Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Can You Recommend a Nasal Decongestant to Replace Oxymetazoline?

Friday, 29 January 2010 10:37 AM

Question: For the past four years, I have had a problem with congested nostrils. I have been tested for allergies, and I am allergic to some trees. According to my allergist, it is not a severe allergy.

I use a nasal decongestant. (Oxymetazoline HC1 0.05%) and spray my nostrils at least three times daily. Still, I awake in the night unable to breathe through my nose. Is there a less dangerous medication I can use? I also have Type 2 diabetes, and I’m sure this medicine is causing my sugar count to be over 200.

Dr. Hibberd's Answer:

Welcome to rhinitis medicamentosa! This is an ongoing condition caused by overuse of nasal constricting sprays such as the nasal spray you are using. When these sprays are used for more than three to five days, you set yourself up for severe and persistent rebound congestion that cannot be cleared until you stop the spray.

Most patients need to substitute a nasal cortisone preparation (such as Nasacort, Beconase or Nasonex) for several days or even weeks. Oral nasal decongestants may help a little, and occasionally a brief three to five day course of oral cortisone for may help recovery in non-diabetic patients.

Steroids tend to elevate blood glucose values in diabetics, and if used, need close blood glucose management.

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