Can You Get Addicted to Nasal Spray?

To prevent rebound congestion, experts advise using these types of sprays no more than twice a day for three days:

• Oxymetazoline (Afrin, Anefrin, Dristan, Vicks Sinex, Mucinex Sinus-Max)
• Phenylephrine (Neo-Synephrine, 4-Way)

Worth noting: If you cleared your medicine cabinet of all decongestants that contain phenylephrine after the U.S. Food & Drug Administration concluded last fall that the ingredient is ineffective when taken by mouth, it’s important to note that the same isn’t true when it’s delivered directly to the nose as a spray. Although phenylephrine taken orally is rendered useless before it can enter your bloodstream, that’s not the case when used as a nasal spray or, for that matter, drops to dilate the eyes.

Not all nasal sprays are the same

Allergy sufferers, know this: Just because nasal decongestant sprays aren’t meant to be used for more than three days doesn’t mean you have to white-knuckle your way through allergy season.

Nasal sprays that provide allergy relief are altogether different. Not only is it OK to use them every day, they should be used daily to control allergy symptoms. In fact, some should be used in advance of allergy season.

There are three types, and none is habit-forming:

• Steroid sprays: fluticasone (Flonase); mometasone (Nasonex); budesonide (Rhinocort); triamcinolone (Nasacort)
• Antihistamine sprays: azelastine (Astepro, available over the counter; Astelin, by prescription); olopatadine (Patanase, by prescription)
• Saline nasal sprays

“Nasal decongestant sprays tend to work faster than these sprays, but these aren’t habit forming and there’s no risk of developing rebound congestion,” says Daniel Alicea, M.D., a sinus surgeon and assistant professor in the Department of Otolaryngology — Head and Neck Surgery at the Icahn School of Medicine at Mount Sinai. “Each of them works differently, but ultimately they all provide relief for nasal symptoms such as congestion, runny nose, postnasal drip, sneezing and nasal itching.”

How to kick the habit

If you’ve used a nasal decongestant spray for a couple days longer than recommended and you’ve got all the symptoms of rebound congestion, you might be able to taper off on your own. If not, talk to your doctor about how to break the cycle — especially if you’ve been using one for weeks, months, even years.

“If you’re stuck in a cycle of rebound congestion from overusing nasal sprays, it’s best to see a board-certified otolaryngologist for help,” says Alicea, adding that they might recommend a short course of oral corticosteroids and switching to a nasal steroid spray.

Your doctor may also discover the root of the problem. “Individuals who become reliant on these sprays typically have some sort of underlying nasal or sinus problem, which is why they start using them in the first place,” Rowan says.

How to prevent rebound congestion

It’s one thing to swear off overusing the habit-forming nasal sprays if you suffer from the occasional sinus infection or cold. These usually resolve on their own. But it’s altogether different if you suffer from what’s known as chronic rhinitis (inflammation of the inner lining of the nose). For sinus sufferers who need ongoing relief, there are a number of options that won’t set them up for rebound congestion.

“Nasal saline sprays, steroid sprays, irrigations like a sinus rinse bottle or a neti pot, and over-the-counter antihistamines are all effective,” Rowan says. “They are best used on a daily basis while you’re sick or during allergy season.”

So-called natural decongestants can also play a role. A steamy shower or a hot towel wrapped around the face may relieve congestion. Drinking plenty of fluids, especially hot beverages, to keep mucus moist and flowing also helps.  

“If symptoms don’t improve, seek out care with your primary doctor or an ear, nose and throat surgeon,” Rowan says. “Sinus and nasal conditions are incredibly common and there are solutions available.”