The Honorary Secretary of the Allergy Society of South Africa (ALLSA), Dr Shaunagh Emanuel, explains that there are three main types of nasal sprays that are commonly used for allergy symptoms; each with different benefits and applications.
Saline nasal sprays are the most basic type of medication on this list, says Celeste Fouche, OTC Marketing Manager – Respiratory and Probiotics at Cipla. “This kind can be used as frequently as required. Saline spray is basically just sterile salt water and is a great natural remedy for clearing the nasal passages of mucous and irritants such as dust and pollen that may be causing allergies. During winter, cold dry air can also cause one’s nasal passages to become dry and cracked, leading to irritation. In this instance, saline sprays keep the nasal passages hydrated.”
Fouche adds that saline nasal spray does not have an active pharmaceutical ingredient and is safe to use every day. “Regular use can help to alleviate the symptoms of allergic rhinitis caused by allergens such as pollen, dust and smoke.”
The second kind is a steroid nasal spray, says Dr Emanuel. “The active ingredient in these types of nasal sprays is a glucocorticosteroid, commonly referred to by people as cortisone. This type is anti-inflammatory and is effective at causing a ‘settling’ of the nasal mucosae (the lining on the inside of the nasal passages).”
According to Dr Emanuel, cortisone nasal sprays are most effective if used regularly over a long period. “People who persistently suffer from allergic rhinitis may benefit from using a cortisone nasal spray every day. A cortisone spray takes about a week to become fully effective and you have to use it consistently every day in order to control symptoms. If you do not use it every day, it won’t be very effective. The amount of cortisone in a dose of nasal spray is also small enough to not have significant negative effects in long-term users.”
The third kind is the decongestant nasal spray, says Dr Emanuel. She explains that these nasal sprays are specifically designed to cause the blood vessels inside the nasal passages to constrict. “This results in a decrease in the blood flow to the membrane lining the inside of the nose, which reduces the amount of mucous produced, and the nose becomes less congested.”
Dr Emanuel says that decongestants are intended for symptomatic relief only. “Decongestant sprays are great for quick relief of symptoms, and can dry up the nasal passages rapidly if the patient’s nose is running as a result of something like a severe bout of allergic rhinitis or a viral respiratory tract infection. This is also the kind of spray that you might use to quickly clear up a runny nose before writing an exam or giving a talk, for example.”
However, she warns that decongestant nasal sprays can have negative side-effects if used in the long term. “Decongestants are only meant to be used for a few days at a time (maximum of a week). We unfortunately see a lot of over-use of this kind of spray. Decongestants are powerful as symptom controllers, which is why people often continue to use them for longer than prescribed. The problem with that is that you can get a condition called rhinitis medicamentosa, which is when your nose no longer responds to the decongestant, and runs continuously, even when you are well.
Fouche says that with the aim to educate South Africans about the importance of proper diagnosis and medication usage, Cipla has launched an interactive educational website called the State of the United Airways at www.ciplaallergy.co.za.
Lastly, Dr Emanuel explains that it is vital to follow the instructions included in the package insert. “Nasal sprays offer some of the best treatment for allergic rhinitis, but only if you use each type exactly as directed,” Dr Emanuel concludes.