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November 8, 2009
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Nasal Allergy Medications (cont.)

Other Nasal Sprays That Might Help

Ipratropium Bromide Spray (Atrovent)

Ipratropium bromide blocks the effects of acetylcholine, which is a chemical that, among other actions, signals the mucous glands in the nose to produce mucous. Allergic reactions can trigger excessive acetylcholine activity on the mucous glands. Ipratropium bromide occupies the same receptor on the glands as does acetylcholine and in this way reduces mucous secretion. You see, the ipratropium bromide that replaces acetylcholine on the receptor does not stimulate mucus secretion.

Ipratropium Bromide is available as a spray pump and comes in two strengths (0.03% and 0.06%). It is only effective for runny noses and can literally "turn off the faucet." The drug does not help itchy or stuffy noses and does not usually take the place of an intranasal steroid, but rather is used along with it. Typically, two sprays 3 to 4 times per day in each nostril are required to control symptoms. Once improvement is seen, the dose can often be lowered to one spray 3 to 4 times per day or two sprays 2 times per day.

Side effects of ipratropium bromide are infrequent but include dry nose, nasal irritation, and nose bleeding. If accidentally sprayed into the eyes, the drug may cause temporary blurred vision.

Allergy Assist

Ipratropium bromide nasal spray can dry up mucous, regardless of the cause. The spray may be effective in non- allergic rhinitis and even the common cold (usually at the higher 0.06% dose).

Cromolyn Sodium Nasal Spray (Nasalcrom)

Cromolyn works to reduce nasal inflammation without the use of steroids. It acts on mast cells to stabilize them, thereby preventing the release of histamine and other mediators. Since cromolyn is strictly a "controller" medication, it must be taken before allergic exposure, usually at least 2 weeks prior, due to its slow onset of effectiveness. The drug tends to be more effective in younger people with higher levels of IgE. It is given at doses of one to two sprays in each nostril 4 times per day. Cromolyn appears to be helpful in reducing runny nose, sneezing, and congestion in milder cases, but may not be effective at all in more severe cases. The medicine became available OTC in 1997. It is a particularly well tolerated medication with minimal side effects (usually sneezing, nasal irritation, or stinging. Rare cases of nasal bleeding or residual bad taste are reported.) There are no systemic, or body-wide, side effects.

Allergy Assist

Cromolyn nasal spray is safe for pregnancy, lactation, and children under the age of 6 years old.


Next: Tips for proper use of nasal sprays »

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