Over the Counter Medication

I hate to shop.  My goal at the store is to get what I need and get out as fast as possible.  The other day though I couldn't find what I was looking for so took a tour of the pharmacy section of the store.  I noticed a big display of Nasacort nose spray.  I thought I would write about this because I suspect few people will use it correctly so I want to make sure everyone gets their money's worth (it's not cheap!)

Nasacort is a nasal steroid and it is in the same family of medications such as Flonase, fluticasone, and Nasonex.  I usually prescribe the generic Flonase since it is usually the cheapest.  The nasal steroids are used for allergies and work best at preventing allergy symptoms.  They need to be used daily during allergy season for them to work. It takes 1-2 weeks before they start working.

I recommend that my patients blow their noses before using the nasal steroid and then squirt one spray in each nostril one time a day.  Do not sniff in when it is used.  I tell my patients to breathe normally when they use it. If you sniff hard when you use it the medication then gets sucked up to the back of the nose and throat and then it won't work and you likely will have a bad taste in your mouth. Do not blow your nose after you use it because then you blow the medicine out. If your child sneezes or forgets and blows their nose right away it is fine to give another dose right away.  It doesn't matter what time of day the medication is used. Whenever you are going to remember is best!

The most common side effect I see is bloody noses. If this happens then I recommend stopping it for 1-2 days and then restarting it.  You don't want to stop it for long or your allergy symptoms will come back.

I suspect that I will see two common mistakes. For one I will see people using it for illnesses and cold viruses.  It won't work -- nasal steroids only work for allergies.  Secondly, I suspect it will not get used daily.  It won't work if you only use it a day or two here or there.  (It doesn't work right away like a pain reliever helping a headache.)

In summary, nasal steroids are great medications for allergies and have few side effects so it is good news that Nasacort is now over the counter. (Just save yourself money and use it correctly!)