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.
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