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Can you get addicted to certain
nasal sprays?

By Daniel Larson, MD

As ENT surgeons we are often asked if nasal sprays can be addictive. For the majority of nasal sprays, the answer is NO.

Nasal steroids sprays (Flonase®, Nasocort®, Nasonex®, etc. ) are safe to use on a daily basis and are now largely over-the-counter. These sprays are non-addictive and typically do not cause any long term changes to the nasal passages. Their most common side effect is nose bleeds, which occur only in a small % of patients and often are due to improper spraying techniques. Recent evidence has also shown that these sprays may increase the pressure inside of the eye and should be used with caution in patients with glaucoma.

Nasal antihistamine sprays (Asteline®, Patanase®, Dymista®, etc) are also safe to use on a daily basis and work by blocking the effects of allergens in the nasal lining. These sprays are most effective at improving sneezing and runny nose.

Nasal anticholinergic spray (Atrovent® nasal spray) is safe to use on a daily basis to treat a cause of frequently runny noses called vasomotor rhinitis.

THERE IS ONE TYPE OF NASAL SPRAY THAT IS "ADDICTIVE"

These are nasal decongestant sprays such as OXYMETAZOLINE (AFRIN®, SINEX, SUDAFED NASAL SPRAY) or NEOSYNEPHRINE!

This medication is marketed as a nasal decongestant spray and is found under many different names. These medications all work by constricting blood flow through the nasal tissues, thereby shrinking them and allowing more airflow. They cannot be used for more than 3 days! If used for too long, then the tissues of the nose become used to the medication being there, and the blood vessels begin to swell more easily. This causes a condition known as Rhinitis Medicamentosa where nasal congestion actually worsens despite the use of these sprays. IT IS SAFE TO ASSUME THAT ANY SPRAY LABELED AS A "NASAL DECONGESTANT SPRAY" IS POTENTIALLY ADDICTIVE - MAKE SURE TO READ THE LABEL SINCE THESE SPRAYS SHOULD NOT BE USED FOR MORE THAN 3 DAYS.

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