Products
Nasal sprays are very widely used and there are many different products on the market, which are approved drugs or medical devices (see below). Nasal sprays are also manufactured in pharmacies.
Structure and properties
Nasal sprays are solutions, emulsions, or suspensions intended for spraying into the nasal cavities. They may contain one or more active ingredients. Nasal sprays are usually marketed in multidose containers, which are equipped with a suitable applicator. They may contain various excipients such as preservatives (e.g., benzalkonium chloride) or thickeners such as cellulose derivatives.
Effects
On the one hand, the active ingredients contained in nasal sprays can exert their effects locally on the nasal mucosa. These include, for example, decongestant nasal sprays containing active ingredients such as xylometazoline and oxymetazoline, which constrict the nasal vessels. Other examples are antihistamine nasal sprays or glucocorticoid nasal sprays for the treatment of hay fever. On the other hand, active ingredients can be absorbed through the mucosa into the blood vessels and exert their pharmacological effects systemically on various organs. Typical examples are triptans for the treatment of a migraine or salmcalcitonin for the acute prevention of osteoporosis.
Indications
Typical indications for nasal sprays are (selection):
- Cold rhinitis
- Stuffy nose
- Dry nose
- Allergic rhinitis, e.g. hay fever, perennial allergic rhinitis.
- Crusting, nasal cleansing
- Sinusitis
- Tubal catarrh
- Otitis media
Dosage
According to the professional information. The application depends on the product and the active ingredient. Some products need to be shaken before use. Expiration may be limited after opening.
- Clean the nose.
- Remove the protective cap of the spray.
- Before the very first use, the spray must be activated by pressing several times.
- Especially glucocorticoid nasal sprays are in suspension form and must be shaken immediately before use. This does not apply to most decongestant nasal sprays and seawater nasal sprays.
- Insert the nozzle into the nostril. Direct glucocorticoid nasal sprays slightly away from the nasal septum toward the outside of the nose.
- Exhale, inhale gently through the nose and release the spray.
- Even before the pressure subsides, withdraw the spray from the nostril.
- Replace the protective cap.
A nasal spray should be used by only one person to prevent transmission of infectious diseases.
Abuse
With long-term use, decongestant nasal sprays can lead to a condition called rhinitis medicamentosa. It manifests as chronic swelling of the mucosa. Patients develop a dependence on the nasal spray, which is needed repeatedly to clear the nose.
Active ingredients
Active ingredients that may be present in nasal sprays include (selection): decongestant nasal sprays:
- Oxymetazoline
- Phenylephrine
- Tuaminoheptane
- Xylometazoline
Antibiotics:
- Neomycin
Antihistamine nasal sprays:
- Azelastine
- Dimetinden maleate
- Levocabastine
Essential oils:
- Eucalyptus
- Menthol
Humidifying nasal sprays:
- Ems salt
- Hyaluronic acid
- Sodium chloride
- Seawater
Glucocorticoid nasal sprays:
- Beclometasone nasal spray
- Budesonide nasal spray
- Fluticasone
- Mometasone nasal spray
- Triamcinolone acetonide nasal spray
Parasympatholytics:
- Ipratropium bromide
Phytopharmaceuticals:
- Aloe vera
- Chamomile
- Alternative therapeutics
Systemically active nasal sprays:
- Desmopressin
- Dihydroergotamine (out of commerce).
- Midazolam nasal spray
- Nafarelin
- Naloxone nasal spray
- Oxytocin
- Salmcalcitonin
- Sumatriptan
- Zolmitriptan
Vitamins:
- Dexpanthenol
Contraindications
Full precautions can be found in the drug label.
Adverse effects
The most common possible adverse reactions include local reactions such as dry nose, nosebleeds, irritation, and a burning sensation. An unpleasant taste may be perceived in the mouth and taste disturbances may occur. Active ingredients that are absorbed into the circulation can cause systemic adverse effects. Preservatives may be involved in the development of adverse effects. Therefore, products without them are increasingly entering the market.
