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Nasal Sprays for Allergies 101:  A Comprehensive Guide

Nasal Sprays for Allergies 101: A Comprehensive Guide

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Written by:
Dr. Shuba Iyengar, MD, MPH
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Dr. Shuba Iyengar, MD, MPH
After graduating from UC Berkeley, Shuba completed medical school at Duke University, earning her MPH in tandem at UNC. After a research fellowship at the NIH, Shuba completed her residency at Stanford, then fellowship in allergy-immunology at Boston Childrens/Harvard.

Shuba returned to the Bay Area to join Dr. Bocian at a large multi-speciality health system where she helped lead an allergy practice. She cofounded Allermi to make expert allergy care more accessible for all.

Nasal sprays are a popular choice to target nasal allergy symptoms directly and minimally affecting the rest of the body. They are incredibly effective in reducing side effects and increasing results.

There are numerous types of nasal sprays, both over-the-counter and prescription, available to choose from, and here's a quick guide to help you decide which one is right for you.

Please note that this list is not comprehensive, and consulting with your physician before starting any medication is essential. It is important to use all nasal sprays correctly to avoid nosebleeds and other possible side effects.

Understanding the Connection Between Allergies and Nasal Spray

When it comes to allergies, nasal sprays can be an important tool to alleviate symptoms like sneezing, congestion, and a runny nose. These sprays work in different ways to help combat allergy symptoms. 

Understanding Nasal Sprays: Uses and Benefits

Different nasal sprays  are formulated with different medications to help alleviate the allergy and other nasal symptoms. By being sprayed directly into the nasal passages, it can help relieve congestion and other related symptoms in a fast and efficient manner. They can also be used to treat conditions that affect the nose and sinuses such as nasal inflammation and dryness.

What are the different types of nasal sprays?

Nasal sprays and irrigations can be useful for allergy relief. Here are some options to consider:

Nasal Steroid Sprays
Nasal steroids are often the first line of therapy for allergies, and they work by reducing inflammation within the nasal passages. These sprays provide relief from nasal congestion, sneezing, watery eyes, and a runny nose.

Many nasal steroids are available over-the-counter, but to work correctly, it is essential to use them daily or twice daily for several weeks. Steroids have many side effects, like affecting the eye pressure in susceptible people. However, mos risks are much lower in nasal form compared to the oral form.

Generic Names: Budesonide, Ciclesonide, Fluticasone, Flunisolide, Mometasone, Triamcinolone

Brand Names: Rhinocort, Omnaris, Zetonna, Flonase, Nasonex, Nasacort, Xhance, Beconase, Nasarel, Qnasl, Vancenase, Veramyst, Zetonna

Nasal Antihistamine Sprays
Azelastine is an example of a nasal antihistamine spray. The medication blocks histamine receptors and helps alleviate itchy noses. The most common side effect is a bitter taste when not used properly .

Brand Names: Astelin, Astepro

Combination Nasal Steroid and Antihistamine Sprays
Available only with a prescription, these nasal sprays contain both a nasal steroid and antihistamine (Azelastine and Fluticasone).

Brand Name: Dymista


Nasal Decongestant Sprays
If you're experiencing nasal congestion, over-the-counter nasal decongestant sprays can provide temporary relief by constricting the blood vessels in your nose. However, these sprays should only be used for short-term relief (no more than three days) as they can cause rebound nasal congestion (Rhinitis medicamentosa).

Generic Names: Oxymetazoline, phenylephrine, xylometazoline, naphazoline, neo-synephrine

Brand Names: Afrin, Sinex, Dristan, Zicam


Nasal Anticholinergic Sprays
These sprays work by blocking the acetylcholine receptor and are effective in treating runny noses in patients with both allergic and nonallergic rhinitis. Dry mouth is a common side effect.

Generic Name: Ipratropium Bromide

Brand Name: Atrovent


Nasal Cromolyn Sodium and Olopatidine Sprays
These nasal sprays inhibit mast cells and help with nasal congestion, sneezing, and runny nose in patients with allergies. The most common side effects are nasal irritation and a bitter taste.

Generic Name: Cromolyn nasal, Olopatidine nasal

Brand Name: Nasalcrom, Patanase

Nasal Saline Spray or Gel
These nasal sprays contain saline to keep the nose moist and rinse nasal passages. 

