Safe use of nasal drops for stuffy nose

The article was professionally consulted by Pharmacist Ngo Thi Thu Thuy - Dean and Pharmacist Nguyen Hoang Phuong Khanh - Faculty of Pharmacy - Vinmec Central Park International General Hospital.

Weather changes, polluted environment, not only children but also adults can get nose diseases, and one of the quite common symptoms in these diseases is stuffy nose. Nasal congestion occurs when the nose and nearby tissues and blood vessels swell with excess fluid, causing a "stuffy" sensation. Nasal congestion may or may not be accompanied by a runny nose.
Nasal congestion is usually just annoying for older children and adults. However, a stuffy nose can have a serious effect on babies by disrupting sleep or making it difficult for babies to suckle.
There are many over-the-counter medications used to relieve symptoms of nasal congestion, taken orally and as a nasal spray, this article only deals with nasal sprays, be aware that overuse of topical drops/ sprays Nasal congestion has the potential to cause serious health consequences.

There are currently on the market the following types of nasal drops and sprays:
Vasoconstrictors These drugs can be purchased without a doctor's prescription. These drugs, when used, constrict the blood vessels in the lining of the nose. , leading to reduce swelling of these mucous membranes should clear, reduce nasal congestion. These drugs include short acting (ephedrine, naphazolin, phenylephedrine) and long acting (tetrahydroxyzin, xylometazolin, oxymetazolin) products
Some brand names: Naphazoline (brand name Nasoline, Rhinex 0.05%), , xylometazolin (Otrivin 0.05% or 0.1%) ... , these drugs cause vasoconstriction and reduce congestion in the nasal mucosa, reducing runny nose. One study evaluated the effectiveness of a single-dose trial of oxymetazoline. The drug relieves nasal airway resistance and symptoms of nasal obstruction within 1 hour, with effects lasting up to 7 hours.
Physiological saline or deep sea water spray, nasal drops These products can be drugs or medical supplies, do not need a prescription when purchased and are very safe to use for different ages and subjects such as: pregnant women, infants... , these products work to dilute secretions and help clean and clear the nose, making it comfortable
Anti-inflammatory glucocorticoid nasal spray Includes 2 drugs that require a prescription and without a prescription. These drugs are often considered first-line drugs for the relief of symptoms of allergic rhinitis. There are 2 groups (2 generations) of glucocorticoids commonly used in nasal spray form, these substances are equally effective, but the 2nd generation glucocorticoids are less absorbed into the body, so systemic side effects are lower:
Generation 1: Beclomethasone, flunisolide, triamcinolone, and budesonide 2nd Generation: Fluticasone propionate, fluticasone furoate, and mometasone furoate Some brands contain nasal steroids such as Rhinocort aqua (Budesonide), Avamys (Fluticasone furoate) or Flixonase (Fluticasone propionate). These drugs vary in frequency of doses and costs, but are equally effective for treating all symptoms of allergic rhinitis.
If you have symptoms of severe nasal congestion, you should use a vasoconstrictor nasal spray for a few days before you start using a glucocorticoid nasal spray, taking them side-by-side helps the glucocorticoid nasal spray to reach more areas in the body. your nasal passages more.
Antihistamine nasal spray Nasal spray - Azelastine is a prescription nasal allergy spray that can be used daily or as needed to relieve symptoms of postnasal drip, congestion and sneezing, which usually takes effect within a few minutes of application. The most common side effect with azelastine is an unpleasant taste in the mouth shortly after use and can be minimized by keeping your head tilted forward while spraying to prevent the medication from running down your throat. The brand name drug on the market is Nozeytin 0.1%, there are also products that combine glucocorticoids such as Meseca or Nozeytin -F.

