By Haidy Marzouk, MD; Nalin Patel, MD Wondering what the evidence shows in terms of pediatric otitis media and allergies shows? What’s the best approach to children with recurrent issues, especially after placement of tympanostomy tubes? What should we counsel…
Understanding the Different Types of Nasal Sprays
Nasal sprays work well as they are sprayed directly into the nose in order to target nasal allergy symptoms without going to the rest of the body. These can decrease side-effects of the medication and increase results. There are many types of nasal sprays – both prescription and over-the-counter. Here is a quick guide about the different types. Listed are some common generic and brand names, but this is not an inclusive list. Please consult with your physician before starting any medication. All nasal sprays can cause nose bleeds if not used correctly.
Nasal Steroid Sprays
Usually one of the first-line therapies for allergies. Nasal steroids work by decreasing inflammation within the nasal passages. These sprays offer relief from nasal congestion, sneezing, watery eyes and runny nose. Many of these sprays are available over-the-counter. For these medications to work properly, it is important to use them daily or twice daily for a few weeks. Often times people only try them for a week or do not use them on a regular basis and these medications are unlikely to work. Steroids have many side effects (such as cataracts), but these risks are much lower in the nasal form compared to the oral form, but always discuss with your physician before starting a medication.
Generic- Budesonide, Ciclesonide, Fluticasone, Flunisolide, Mometasone, Triamcinolone
Brand – Rhinocort, Omnaris, Zetonna, Flonase, Nasonex, Nasacort, Xhance, Beconase, Nasarel, Qnasl, Vancenase, Veramyst, Zetonna
Nasal Antihistamine Sprays
Nasal antihistamine sprays are similar to oral antihistamines by blocking histamine. These medications are good at treating the runny nose aspect of allergies. The most common reaction is bitter taste.
Generic – Azelastine, olopatadine
Brand – Astelin, Astepro, Patanase
Combination nasal steroid and antihistamine sprays
This nasal spray contains both a nasal steroid and antihistamine (azelastine and fluticasone). Currently only available by prescription.
Brand – Dymista
Nasal Anticholinergic Sprays
Anticholinergic nasal sprays are good for treating runny nose in patients with both allergic and nonallergic rhinitis. These work by blocking acetylcholine which decreases secretions from the glands in the nasal passage. Common reactions include dry mouth and bad taste.
Generic – Ipratropium Bromide
Nasal Cromolyn sodium spray
This nasal spray helps with nasal congestion, sneezing and runny nose in patients with allergies. It works by inhibiting mast cells. It is available over-the-counter. The most common side-effect is nasal burning and bad taste.
Generic – Cromolyn nasal
Nasal Decongestant Sprays
Nasal decongestants provide temporary relief of nasal congestion by constricting the blood vessels in the nose which reduces nasal swelling and congestion. These are available over-the-counter. Nasal decongestants are good for short periods of time such as when you have a cold or during a bad allergy episode. These should not be used for more than three days as they can become addictive by causing a rebound nasal congestion effect. This is called Rhinitis medicamentosa.
Please see the link here for further information on treating chronic nasal decongestant use.
Generic- Oxymetazoline, phenylephrine, xylometazoline, naphazoline, neo-synephrine
Brand- Afrin, Sinex, Dristan, Zicam
Nasal saline spray or gel
These sprays contain saline. The sprays are good to keep the nose moist, but they are unlikely to help with nasal congestion. Often times there are good for patients who have epistaxis.
Generic – nasal saline spray
Brand- Simply Saline, Xlear, A&H, Ayr
Sterile water that is mixed with salt and often baking soda is flushed into the nose. The idea is to rinse out the mucus out of the nose. These are often used before using a nasal spray. Your physician may add steroids or antibiotic ointment to it as well. If used and cleaned proper, these have few side-effects. Water from the tap or well cannot be used as it is not adequately filtered.
Generic – Bulb syringe
Brand- Nettipot, Neimed, Ayr
As always, if you are unsure, please ask your doctor. Also, if you have tried one or more of the above, and you continue to have allergy symptoms, perhaps it’s time to visit your local allergist and discuss other options.