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Nasal corticosteroid sprays

Alternative names

Steroid nasal sprays; Allergies - nasal corticosteroid sprays

What is a nasal corticosteroid spray?

A nasal corticosteroid spray is medicine prescribed by your doctor to help make breathing through the nose easier.

How does a nasal corticosteroid spray help you?

A nasal corticosteroid spray reduces swelling and mucus in the nasal passageway. It also relieves bothersome nasal symptoms. The sprays work well for treating:

  • Allergic rhinitis symptoms , such as congestion, runny nose, sneezing, itching, or swelling of the nasal passageway
  • Nasal polyps , which are noncancerous (benign) growths in the lining of the nasal passage

A nasal corticosteroid spray is different from sprays you can buy at the store without a prescription.

A corticosteroid spray works best when used every day without stopping. Your doctor will recommend a daily schedule of the number of sprays for each nostril.

You may also use the spray on an as-needed basis only, or as needed along with regular use. Regular use gives you better results.

It may take two weeks or more for your symptoms to improve. Be patient. Relieving the symptoms can help you feel and sleep better and have fewer symptoms during the day.

Starting a corticosteroid spray at the beginning of pollen season will give you the best results in terms of decreasing symptoms during that season.

Several brands of nasal corticosteroid spray are available. They all have similar effects.

How do you use a nasal corticosteroid spray?

Make sure you understand your dosing instructions. Spray only the number of prescribed sprays in each nostril. Read the package instructions before using your spray the first time.

Most corticosteroid sprays suggest the following steps:

  • Wash your hands well.
  • Gently blow your nose to clear the passageway.
  • Shake the container several times.
  • Keep your head upright. Do not tilt your head back.
  • Breathe out.
  • Block one nostril with your finger.
  • Insert the nasal applicator into the other nostril.
  • Aim the spray toward the outer wall of the nostril.
  • Inhale slowly through the nose and press the spray applicator.
  • Breathe out and repeat to apply the prescribed number of sprays.
  • Repeat these steps for the other nostril.

Avoid sneezing or blowing your nose right after spraying.

Side effects

Nasal corticosteroid sprays are safe for all adults. Specific types are safe for children (age 2 and older). Pregnant women can safely use corticosteroid sprays.

The sprays usually work only in the nasal passageway.The medicine does not affect other parts of the body unless too much is used.

Side effects may include any of the following:

  • Dryness, burning, or stinging in the nasal passage. This can be helped by using the spray after showering or placing your head over a steamy sink for 5 to 10 minutes.
  • Sneezing.
  • Throat irritation.
  • Headaches and nosebleed (uncommon, but report these to your doctor right away).
  • More likely to have an infection in the nasal passages.
  • In rare cases, perforation (hole or crack) in the passageway may occur. This can happen if you do not spray away from the middle of the nose.

Make sure you or your child uses the spray exactly as prescribed to avoid side effects. If you or your child uses the spray regularly, see a doctor periodically for examination of the nasal passages to make sure problems are not developing.

When to call the doctor

Call your doctor if you have:

  • Nasal irritation, bleeding, or other new nasal symptoms
  • Continued allergy symptoms after repeated use of nasal corticosteroids
  • Questions or concerns about your symptoms
  • Trouble using the medication

References

American Academy of Family Physicians. Nasal sprays: how to use them correctly. http://familydoctor.org/familydoctor/en/diseases-conditions/allergic-rhinitis/treatment/nasal-sprays-how-to-use-them-correctly.html. Accessed January 14, 2014.

Corren J, Baroody FM, Pawankar R. Allergic and nonallergic rhinitis. In: Adkinson NF Jr., Bochner BS, Burks AW, et al., eds. In: Middleton's Allergy Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 42.

Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008;122(2 Suppl):S1-S84.

Updated: 1/14/2014

Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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