Ask The Pharmacist

pharm Q: My nose is constantly congested; I think it is allergies. I am using an over-the-counter nose spray to help me breathe. It works for a while, but the congestion has been going on for weeks. Is there something else I can try?


A: It sounds to me like you have rebound congestion. This occurs when you use decongestant nose sprays for more than three to five consecutive days. Nasal sprays contain chemicals that shrink the congested blood vessels in the nasal passages. They give quick relief but after a few days, the blood vessels don’t respond to the medication and the problem gets worse. This can continue for days, weeks, months, even years; you will sometimes hear people say they are “addicted” to their nose sprays.

First, determine if your congestion is coming from a cold or allergies. Allergies often have other symptoms, including sneezing, runny nose, itchy and watery eyes. Seasonal allergies are best treated with over-the-counter antihistamine pills, such as Claritin, Zyrtec, Allegra, and the new (formerly prescription only) Xyzal. Steroid nasal sprays are very effective and can be used long term unlike decongestant sprays. In fact, they often take one to two weeks to start working and are best used on a regular, preventative basis. These include Flonase and Nasacort, both previously available by prescription only.

If the cause of your congestion was a cold, you will need to end the cycle, and there’s only one permanent solution: Stop using the decongestant nasal spray. It’s probably going to take a few weeks, and the first week will be the hardest. During this time, you could try oral decongestants to get some relief or a saline nasal spray to flush out the stuffy airways. If it is too uncomfortable, contact your doctor. Some physicians may prescribe a short course of oral steroids to get you through the initial severe congestion.

In the future, remember you can use decongestant nasal sprays for relief, but for no more than three to five consecutive days and only as often as the package directions state, which is usually every 12 hours, or you will be congested indefinitely.


Brenda Johnson, R.Ph.
Calabasas Pharmacy Owner
Inside Gelson’s Market
22277 Mulholland Hwy.
M – F: 9 a.m. – 7 p.m.
Saturday: 10 a.m. – 4 p.m.
Sunday: 10 a.m. – 4 p.m.
P: 818.223.8656
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