[Text on screen: The Ohio State University Wexner Medical Center
Know this before using allergy nasal sprays]

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Rekha Raveendran, MD: When you're using allergy nasal sprays, there's a couple of tips that we have to help make them much more effective for you and to optimize their usage. 

[Text on screen: Rekha Raveendran, MD
Division Director, Allergy/Immunology
Ohio State Wexner Medical Center]

So when people have congestion or drainage, it all comes kind of from the sinuses and they kind of swell to the center of the nose. The nose is kind of just a house for all of that, so it's not really the part that's swollen. And it looks like it goes straight up, but it actually goes straight back. So when people get post-nasal drip, it's because it's a waterfall back there.

So when you do your nasal spray, the best way to do it is to look down. So I always say nose to toes and to point your nasal spray out towards your sinuses here. It's almost like you're pointing toward the corner of your eye. You don't want to point to the center, you don't want to point straight up because the center of the nose just has very thin skin, blood vessels, nerves, and those can become irritated or cause nosebleeds if you're pointing in that direction.

The last thing I always tell patients is that when you spray your nasal spray and you're pointing it out, the last thing you want to do is you actually don't want to sniff a lot. It seems really counterintuitive to what you would want to do, but when you sniff, you actually suck it all down here. And one, it tastes bad. And the second part is you've lost a lot of the medication and swallowed most of it, and you really want to treat it like you would put a cream on a rash. So you want the nasal spray to stay in the nose, decrease the inflammation where it's at. If some of it drips out the front, which it will probably do, you wipe it away and that's it.

So for full effectiveness of the medication, how often you use it often depends on which type of medication we're using. So nasal corticosteroids do take some time to start working. So I recommend that patients use those pretty consistently. And you won't see improvement maybe day one or day two, but as you use it over the next couple of weeks and moving forward, it will get better and better as you use it. But consistency is pretty key with those medications.

Something like a nasal antihistamine can be used a little less often and can be used a little bit more on demand. So you have a little bit of control with that. It's great at drying up the secretions, any runny nose that you have, and can be used as needed.

So nasal sprays for the most part stay topically in your nose where they tend to belong, but there are some patients who may not be good candidates for nasal sprays. There has been a small amount of evidence that shows nasal steroids can increase intraocular pressures or increase the risk of getting cataracts a little bit early. That tends to be pretty low. But if someone is dealing with high intraocular pressures or having glaucoma, it would be best to discuss with your ophthalmologist as well as your allergist to decide what is the best option for you.

Nasal sprays, for the most part, are actually very safe in patients who have high blood pressure and any type of kind of cardiac issues because the medication stays right in the nose where it belongs and it doesn't tend to travel throughout the bloodstream, so it doesn't cause a lot of full-body side effects.

[Text on screen: The Ohio State University Wexner Medical Center
For more information, visit: wexnermedical.osu.edu/allergy]

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