Antihistamines work by competing for receptor sites to block the function of histamine, thereby reducing the inflammatory effect. Antihistamine nasal sprays include:
Saline sprays are typically non medicated. A mist of saline solution containing sodium chloride is delivered to help moisturize dry or irritated nostrils. This is a form of nasal irrigation. They can also relieve nasal congestion and remove airborne irritants such as pollen and dust thereby providing sinus allergy relief.
Three types of nasal sprays preparations of sodium chloride are available including hypertonic (3% sodium chloride or sea water), isotonic (0.9% sodium chloride) and hypotonic (0.65% sodium chloride). Isotonic solutions have the same salt concentration as the human body, whereas hypertonic solutions have a higher salt content and hypotonic solutions have a lower salt content. Isotonic saline nasal sprays are commonly used in infants and children to wash out the thick mucus from the nose in case of allergic rhinitis. Hypertonic solutions may be more useful at drawing moisture from the mucous membrane and relieving nasal congestion.
Natural nasal sprays that include chemical complexes derived from plant sources such as ginger, capsaicin and tea-tree oil are also available. There is however no trial-verified evidence that they have a measurable effect on symptoms.
Topical decongestants
Decongestant nasal sprays are available over-the-counter in many countries. They work to very quickly open up nasal passages by constricting blood vessels in the lining of the nose. Prolonged use of these types of sprays can damage the delicate mucous membranes in the nose. This causes increased inflammation, an effect known as rhinitis medicamentosa or the rebound effect. Decongestant nasal sprays are advised for short-term use only, preferably 5 to 7 days at maximum. Some doctors advise to use them 3 days at maximum. A recent clinical trial has shown that a corticosteroid nasal spray may be useful in reversing this condition.[3] Topical nasal decongestants include:
In some countries, Dymista is marketed by Viatris after Upjohn merged with Mylan to create Viatris.[5][6]
In 2022, the combination azelastine/fluticasone was the 299th most commonly prescribed medication in the United States, with more than 300,000 prescriptions.[7][8]
^Vaidyanathan S, Williamson P, Clearie K, Kahn F, Lipworth B (July 2010). "Fluticasone reverses oxymetazoline-induced tachyphylaxis of response and rebound congestion". American Journal of Respiratory and Critical Care Medicine. 182 (1): 19–24. doi:10.1164/rccm.200911-1701OC. PMID20203244.