Generic Name: Nasal saline spray

Brand Names: Simply Saline, Xlear, A&H, Ayr

Nasal Irrigations
This method involves flushing the nose with sterile water mixed with salt and baking soda to rinse out the mucus. Your physician may add steroids or antibiotic ointment to the mix as well. If used and cleaned properly, there are few side effects. However, water from taps or wells cannot be used as it is not adequately filtered.

Generic Name: Bulb syringe

Brand Names: Nettipot, Neimed, Ayr

 

Mastering the Proper Technique for Allergy Nasal Sprays

When it comes to allergy nasal sprays, it's essential to use the right technique to avoid soreness or discomfort. Follow these simple steps:

  • Stand up straight and bend at the hips to look down towards your feet, known as the "nose-to-toes" position.
  • Insert the nozzle about a centimeter into your nose, pointing it straight up or slightly angled towards your ears. Avoid touching the sensitive middle of your nose to prevent bleeding.
  • Squeeze the bottle firmly and quickly into one nostril while holding down the other, sniffing up at the same time. Repeat with the other nostril.
  • Stay in the nose-to-toes position and sniff up for ten seconds with tiny bunny-like sniffs.

Before using a medicated spray, most allergists recommend a nasal saline spray to wash out allergens and moisturize nasal passages. Saline sprays typically contain salt and sterile water. For more information on nasal sprays, see our section on nasal allergies.

Can you combine different nasal sprays?

Are you wondering if it's safe to use multiple OTC nasal sprays simultaneously?

The answer is yes!

Combining steroid and antihistamine sprays can be especially effective. However, it's important to wait at least 15 minutes between each spray and be aware of potential side effects, such as nasal irritation.

Let's take a closer look at each type of nasal spray to understand how they work.


OTC steroid nasal sprays

How Steroid Nasal Sprays Work to Combat Allergies:

Steroid nasal sprays are effective because they calm down your immune system's reaction to the allergen that triggers your allergy symptoms. By doing so, they decrease swelling in your nasal passages and reduce mucus production. The following over-the-counter steroid nasal sprays are available:

  • Flonase Allergy Relief (fluticasone propionate)
  • Flonase Sensimist (fluticasone furoate) – a gentler spray with a finer mist than regular Flonase
  • Nasonex (mometasone)
  • Nasacort (triamcinolone)
  • Rhinocort (budesonide)

Although steroid nasal sprays are effective, they may not provide immediate relief. Consistent daily use is necessary, and it may take several weeks before they reach their full effect. For those with seasonal allergies, starting a steroid nasal spray a week or two before allergy season may provide better management of allergy symptoms.


If you need a customized solution… Allermi

Unlike these OTC nasal sprays, Allermi offers a personalized approach for allergy sufferers. Allermi's four active ingredients can adapt to your needs, so it's possible to adjust the dosage to meet your specific symptoms. An Allermi doctor will select and dose the ingredients based on your symptoms, severity, and medical history.

If you're not getting the desired relief, Allermi can reformulate your spray based on how you respond, providing a truly customized treatment. No more tinkering with your own "Hay Fever Cocktail" - leave it to the experts at Allermi.

Allermi: The Ultimate Hay Fever Solution

What sets Allermi apart is its multi-faceted approach—it contains not just one, but four active ingredients:

  • Antihistamine to alleviate sneezing and itchiness
  • Decongestant to ease a blocked nose
  • Anticholinergic to prevent a runny nose and post-nasal drip
  • Anti-inflammatory to counteract inflammation

In contrast, Flonase and Afrin each only have one active ingredient, fluticasone and oxymetazoline respectively. Flonase is an anti-inflammatory designed to reduce redness and keep your nose comfortable, while Afrin is a decongestant designed to clear out congestion. Although they might be helpful for their intended purposes, they simply cannot offer the comprehensive results that Allermi can.


What about a Nasal Saline Rinse?

When people think of nasal sprays, a nasal saline rinse is what usually comes to mind. This natural solution is made up of sodium chloride (salt) and water, with the same concentration as your body. You can buy it over-the-counter (OTC) in a spray bottle, or make it yourself at home using a neti-pot.

Using saline nasal rinses regularly can help flush your sinuses, remove allergens that trigger allergy symptoms, and hydrate your nasal passages while thinning mucus. During allergy season, use these sprays frequently, especially after being exposed to allergens or before bed.