Seasonal Advice, Treatment and Prevention
Allergy Advisor - Seasonal Update  WINTER/ SPRING/ SUMMER/ FALL
Limiting Exposure to Allergens in the Home 
Prevention of Allergy and Asthma in Children
Treatment of Allergy and Asthma
Skin Testing and Allergy Injection Treatment
Inhalers for Asthma
Spacers for Asthma Inhalers
Inhalers for Rhinitis
Tricks for - children to swallow pills
                  - eye drops
Mexican Medications

Nasal Inhalers for Rhinitis              
                                                     Pictures of nasal inhalers

Mild symptoms of allergic rhinitis respond well to oral medications including antihistamines and decongestants.  When these medications do not give adequate relief, nasal inhalers may be used.  Two types are available: aqueous sprays that spray a liquid from a bottle through a nozzle fixed to the top of the unit, and metered dose nasal inhalers that deliver the drug from a pressurized canister through a nozzle on the side near the bottom of the unit. 

Before using a nasal inhaler, it is important to blow the nose, block one nasal passage with a finger on the side of the nostril, insert the nozzle of the inhaler into the other nostril and aim the inhaler so that the spray is directed 45 degrees upward and slightly outwards and away from the mid line.  This is best done by holding the spray bottle with your left hand to spray the right side of the nose, while blocking your left nostril with your right index finger.  Switch hands to spray the other side of the nose.  Your doctor will tell you to use a different method if your nasal septum is deviated to one side. 

For aqueous nasal inhalers, insert the nozzle as far as possible into the nose before spraying.   Wait 30 seconds, then lean forward with your head between your knees for one minute, while pinching your nose.   If nose bleeding starts to occur after starting nasal spray treatment, clean the inside of the nostrils with a cotton swab to remove excess drug after each use of the spray, and then apply a small amount of Vaseline to the inside of the nostrils with a clean swab.

Over-the-Counter, Non-Prescription Inhaled Medications for Rhinitis

Nasalcrom (cromolyn sodium).  Not a steroid, this mast cell stabilizing drug needs to be used 3-4 times a day to be effective.
Nasal Decongestants.  These drugs are very effective for relieving nasal obstruction, but the effect is transient and if over-used they can cause rebound nasal congestion, or perforation of the nasal septum. 

• Preparations that have a 12 hour action include oxymetazoline (Afrin, NeoSynephrine 12 hr, Vicks Sinex 12 hr).  Do not use twice a day for more than 5 days.
• Preparations that have a 4 hour action include phenylephrine (NeoSynephrine, Vicks Sinex).  Do not use every 6 hours for longer than 5 days or every 8 hours for more than one week.

Prescription Medications

Antihistamine:  Astelin (azelastine) is not a steroid. It may cause drowsiness.
Corticosteroids (Steroids):  Nasal steroids are not usually absorbed in sufficient amounts to cause serious side effects, when used in approved doses.  One exception is Decadron Turbinaire, a dangerous medication because it is known to cause steroid toxic side effects. This medication has been discontinued in the U.S.  Like orally inhaled steroids for asthma, regular use is needed for benefit to occur in most patients.  The more potent nasal steroids such as fluticasone, budesonide and mometasone are usually more effective than the non-sedating antihistamines in controlling symptoms of allergic rhinitis.  Side effects of from nasal steroids, and although seldom serious, may require the intervention of your allergist to find alternative treatments including allergen immunotherapy ("allergy shots"). 

Disclaimer:   This site is for educational purposes only.  Any information that you have found in this web site is not intended to replace medical care or advice given to you by your own physicians. You should consider consulting your local medical library and other web sites for additional information. 

Comments and suggestions welcome!   Email: schumach@u.arizona.edu
Content Owner:  Michael J. Schumacher, MB, FRACP, The University of Arizona
Updated 6/2006