“Can nasal sprays be addictive?”
My husband wakes up with early morning nasal congestion. He ends up using the nasal spray every morning to get relief. Are these nasal sprays addictive?
8 Answers
The short answer is yes. Any decongestant spray that contains oxymetazoline can be addictive and in the long term can damage the mucus membrane lining of the nose. In the short term, they can be helpful, but should not be used more than 3-4 consecutive days to avoid addiction. Other types of sprays, such as those containing steroid or antihistamine are not addictive and can be used long-term if needed. Saline sprays are also non-addictive and can be used indefinitely.
Many decongestant type over-the-counter nasal sprays lead to a syndrome of refractory nasal congestion for which the use of the topical sprays are potentially addictive in a different sense. They become more of a habit rather than a true addiction. They cause a “rebound” phenomenon leading to the use of the spray on a regular basis to open the nasal airway.
The use of nasal decongestant sprays are not necessarily "addictive," but lead to a rebound problems of the nasal membranes, which usually makes the individual use the spray over and over again. The solution is to give the nose 48 hours with no spray to return back to normal.
Sprays that contain decongestants in them like oxymetazoline sure can be. They are very potent agents that shrink the soft tissue in the nose, making it more open but should only be used for 5 days at a time, then you need at least 2 days off them for the nose lining to recover.
Over-the-counter decongestant sprays (xylometazoline, oxymetazoline) can cause changes in the nasal linings that promote dependence. That means that using the same amount over time causes less effect. Over the course of a few weeks, using two puffs of one of these sprays a few times a day causes less relief, and people end up needing to use more puffs to accomplish the same effect.
Nasal steroids do not cause dependence. They work differently in the nasal linings. Using a nasal steroid will often lead to improvement in nasal symptoms, and usually will not lose their effectiveness over time (though if someone gets sick, their allergies kick in or are exposed to a new irritant, they may not feel it is as effective). However, if they have a chronic nasal condition like allergies, or they smoke and they stop their nasal steroid after a time, their symptoms will often recur. This is not failure of the medication to fix the problem.
In general, I would advise someone with nasal congestion with a cold to try a nasal decongestant for a few days to get through their symptoms and stop after five days. If they are experiencing daily nasal symptoms longer than a few weeks, then they need to be checked and possibly prescribed a nasal steroid spray. Nasal steroid sprays are the safer long-term option, as long as there are no contraindications to using them.
Good luck!
Nasal steroids do not cause dependence. They work differently in the nasal linings. Using a nasal steroid will often lead to improvement in nasal symptoms, and usually will not lose their effectiveness over time (though if someone gets sick, their allergies kick in or are exposed to a new irritant, they may not feel it is as effective). However, if they have a chronic nasal condition like allergies, or they smoke and they stop their nasal steroid after a time, their symptoms will often recur. This is not failure of the medication to fix the problem.
In general, I would advise someone with nasal congestion with a cold to try a nasal decongestant for a few days to get through their symptoms and stop after five days. If they are experiencing daily nasal symptoms longer than a few weeks, then they need to be checked and possibly prescribed a nasal steroid spray. Nasal steroid sprays are the safer long-term option, as long as there are no contraindications to using them.
Good luck!
Over the counter nasal sprays with decongestants such as oxymetazoline are addictive. The nasal lining (mucosa), with continued use of these medications, will change over time and require more and more of these types of medications in order to decongest the nose. This creates a vicious cycle which is difficult to break. I recommend your husband see an otolaryngologist to help break this cycle and find the underlying cause of his nasal congestions and a safer solution to relieve him of this issue.
Decongestant nasal sprays like afrin or 4way are absolutely addictive if you use them more than 3 days. The nasal lining can become tachyphylactic which means it is swelling each morning expecting the nose spray and using it just prolongs the problem. He should see an otolaryngologist to help him not only get off the spray but to address the underlying reason he started it to begin with. And yes, his wife is always right.
Not addictive in the common sense. Vosoconstrictor nasal sprays, e.g., Afrin, used on a regular basis can lead to tachyphylaxis and rebound turbinate congestion. These sprays are meant to be used only occasionally ally or colds/sinus infections to keep airway open. Over use can cause a reflex parasympathetic reaction, i.e., congestion, in attempt restore autonomic nervous system controls. This condition responds to oral medications, i.e., prednisone for short Tx period, topical corticosteroid spray. Also, spray must be discontinued, no smoking. Have him see ENT MD for evaluation.
