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Which Nasal Spray is Best for You?

young-woman-sick-at-home-spraying-nasal-spray How do you know which nasal spray to use when there are so many on the market? Which will work the best?

These are common questions at Sinus Snoring Specialists.  Let’s talk about the most common types of sprays and what they can do for you.  You should ultimately consult with your health care provider to confirm which spray (if any) you should use for your symptoms.

1. Nasal Antihistamines

Examples:

  • Azelastine/Astelin

This is a prescription only spray that blocks allergies in your nose. Consider this a “Zyrtec spray” that can be helpful for nasal congestion, drainage, sneezing, and more. It can often be used twice a day.

2. Nasal Steroids

Examples:

  • Flonase/Fluticasone
  • Nasocort/Triamcinolone acetonide
  • Nasonex/Mometasone furoate

All nasal steroid sprays are over the counter. Steroid sprays are helpful for swelling in the nose because they decrease inflammation. They can be helpful for nasal congestion.
Sometimes patients will take both a nasal antihistamine and steroid together as they are a good combination to alleviate allergy symptoms. There is a prescription spray called Dymista that is a pre-mixed formulation of these two sprays.

3. Nasal Anticholinergics

Examples:

  • Atrovent/Ipratropium Bromide

This anticholinergic nasal spray is available by prescription only. It works by targeting an overactive nerve in the back of the nose that can cause nasal congestion and drainage. This nerve can become overactive in older individuals or those who have severe uncontrolled allergies for many years. It tends to work well for those with nasal drainage or postnasal drip.

If you find this spray effective for your symptoms, you may be a candidate for a nasal procedure that can target the overactive nerve called Rhinaer®. You can discuss it with one of our providers if you think this may be a procedure for you.

4. Nasal decongestants

Examples:

  • Afrin/Zicam/Sinex/Oxymetazoline

These sprays are over the counter. They are helpful only in short-term use (1-2 days), however, they can create damage in the nose with continued use. When used for more than 3 days, they create a rebound effect called rhinitis Medicamentosa. This is a phenomenon where a person has worsening of nasal swelling/congestion after discontinuing a nasal decongestant.
Here at Sinus and Snoring Specialists, we strongly advise against the use of these sprays due to their long-term damaging effect.

Consultation

We recommend talking to a health care provider for more information about what nasal spray may be helpful for you (if any). Our goal at Sinus and Snoring Specialists is to evaluate the underlying cause of your symptoms, often with testing such as CT imaging, nasal endoscopy, and/or allergy testing. Often the best long-term treatment is not nasal spray but treating your underlying cause for your nasal symptoms. This may include treatment with sublingual immunotherapy (allergy drops) as it can alleviate symptoms long-term with no need for medication.  To request a consultation, call or securely text us at 512-601-0303 or complete our request and appointment form.

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Posted in: Allergies, Sinus and Nasal

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