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January 8, 2009
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Nasal Allergy Medications (cont.)

When should I use topical decongestants?

The best use for topical decongestants, the nose drops and sprays, is for the quick, temporary relief of nasal stuffiness due to either allergic or non-allergic causes. They are helpful for relieving congestion in the Eustachian tubes, which equalize pressure between the inner ear and the nasopharynx. Decongestants are frequently used, therefore, before air flights to prevent ear symptoms during flight. In this regard, they may also be useful in treating ear infections. It is important, however, not to use these topical agents for longer than 3 to 5 days, since this may cause rebound congestion. Also, be careful to follow the daily use instructions - some decongestants need to be taken only twice a day while others may need to be used 3 to 4 times a day.

Allergy Fact

Nasal decongestants are effective in opening the entrances to the sinus cavities. This is particularly helpful in treating sinusitis and relieving sinus pressure.

The oral form of decongestants is the preferred choice for most cases of nasal congestion, particularly when you expect to use them for more than 3 to 5 days. They can also be taken for Eustachian tube blockage, infected ears, and sinusitis. Oral decongestants rarely cause rebound nasal congestion even if taken for long periods.

What are side effects of decongestants?

Topical sprays sometimes cause burning or dryness in the nose. The most well known side effect of topical decongestants is rebound nasal congestion. The longer you use the spray, the less effective it becomes and the more you find you need to use it in order to obtain the desired effect (virtually an addictive quality if used excessively). After prolonged use, the spray begins to cause more congestion than it relieves. The only way to break this cycle is to stop the medication. If the cycle is not broken, permanent changes can occur on the nasal membranes, which lead to a condition known as rhinitis medicamentosa. Rhinitis medicamentosa refers to an inflammation in the nose that is caused by the use of medications. Symptoms include severe stuffiness, burning, bleeding, and dryness of the nose.

Side effects from oral decongestants are more common and potentially more dangerous. They can stimulate the nervous system causing palpitations, insomnia, nervousness, and irritability. Some people may have trouble with urination and a decreased appetite. Although frequently mentioned, high blood pressure is not commonly caused or worsened by these drugs. If you have any concerns regarding the side effects of these drugs, discuss them with your doctor.



Next: What about combination antihistamine/decongestant preparations? »

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