flonase and Nasonex. Steroid drugs are effective anti-inflammatory agents, so help to open up nasal passages swollen due to sinusitis or allergies. While these nasal decongestants have no long-term adverse effects, according to Dr. Oren Friedman of the Mayo Clinic, they can cause "burning, dryness, irritation and itching inside your nose and throat, sneezing, headaches, nosebleeds, runny nose or an upset stomach." Friedman recommends contacting a physician if such symptoms persist.
Homeopathic Nasal Decongestant Sprays
HealthNews.com reported that a study published in the July 2010 "Archives of Otolaryngology" found that zinc gels, which are used in homeopathic nasal decongestant sprays, may cause some people to lose their sense of smell or to have a diminished sense of smell, sometimes permanently. The number of people in the study was rather small, though, so further research may be called for to determine just how many people could be affected.
References
- Can Saline Additives Be Harmful?: Dr. Grossan - The Ear, Nose & Throat On-line Consultant
- Drugs.com: Vicks Sinex 12 Hour
- New York Times Health: Nasal Sprays Can Bring on Vicious Cycle
- Mayo Clinic: Nasal spray addiction: Is it real?
- Mayo Clinic Medical Edge Newspaper Column: Can Nasal Steroid Sprays Be Used Long Term?
