Nasal-Spray Brands. Corticosteroids available in nasal spray form include:
- Triamcinolone (Nasacort, generic). Approved for patients age 2 and older.
- Mometasone furoate (Nasonex). Approved of patients age 3 and older.
- Fluticasone (Flonase, generic). Approved for patients age 2 and older.
- Beclomethasone (Beconase, Vancenase, generic). Approved for patients age 6 and older.
- Flunisolide (Nasarel, generic). Approved for patients age 6 and older.
- Budesonide (Rhinocort, generic). Approved for patients age 6 and older.
- Ciclesonide (Alvesco, Omnaris). Approved for patients age 12 and older
Side Effects. Corticosteroids are powerful anti-inflammatory drugs. Although oral steroids can have many side effects, the nasal-spray form affects only local areas and has less risk for widespread side effects unless the drug is used excessively. Side effects of nasal steroids may include:
- Dryness, burning, stinging in the nasal passage
- Headaches and nosebleed (uncommon but should be reported to your doctor immediately)
Possible Long-Term Complications. All corticosteroids suppress stress hormones. This effect is known to produce some serious long-term complications in people who take oral steroids. Researchers have found far fewer concerns with nasal administration or inhaled forms, but there may be certain problems:
- Effect on growth. The major concern for children is whether nasal steroids, like other forms of steroids, will adversely affect growth. Different steroids may be absorbed differently or may stay longer in the body. Growth impairment from nasal corticosteroid sprays taken at correct dosages has not been demonstrated. Most children who take only recommended dosages of nasal sprays, and do not also take inhaled corticosteroids for asthma, will not have any problems.
- Effect on eyes. Glaucoma is a known side effect of oral steroids. Some ophthalmologists have observed higher pressure in the eye (a sign of glaucoma) in some patients taking nasal steroid sprays, particularly those taking higher dosages or those who also take inhaled corticosteroids for asthma. However, studies to date have not shown an increased risk for glaucoma. Periodic eye examinations are advised.
- Use during pregnancy. Steroids are most likely safe during pregnancy, but pregnant women should talk to their doctors before taking them.
- Nasal passage injury. Steroid sprays may injure the nasal septum (the bony area that separates the nasal passage) if the spray is directed onto it. This complication is very rare.
- Lower resistance to infection. People with any infectious disease or injury in the nose should not take these drugs until the disease or wound has been treated and cured.
Cromolyn serves as both an anti-inflammatory drug and a specific blocker for allergens. The standard cromolyn nasal spray (Nasalcrom, generic) is not as effective as steroid nasal sprays but does work well for many people with mild allergies. It is one of the preferred first-line therapies for pregnant women with mild allergic rhinitis. It may take up to 3 weeks to experience full benefit.
Side Effects. Cromolyn has no major side effects, but minor ones include nasal congestion, coughing, sneezing, wheezing, nausea, nosebleeds, and dry throat. The spray can cause burning or irritation.
Review Date: 05/03/2011
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.