2.1. If you have a stuffy nose with or without a runny nose, you can use nasal drops that contain a vasoconstrictor. The use of decongestant nasal decongestants should be limited to 3 to 5 days to avoid a "rebound" reaction that initially clears the runny, stuffy nose but then causes nasal congestion again, leading to congestion. to chronic inflammatory diseases of the nasal mucosa, difficult to treat.
Decongestant vasoconstrictors are relatively safe if used appropriately, but their use is associated with many side effects due to their direct effects on adrenergic receptors and stimulation of the nervous system. central nervous system. Common side effects include insomnia, increased blood pressure, restlessness, anxiety, tachycardia, palpitations, arrhythmias, hallucinations, and urinary dysfunction. These vasoconstrictor nasal drops should be avoided in patients with heart disease, hypertension, thyroid disease, diabetes, and benign prostatic hyperplasia (BPH), nor should decongestants be used in patients with are taking monoamine oxidase inhibitors concurrently; This combination can lead to life-threatening hypertension.
For pregnant and lactating women must be very careful, should only use this type of nasal drops when prescribed by a doctor, should not be used arbitrarily.
For children under 2 years old, the vasoconstrictor effect of the above-mentioned nasal drops is not only confined to the nasal mucosa but causes systemic vasoconstriction, ie vasoconstriction in the heart, liver, and kidneys... lead to a stroke that causes cyanosis, sweating, and shock, requiring emergency treatment at the hospital. Therefore, for children under 2 years old, absolutely do not use nasal sprays containing drugs that cause vasoconstriction. In addition, clinical data are lacking to support the safety and effectiveness of decongestants in children younger than 6 years of age, and therefore they are not recommended for use in this age group.

2.2. Glucocorticoid Nasal Drops/Nasal Sprays Glucocorticoid Drops/Sneezes have mainly local effects, however, if used incorrectly, for example, when used for a long time, at high doses, and if the dose is not reduced before stopping, it will cause problems. causes side effects as follows:
Local side effects: irritation of the nasal mucosa, nosebleeds or blood stains in the nasal secretions, drying and atrophy of the nasal mucosa, ulceration of the nasal septum. Systemic side effects: Although many long-term studies of adverse growth effects in children are unknown, it is necessary to monitor the effects on growth in children when these drugs are used. Similarly, studies of osteoporosis, glaucoma or ocular cataracts have also suggested a possible (albeit low) risk with long-term use of glucocorticoids/nasal sprays/drops containing glucocorticoids.

Type of medicine: In order not to damage the nasal mucosa, ensure the physiological activity of the mucus system, the drugs put into the nose must ensure pH = 7-9, the temperature is in the range of 23 degrees C - 40 degrees C, suitable viscosity and osmotic pressure.
Do not drop the nose with flowers, fresh herbs ... homemade because these drugs do not guarantee sterility will cause more diseases or contain allergens that cause allergic reactions.
Except for nasal drops, nasal spray only contains physiological saline 0.9% sodium chloride which is safe for children (used with nasal aspirator for young children), nasal drops, nasal spray The rest need to be used according to the doctor's prescription for prescription drugs or the pharmacist's advice for over-the-counter drugs.
Time and dose of drug: As mentioned above, vasoconstrictor drugs should not be instilled many times a day, lasting for many days continuously because it will cause drug-induced rhinitis (Rhinitis medicamentosa).
In children, prolonged use of glucocorticoid nasal sprays/drops can slow growth, so if you have to use nasal sprays/drops for your child for about 2 months out of a year, talk to your doctor. your child's doctor. In general, for patients with moderate to severe persistent symptoms, glucocorticoid nasal sprays should be started at the highest recommended dose for age and tapered to the lowest effective dose. results after controlling symptoms.
Note: If you have a persistent runny nose or stuffy nose in children under 2 months, you should go to an otolaryngologist for examination and treatment. You need to pay attention, nasal disorders are not only symptoms of colds and flu, but also the beginning of other chronic diseases such as allergic rhinitis, sinusitis ... Therefore, you need to see a doctor. ear, nose and throat specialist to receive the right treatment regimen right from the start so as not to cause adverse effects later.
In addition, it is necessary to store drugs out of reach of children, especially vasoconstrictor drugs, to avoid taking by mistake causing serious consequences.
Vinmec International General Hospital examines and treats common nasopharyngitis diseases, head and neck tumors, congenital malformations of the ear, nose and throat area with the most optimal internal-surgical methods for patients, both children and adults. Coming to Vinmec International General Hospital, patients will receive direct, dedicated and professional examination from a team of qualified and experienced medical staff.
To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE

MORE
Is Allergic Rhinitis Contagious? What is the difference between Allergic Rhinitis and Common Rhinitis? How to effectively treat Allergic Rhinitis Diagnostic Tests