A runny and/or blocked nose can be very irritating. Even more so when it is a chronic (long term) problem. Many of us may suffer from occasional cold or nasal allergies from time to time. Some people suffer from seasonal or chronic allergies. So, what do we usually treat these problems with?
A topical nasal decongestant.
As the name implies, this group of medicines clears up congestion within the nose and is delivered topically. Topically means it is administered to act directly on the site with minimal entry into the blood stream. In this case, it can either come in the form of a nasal spray or nasal drop.
These decongestants usually contain ingredients that causes vasoconstriction. This means that the medication will cause blood vessels around the area to constricts and thus reducing mucus production. Some of the names of these ingredients include oxymetazoline and xylometazoline. This excludes steroid nasal sprays that is usually meant for long term use. If you are unsure which type of medication you are using, please consult your pharmacist or doctor.
Why shouldn’t it be used for long term?
If you look carefully at the instructions on the boxes of these medications, you should notice the cautionary advice that they should not be used continuously for more than 3 to 5 days.
What happens if we used it longer than that?
Using it continuously, one may find that the spray will become less effective over time and sometimes the nasal congestion may even get worse. This is called rebound congestion. Healthcare professionals have a cooler name for it; rhinitis medicamentosa.
This occurs because your body reacts to the medication by compensating for its action. Over time, the body over-compensates which leads to a rebound of the original symptoms the medications are meant to treat.
Identifying rebound congestion
Here are some signs of rebound congestion:
- You have used the decongestant for more than 3 to 5 days
- The is no identifiable trigger of the nasal congestion, such as allergies, or a cold
- The spray stopped working for you, or work with much less efficacy compared to when you first started using it
- Usually other conditions have other symptoms i.e a cold with a cough or mild fever. Allergies with itchy eyes or rash. In rebound congestion, there’s only one symptom, a nasty nasal congestion and nothing else.
- Headaches, anxiety, restlessness and insomnia. If these occur when you stop using the medication, it is likely that these are symptoms of withdrawal.
Oh dear, I think I have rebound congestion. What can I do?
There is only one way out. Just like addiction to drugs, to quit this medication is through cold turkey. It will be difficult, especially in the first few weeks, when you stopped using the medication completely.
If you find that it is too difficult to handle, talk to your doctor and he/she may prescribe some medications to temporarily help you through the difficult times.
Can I prevent this from happening?
Although this article may make this group of medications sound scary, they are usually very safe when used according to instructions from your healthcare professionals. To top that off, they are also very effective in controlling short term nasal congestion.
To prevent this from happening, prior to using this medication, make sure what kind of nasal congestion you are having. If it is a chronic nasal congestion, consult your doctor to see if you require other medications that may be given for long term.
If it is a nasal congestion that just occurred, make sure that you do not use these medications for more than 3 days in a row.
You can also try other products such as a saline nasal flush or anti-histamines. Speak to your pharmacist to find out more about other options that you have.
- deShazo, R. and Kemp, S. (2018). UpToDate. [online] Uptodate.com. Available at: https://www.uptodate.com/contents/pharmacotherapy-of-allergic-rhinitis [Accessed 8 Mar. 2018].
- Peden, D. (2018). An overview of rhinitis. [online] Uptodate.com. Available at: https://www.uptodate.com/contents/an-overview-of-rhinitis [Accessed 8 Mar. 2018].