The FDA recently approved Over-The-Counter (OTC) use of a previously prescription-only class of nasal spray medications called intranasal glucocorticoids, sometimes known as steroid nasal sprays. These types of nasal spray medications are very effective for allergic nose symptoms such as nasal congestion, runny nose, nasal itching and sneezing. They work by inhibiting allergic inflammation on many different levels by blocking multiple types of inflammatory chemicals as opposed to merely histamine alone. Commonly prescribed brands include Flonase and Nasonex but there are several others. The new OTC nasal spray is known as Nasacort Allergy 24 hour and contains the same type and dose of medication (triamcinolone 55mcg/spray) as its prescription counterpart Nasacort AQ. It is indicated for ages 2 years and older.
There are concerns regarding the safety of chronic use of this type of medication particularly with the potential for growth suppression in children among a few others associated the chronic use of glucocorticoids, although the risk is relatively low. Nose bleeds are not uncommon with the use of steroid nose sprays, but they are usually minor and quickly resolve with discontinued use. There was also some concern for its use for non-allergic problems such as nasal congestion due to a virus like the common cold; however this type of nasal spray may not significantly help in this circumstance, and the cold will resolve on its own likely leading to self-discontinuation after a few days.
The allergy medication section at the pharmacy can sometimes be a little confusing. The allergists here at Atlanta ENT, Sinus & Allergy can help you sort out which medications can help you most and are ready to help you breathe and feel better as the spring season is just around the corner.
By Rodney Johnson, MD, Atlanta ENT