Steroid nasal sprays are medicines that are commonly used to treat allergies of the nose, such as hay fever and persistent rhinitis (inflammation of the nose). Steroid sprays reduce inflammation in the nose, and usually work well. Some people only need to use them for a few months of the year (hay fever). Other people may need to use them long-term (persistent rhinitis). You can buy some steroid nasal sprays from your supermarket or local pharmacy - for example, beclometasone and fluticasone.
What are steroid nasal sprays?
A steroid nasal spray is commonly used to treat allergies of the nose, such as hay fever and persistent rhinitis (inflammation of the nose). Steroid sprays reduce inflammation in the nose, and usually work well. There are a number of different steroid nasal sprays - these include: beclometasone, budesonide, flunisolide, fluticasone, mometasone and triamcinolone. They come in different brands.
How to use a steroid nasal spray
- Blow your nose and shake the bottle.
- Tilt your head forward.
- Hold the spray bottle upright.
- Insert the tip of the spray bottle just inside one nostril. Close the other nostril with your other hand, and apply one or two sprays as prescribed.
- Breathe in as you spray (but do not sniff hard as the spray then travels past the nose to the throat).
- Do not angle the canister towards the middle or side of the nose, but straight up. With your head tilted forward, the spray should go to the back of your nose.
- Repeat in the other nostril.
What if my nose is very blocked or runny?
Sometimes a very blocked or runny nose will prevent the steroid spray from getting through to work. A decongestant nasal spray which you can buy at pharmacies may then be useful. A decongestant spray has an immediate effect to clear a blocked nose. You can then use the the steroid spray once the nose is clear.
(Note: decongestant sprays are not usually advised for more than a few days. If you use one for more than 5-7 days, a rebound, more severe congestion of the nose may develop. In contrast, steroid sprays work well to clear symptoms, and can be used for long periods.)
How long does it take for steroid nasal sprays to work?
It takes several days for a steroid spray to build up to its full effect. Therefore, you will not have an immediate relief of symptoms when you first start it. In some people it can take up to three weeks or longer to get the maximum benefit.
If you use the spray for hay fever, it is best to start using it at least a week before the hay fever season starts.
What is the usual length of treatment?
Some people only need a nasal spray for the hay fever season (a few months). However, if you have a persistent rhinitis, you may have to take treatment long-term to keep symptoms away. Long-term use of a steroid nasal spray is thought to be safe.
Once symptoms are gone, you are still likely to need to use a steroid nasal spray regularly, to keep symptoms away. Your doctor may advise that you reduce the dose to a lower maintenance dose once symptoms have gone. The aim is to find the lowest dose that controls symptoms.
An occasional forgotten dose should not be a problem, but symptoms usually return after a few days if you stop taking the spray.
What are the possible side-effects?
Steroid nasal sprays rarely cause side-effects. This is because they are applied directly to the nose and very little of this medicine is absorbed into the body. Therefore, they are much less likely to cause side-effects in other parts of the body. Occasionally, they cause dryness, crusting, and bleeding of the nose. If this occurs, stop it for a few days and then restart. There have been reports of nasal steroids possibly having an effect on behaviour. This is thought to be rare, but a few people have reported hyperactivity, problems sleeping, anxiety, depression, and aggression (in children).
For a full list of possible side-effects please read the leaflet that came with your medicine.
Can I buy steroid nasal sprays?
You can buy a number of steroid nasal sprays from the supermarket and your local pharmacy. These include beclometasone, fluticasone, and triamcinolone.
Who cannot use a steroid nasal spray?
Most people can use a steroid nasal spray, unless they have ever had an allergic reaction to this medicine. However you should talk to your doctor or pharmacist before using a steroid nasal spray if you:
- Have recently had surgery on your nose, or recently suffered from a nasal infection.
- Have pulmonary tuberculosis (TB).
- Are pregnant, trying for a baby or breast-feeding.
You may still be able to have this medicine - your doctor will advise you.
How to use the Yellow Card Scheme
If you think you have had a side-effect to one of your medicines, you can report this on the Yellow Card Scheme. You can do this online at the following web address: www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that your medicines may have caused. If you wish to report a side-effect, you will need to provide basic information about:
- The side-effect.
- The name of the medicine which you think caused it.
- Information about the person who had the side-effect.
- Your contact details as the reporter of the side-effect.
It is helpful if you have your medication and/or the leaflet that came with it with you while you fill out the report.
Further reading & references
- Corticosteroids - topical (skin), nose, and eyes; NICE CKS, August 2010 (UK access only)
- British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Inhaled and intranasal corticosteroids: risk of psychological and behavioural side effects, Medicines and Healthcare products Regulatory Agency (MHRA), September 2010
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Tim Kenny
Mrs Jenny Whitehall
Prof Cathy Jackson