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Your nose is stuffy from a cold or allergies so you use one of those over-the-counter nasal decongestant sprays. Relief! A week or more goes by and you find that you need to use the sprays more often to relieve the congestion. Every time you try to quit using the sprays, the nasal congestion keeps getting worse. What is happening?
Most Americans do not realize that over-the-counter nasal decongestant sprays should not be used for more than 3 days (72 hours). These medications include name brand Afrin nasal spray, Neo-Synephrine, Otrivin, Dristan nasal spray, and several generics. Some of the active ingredients include oxymetazoline HCl, phenyephrine HCl, or Xylometazoline HCl. Prolonged use of nasal decongestant sprays leads to rebound congestion or "getting addicted" to nasal sprays. Rebound congestion is a term used for when your congestion worsens if you stop using the nasal sprays. This is not a true addiction, but rather the nasal passages become less responsive to the effects of the medication. As a result, you may need to use more and more of the medication to control the nasal congestion.
A tolerance, or "addiction", to the nasal decongestion sprays is not permanent. The first step in ending nasal spray therapy is to contact your doctor about the situation and ask if you can
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take any over-the-counter medications to help your congestion. The doctor or pharmacist must look up your current medications and current disease states. Based on your medical history, they can figure out the best over-the-counter medication or prescription.
The best method to reverse the rebound congestion is to completely stop using the nasal decongestant spray. The congestion may worsen for 5-7 days, but eventually will become tolerable or stop. If you are hesitant about quitting the nasal sprays, you may decrease the use slowly by decreasing the number of sprays per day and increasing the time between the sprays. This will make the process longer, so you may battle with congestion for a longer period of time, but with less intensity. In the meantime, based on the recommendation from your doctor or pharmacist, you can use a prescription or over-the-counter medication to alleviate some of the congestion to make it more tolerable.
You may use an over-the-counter nasal saline spray or nasal irrigation device to help the nasal passages recover. A Nedi pot or Neil Med Rinse are two options as a nasal irrigation device. This is helpful in reducing the inflammation within the nasal passages.
Over-the-counter antihistamines may be helpful in controlling some of the congestion. Antihistamines include
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diphenhydramine, loratadine, or ceterizine. Use caution with antihistamines because they may cause drowsiness.
There are several prescriptions available to relieve some of the rebound congestion. The doctor can prescribe a nasal steroid, oral steroid, or an oral antihistamine. This can be given at the discretion of the doctor.
It is important for you to read the patient information provided on the box. Nasal decongestant sprays are not to be used for longer than 3 days. It is always important to ask your doctor if you can use any over-the-counter medications. Also, inform the doctor of any changes in your medications, including over-the-counter medications, vitamins, or herbal supplements.
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