Topical nasal corticosteroids like Nasacort and Flonase are commonly used medications to treat hay fever(allergic rhinitis). Previously, only physicians could prescribe these medications however, FDA has recently approved Flonase and Nasacort to be available over the counter without prescription or need for physician monitoring. Nasal corticosteroid sprays are very helpful in reducing nasal inflammation, swelling and reduce nasal secretions. These medications also help with eye itching, redness and tearing. Having them easily available is extremely convenient for the patients with allergies. However, all good things come with a price and hence, its extremely important for the patients to understand the concerns associated with their use.

  1. Nose bleeds: proper technique is extremely important to avoid nose bleeds. Supervision with a doctor can help determine that the technique is correct. Your doctor can also see if the nasal swelling is responding to the use of this medication. Nasal septum perforation is a rare side effect of this medication and hence, monitoring by your physician is important to rule out this rare possibility.
  2. Hay fever symptoms are similar to viral cold, chronic sinusitis, uncontrolled acid reflux, nasal polyps, and nasopharyngeal benign or cancerous growth. It is important to make sure that these topical nasal sprays are not masking these other conditions, which could be detrimental in the long run.
  3. Older individuals, who have glaucoma, should be careful with use of these topical nasal corticosteroid sprays, without discussing with their physicians or ophthalmologists. They may cause increase in intraocular pressure with continuous use and might exacerbate glaucoma and cause vision problems and headache.
  4. Health insurance plans will no longer cover these medications, since they are available over the counter. This may mean increased economic burden for patients. Your doctor can help you find alternatives which would be covered by your health insurance plan in case these over the counter medications don’t work or you are unable to afford them.

In spite of above concerns, nasal corticosteroid sprays are very effective in managing hay fever symptoms and are, overall, safe medications. However, consulting with your physician and being monitored periodically while being on these medications is advisable. The Allergy Group would be very happy to answer all and every question of yours related to allergies and asthma!! Have an awesome summer!!