Health knowledge and news provided by doctors.

Nasal Spray Decongestant Do’s and Don’ts You Need to Know

Tim Boyer's picture

Nasal congestion that manifests more colloquially as complaints of a “stuffy nose” is the blockage of the nasal passages when nasal tissues and blood vessels lining the interior of the nose become inflamed and swollen. Typical first response to a stuffy nose is the use of an over-the-counter nasal spray decongestant. However, as pointed out in a recent issue of Consumer Reports on Health, misuse of nasal spray decongestants can have undesirable consequences if you do not follow their list of do’s and don’ts that you need to know.

Nasal congestion can occur due to numerous causes such as exposure to cigarette smoke, pollen, pet dander, under the bed dust bunnies, colds and viruses. A nasal discharge (runny nose) may or may not accompany the congestion; however, difficulty breathing and feelings of discomfort such as sinus headaches are often the chief complaints.

Decongestants for treating a stuffy nose come in two forms: oral pills and nasal sprays or drops. Most of the decongestants contain either the active ingredient oxymetazoline or phenylephrine, which provide relieve from congestion typically up to 12 hours and 4 hours respectively. The active ingredients trigger receptors on the blood vessels that cause the engorged blood vessels to shrink and thereby lessen leakage of fluid into the nasal tissues, which then in turn opens up the nasal passages for easier breathing.

The quickest relief is found with nasal sprays that act topically on the nasal tissue in comparison to pills that take some time to dissolve and be absorbed into the bloodstream. One of the complaints of taking a nasal spray is that it often causes a temporary burning sensation in the nose. However, nasal sprays offer fewer overall side effects than pills because less of the decongestant’s ingredients make it into the bloodstream.

Follow eMaxHealth on YouTube, Twitter and Facebook.
Please, click to subscribe to our Youtube Channel to be notified about upcoming health and food tips.

For relief of a congested nose using a nasal spray, it is important to understand that just because a medication is offered over-the-counter without a doctor’s prescription, it does not mean that it is without risk—especially when taken incorrectly or for too long. In the July 2012 issue of Consumer Reports on Health, health experts advise users of nasal spray decongestants to be sure to follow their recommended nasal spray do’s and don’ts as summarized below:

Do Use your Spray Sparingly—Overuse of a nasal spray decongestant is a common misuse of this medication. The current recommendation by health authorities is that this type of spray should not be used for more than 3 days in a row. Using a nasal spray decongestant longer than 3 days can lead to what is called “rebound congestion” where as a decongestant wears off, the sinus membranes respond by flaring back up even more than what the congestion had been originally. This in turn can encourage a person to take larger doses of the spray, which then increases tolerance to the spray medication and causes worsened congestion. This type of misuse can lead to an addiction to decongestant sprays and/or cause permanent damage to your nasal membranes—a condition known as “rhinitis medicamentosa,” of which symptoms include severe stuffiness, burning, bleeding and dryness of the nose.

Don’t Double Your Decongestants
—Doubling your decongestants by taking BOTH a nasal spray and an oral pill at the same time is unnecessary and dangerous. According to health experts, both work the same way on congestion, and by doubling your decongestant types you are actually doubling your dose and increasing your risk of suffering from side effects of the medications. If after 3 days of nasal spray use and your congestion persists, it is recommended that you switch to oral decongestants, which are much less likely to cause rebound congestion.

Do Check With Your Doctor or Pharmacist First—Contraindications for taking a nasal spray decongestant include preexisting medical conditions such as an enlarged prostate gland, high blood pressure, diabetes, glaucoma, allergies to foods, dyes, or preservatives, and thyroid disease—all of which can be made worse by taking a decongestant. To find out if a decongestant is safe for your condition, consult with your doctor or a pharmacist first and follow their advice.

Don’t Rule Out Non-Drug Treatments
—According to Consumer Reports on Health, studies have shown that non-drug treatments can be effective in treating nasal congestion. Two alternatives include mom’s good old-fashioned chicken soup that may decrease white blood cell-induced inflammation; and, saline rinses for irrigating the nasal passages. How nasal irrigation works is that by pouring a saline solution into one nostril, it then flows through your nasal cavity into the other nostril and thereby washes out mucus and allergens.

Do Consider What’s Causing Persistent Congestion
—Over-the-counter nasal decongestant sprays are designed for temporary relief only of nasal congestion symptoms that in most cases will clear up in a few days. However, if prolonged congestion persists, then it is time to see your physician to find out what medically is going on in your nasal passages that may require prescription level anti-histamines or steroid-containing drugs. Although this was said earlier, it bears repeating: do not use a nasal spray decongestant for more than 3 days to prevent the risk of a rebound congestion occurring and/or becoming what is known as “Afrin addicted.”

Image Source: Courtesy of MorgueFile

Reference: Consumer Reports on Health July 2012



This article was posted in 2012. Is it still relevant and true for today? Because my doctor just gave me both a nasal spray and a pill. Nasonex Aqueous Nasal Spray and Levocetirizine Dihydrochloride 5mg Tablets. The pills are for a decongestant in the ear, but a decongestant nontheless. I only wanted temporary relief for my ear, but my nose has been damaged since I was a kid for overusing the spray. I'm sure I can control it's use now, but this article says that Nasals Spray in general are for more temporary relief and not long term. Should I tell my doctor she's wrong or is this article is old?
HI Joseph: Over the counter nasal sprays do cause problems used long-term. I would definitely talk to your doctor. You shouldn't use them long-term.
I have overused nasal decongestant spray and seek help in learning how to bring back my nasal breathing normally. PS what should I do Ulysses Ivey.
Hello. I use Mucinex D everyday to control my congestion. Do you have a suggestion for an alternative?
Is it ok to put six drops of Nasle spray in your nose over a 10 hour time period