Updated: Mar 25, 2022
Many people are told not to use their nasal decongestant spray (e.g. Hysan® , Sudafed®, Otrivin®, Utabon®, Vicks Sinex ®) for longer than 7 days by their pharmacist, doctor or specialist. This is totally true and it would help patients knowing the reason as patients tend to follow advice more.
So, why cant you use them for longer than 7 days?
Decongestant nasal sprays (DNSs) provide immediate relief by shrinking swollen blood vessels in your nasal passages as they’re applied directly to the nose. This reduces the inflammation and helps you breathe easier. DNSs are supposed to be used for a maximum of seven days and the less the better. If you use them longer than that, they can cause rebound congestion.
With rebound congestion you spray and spray, several times a day, but your stuffy nose seems to get worse. After a few days, though, the blood vessels don’t respond to the medication anymore. You spray away, but your problem just gets worse. This cycle can continue for months, years, and even decades. The condition’s official name is rhinitis medicamentosa, and it has one cause: overusing decongestant nasal sprays.
Long-term health problems
That’s why every bottle comes with a warning: “Do not use for more than 3 to 7 days.” Many patients think that a couple of more days won't cause harm. They are wrong.
The longer you use a spray decongestant, the more likely you are to get the rebound phenomenon. It can lead to chronic sinusitis and other serious, long-term problems including more severe and permanent swelling of the nasal tissue. In some of these cases, the only option left would be the surgical removal of the permanent swelling. Long-term use of these sprays can also damage the tissue, causing infection and pain.
When you stop the spray you get headaches, sleep trouble, restlessness, and anxiety.
How to End the Cycle
There’s only one permanent solution -- you have to stop using the nasal spray. It’s probably going to take a few weeks, and the first week will be the hardest. Your pharmacist or doctor can help find the best way to ease your discomfort. Doctors sometimes prescribe a short course of oral steroids to help patients get over the initial severe congestion that occurs while trying to quit the nasal decongestants. Other treatments include drugs for allergy control, nasal emollients, or alternative therapies.