Doctors issue warning over risks of nasal decongestant spray

Here's why you must be careful

Nearly two-thirds of pharmacists (63%) have intervened in cases of suspected over-use of nasal decongestant sprays, the results of a Royal Pharmaceutical Society (RPS) survey have showed.

And there needs to be better public awareness of the risks of nasal decongestant sprays, a RPS report has warned.

Often an alternative is recommended or sale is refused as almost two-thirds of pharmacists have intervened in suspected over-use of the sprays, as per the results of a survey of 309 community pharmacists, which was published by the RPS on 8 January 2025.

In line with NHS and manufacturer advice, RPS has reiterated that nasal decongestant sprays containing xylometazoline or oxymetazoline should not be used for more than seven days in a row.

What happens if you use them for longer than intended?

If you use them for longer, you can get rhinitis medicamentosa, also known as ‘rebound congestion’.

This means that you can get dependent on the sprays to breathe more easily, the RPS warned.

Patients are unaware of the risk of rebound congestion while nearly 74% reported that the seven-day limit should be made clearer in the medication packaging.

“Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realising they could be prolonging their symptoms”, according to Amira Guirguis, chief scientist at the RPS.

“We’d like to see clearer warnings on the packaging, which you can’t miss, and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms”, she added.

How can you use nasal decongestant sprays safely?

Guirguis wrote an accompanying blog, in which she offers advice on how to use them.

While Olivier Picard, chair of the National Pharmacy Association, commented: “As [the RPS] report rightly says, overusing nasal decongestant sprays increases the risk of side effects, which is why pharmacists may refuse to supply them in circumstances where they judge there to be a risk of misuse or abuse of the product.”

“We are concerned that when a patient buys medication off the shelf in places, such as a supermarket or a petrol station, they may be unaware of the potential side effects of what they are taking or how to safely take the medicine”, he added.

He concluded that “pharmacists are experts in medicines and are always the best people to speak to if you have any concerns about a medication you are taking.”