News release, FDA.
A Guide to Nasal Sprays
Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.
Published on June 14, 2022
John Carew, MD, is board-certified in otolaryngology and is an adjunct assistant professor at New York University Medical Center.
Table of Contents
Table of Contents
If you have a runny nose or congestion because of allergies, your healthcare provider may recommend you use an over-the-counter (OTC) or prescription nasal spray to ease your symptoms.
Allergies occur when the immune system mistakes a harmless substance for an invader, and overreacts. The body produces immunoglobulin-E (IgE) antibodies, which then signals the release of chemicals like histamine that result in an allergic reaction. Nasal congestion, runny nose, and sneezing are a few common symptoms of allergies.
A nasal spray can help you feel better when used correctly, but it’s important to use the right type for your symptoms. Always check with your healthcare provider first, especially if you are pregnant or nursing.
Read on to find out more about the six kinds of nasal sprays and how they work, plus possible side effects.
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Best Nasal Sprays
There are six types of nasal sprays, some of which can be purchased at a drugstore and some that are only available by prescription. What works for one person may not work for another.
Antihistamine Sprays
As the name suggests, antihistamine sprays block histamine. This is especially helpful for those with a runny nose caused by allergies. Prescription antihistamine sprays include Patanase (olopatadine) and Astelin (azelastine), and there’s also an OTC form of Astelin called Astepro.
Decongestant Sprays
The main purpose of decongestant nasal sprays, which are available OTC, is to give you temporary relief from nasal congestion. They do this by constricting the blood vessels in your nose, reducing swelling and thus congestion.
Brand names of these nasal sprays include Afrin, Zicam, Sinex, and Dristan. They are meant to help when you have a brief cold or allergy flare-up and should not be used for more than three consecutive days. If used for longer than that, they can cause rebound congestion, leading to your needing more of the nasal spray, causing a vicious cycle.
Steroid Nasal Sprays
Steroid nasal sprays were once only available with a prescription. Today, they can be bought OTC and are often the first treatment used to address allergies. They can reduce nasal inflammation and congestion as well as help with runny nose and sneezing.
In order to get the benefits of the medication, you’ll need to use it once or twice a day for several weeks. Common steroid nasal sprays include Rhinocort (budesonide), Flonase (fluticasone), Nasonex (mometasone), Nasacort (triamcinolone), and Veramyst (fluticasone furoate).
Saline Sprays
Saline sprays are different from the other sprays on this list because they aren’t meant to relieve congestion or other allergy symptoms. Instead, their main function is to help keep your nasal passages moist, which in turn can help prevent nosebleeds due to dryness. Brands of these sprays include Simply Saline, Xlear, and Ayr.
Anticholinergic Sprays
Anticholinergic nasal sprays, such as Atrovent (ipratropium bromide HFA), help to treat a runny nose for those who have allergic rhinitis and nonallergic rhinitis. They work by blocking a neurotransmitter called acetylcholine that triggers nasal secretions. This type of nasal spray is prescription only.
Mast Cell Inhibitor Sprays
Mast cell inhibitor sprays, such as Nasalcrom (cromolyn sodium), work by stabilizing mast cells so that they don’t release chemicals like histamine and leukotrienes that trigger inflammation. This results in fewer allergy symptoms. They are available without a prescription.
Side Effects of Nasal Sprays
Ask your provider about any possible side effects of the the nasal spray you are using. Common side effects can include:
- Bitter taste in the mouth
- Dry mouth
- Nasal burning
- Rebound effect (with nasal decongestants), causing more congestion
- Nosebleeds
Are Nasal Sprays Addictive?
Nasal sprays don’t produce cravings or highs and are not addictive based on the clinical definition. That said, it is possible to misuse them. Overuse of nasal sprays can lead to rebound congestion (which results in you needing more and more of the spray to get relief), nosebleeds, headaches, and reduced effectiveness of the medication.
In particular, one OTC nasal decongestant spray called Benzedrex (propylhexedrine) has the potential to be dangerous if misused. Benzedrex abuse can cause heart problems, such as high blood pressure, and mental health problems, such as paranoia. Always take the nasal spray as directed. If you do not have any relief after using it as stated, talk with your provider.
Alternatives to Nasal Sprays
If you don’t want to use a nasal spray for your symptoms, sometimes nasal irrigation can be helpful. This is when a mixture of sterile water and salt—and sometimes baking soda—is flushed into the nose to rinse mucus out. This can be done with a bulb syringe or a neti pot. It’s important to only use sterile water, not tap water.
Other alternatives to treat your allergies include oral medications like antihistamines, decongestants, and corticosteroids.
Summary
Many different kinds of nasal sprays are available, both over the counter and by prescription only. Talk with your healthcare provider about your symptoms and which nasal spray might be best for you.
A Word From Verywell
Allergies can be incredibly uncomfortable, and nasal sprays can help. But if you find yourself using them more than you should—or you aren’t getting the relief you need—your healthcare provider can help find something that works better for you.
