Question: I have allergies and often use an over-the-counter nasal spray decongestant. Sometimes I’ll use the spray a dozen or more times a day. Is this safe?

Dr. Hibberd’s answer:

Over-the-counter nasal decongestant sprays should be off limits for all allergy patients. They often get used contrary to directions, which is the case with you. The regular and consecutive use of these OTC agents for as little as three to five days at a time may induce a rebound condition called rhinitis medicomentosa. This is a very uncomfortable worsening of the nasal congestion that can only be controlled by stopping the OTC spray. It is usually treated with a prescription steroid spray and often aided by prednisone orally for five days to break the vicious inflammatory cycle.

Allergic rhinitis is best managed with prescription nasal inhaled products containing low doses of cortisone in combination with an oral antihistamine such as Zyrtec. Difficult or recurring cases may require the addition of a leukotriene modifier taken daily, such as Singulair, with a desensitization treatment in a severe recurring case. Of course, the mainstay of treatment should include avoidance of known allergens, irritants, and tobacco, as well a moderate alcohol intake, if at all.