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Nasal sprays are used for the nasal delivery of a drug or drugs, generally to alleviate cold or allergy symptoms. Although delivery methods vary, most nasal sprays function by instilling a fine mist into the nostril by action of a hand-operated pump mechanism. The three main types available are: antihistamines, corticosteroids, and decongestants.
Excessive histamine function is the primary cause of allergic reactions in people. Histamine is a chemical naturally-produced by the body which creates an inflammatory effect to help the immune system remove foreign substances. Antihistamines work by competing for receptor sites to block the function of histamine, thereby reducing the inflammatory effect. Astelin (Azelastin hydrocholoride) is the only local antihistamine available as a nasal spray. It is available by prescription only and has gained popularity with sufferers of allergic rhinitis.
Steroidal nasal sprays, also available only by prescription, use the anti-inflammatory effect of a corticosteroid to reduce swelling and congestion in the nasal passages and sinuses. Examples include Nasonex, Flonase, Nasacort, and Rhinocort. They generally take a week to ten days to reach their maximum effectiveness, and are considered safe for extended use.
Decongestant nasal sprays such as Afrin (Oxymetazoline hydrochloride), which are available over-the-counter in the United States, work to very quickly open up nasal passages by constricting blood vessels in the lining of the nose. With prolonged use these types of sprays can damage the delicate mucous membranes in the nose, ironically causing an increased inflammatory effect known as the "rebound effect". As a result, decongestant nasal sprays are advised for short-term use only.
Saline sprays are also common and are typically unmedicated. A mist of saline solution is delivered to help moisturize dry or irritated nostrils.
It is not uncommon for a doctor or allergist to prescribe several types of nasal sprays in combination with each other or with other drugs. For example, a decongestant spray is often advised for the first few days of treatment with an antihistamine or steroidal spray. The quick-acting effects of the decongestant allow for better initial delivery of the other sprays.
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