Frequently Asked Questions
Is nasal spray bad for you?
Nasal spray is not bad for you when used appropriately and as directed. If you have any medical conditions or are pregnant or nursing, talk with your healthcare provider before using nasal sprays, even OTC ones.
How often can you use nasal sprays?
It depends on which kind you are using. Always follow the instructions from your provider or the ones on the box. If you are using a decongestant nasal spray, do not use it for more than three consecutive days.
How do nasal sprays compare to oral allergy medications?
Because nasal sprays are a type of targeted therapy—meaning they work directly on the area that is symptomatic—they can provide faster relief than a systemic therapy like an oral allergy medication, which circulates throughout your body.
Do you need a prescription for certain nasal sprays?
Yes, you do. Atrovent anticholinergic nasal spray can only be obtained with a prescription. Some steroid nasal sprays are prescription only, as well. Many others can be bought over the counter without a prescription.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- American Academy of Allergy, Asthma, & Immunology. Allergies overview.
- The American Academy of Otolaryngic Allergy. You want me to spray what up my nose? Understanding the different types of nasal sprays.
- American Academy of Allergy, Asthma, & Immunology. Over-the-counter allergy nasal steroid sprays – what does it mean for patients?
- Minutello K, Gupta V. Cromolyn Sodium. StatPearls. 2022.
- FHE Health. Afrin & other nasal spray addiction.
- US Food & Drug Administration. FDA warns that abuse and misuse of the nasal decongestant propylhexedrine causes serious harm.
Nasal Sprays for Allergies
When allergies strike, nasal sprays can help. There are many different types, and most work faster than pills.
You can buy them at the drugstore, or your doctor can prescribe one to relieve a stuffy or runny nose.
Decongestant Sprays
Decongestant sprays shrink swollen blood vessels and tissues in your nose that cause congestion. Oxymetazoline hydrochloride (Afrin, Dristan, Sinex) and phenylephrine hydrochloride (Neo-Synephrine) are some examples of these medicines. You can buy them over the counter.
Don’t use decongestant nasal sprays longer than three days. Using them longer can actually make your nose more stopped up. Ask your doctor before using them if you have glaucoma or high blood pressure that’s not under control.
Antihistamine Sprays
Antihistamine sprays relieve congestion, itchy and runny nose, and sneezing. They are available by prescription and include azelastine (Astelin, Astepro) and olopatadine (Patanase). They usually cause less drowsiness than antihistamine pills, but they still may make some people sleepy.
Steroid Nasal Sprays
These sprays work very well to reduce congestion, sneezing, and itchy, watery eyes. They also help stop a drippy nose. They’re often the first drug recommended for allergies, but it takes about a week before you’ll notice your symptoms getting better.
Examples of steroid nasal sprays available by prescription include beclomethasone (Beconase, Qnasl), ciclesonide (Zetonna), fluticasone furoate (Veramyst), and mometasone (Nasonex). Three medications can be purchased over the counter — budesonide (Rhinocort Allergy), fluticasone (Flonase Allergy Relief), and triamcinolone (Nasacort Allergy 24HR).
Side effects can include headache, sore throat, nosebleed, or cough.
Cromolyn Sodium (NasalCrom)
This nasal spray prevents your body from releasing histamines, chemicals that cause allergy symptoms like runny nose and sneezing. It can also help a stuffy nose. Some people see results in only 30 minutes. For it to work best, you need to start using it one to two weeks before allergy season starts and then use it one or more times every day. It doesn’t work as well as steroid nasal sprays.
You can buy NasalCrom as a nasal spray at the drugstore.
Cromolyn sodium is safe for most people. Ask your doctor before using it if you have wheezing from asthma or sinus pain. Side effects can include sneezing and nasal burning.
Ipratropium Nasal (Atrovent Nasal)
This prescription nasal spray treats a runny nose by stopping the production of mucus. It doesn’t relieve congestion or sneezing very well.
If you have glaucoma or an enlarged prostate, you may not be able to use Atrovent. Side effects can include headache, nosebleeds, sore throat, or nasal irritation.
Show Sources
American College of Allergy, Asthma & Immunology: “Hay Fever Treatment.”
FamilyDoctor.org: “Allergic Rhinitis” and “OTC Relief for Congestion.”
Medscape Reference: “Ipratropium” and “Cromolyn sodium, intranasal (OTC).”
FamilyDoctor.org: “Allergic Rhinitis.”
FamilyDoctor.org: “OTC Relief for Congestion.”
Medscape Reference: “Ipratropium.”
American College of Allergy, Asthma & Immunology: “Hay Fever Treatment.”
Medscape Reference: “Cromolyn sodium, intranasal (OTC).”
News release, FDA.
UpToDate.com. “Patient information: Allergic rhinitis (seasonal allergies) (Beyond the Basics).”
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