A Guide to Best Nasal Sprays for Allergies (2024)

The best nasal spray for allergies will depend on your symptoms. If you have a runny nose or congestion because of allergies, your healthcare provider may recommend you use an over-the-counter (OTC) or prescription nasal spray to ease your symptoms.

Allergies occur when the immune system mistakes a harmless substance for an invader and overreacts. The body produces immunoglobulin-E (IgE) antibodies, which then signal the release of chemicals like histamine that result in an allergic reaction. Nasal congestion, runny nose, and sneezing are a few common symptoms of allergies.

A nasal spray can help you feel better when used correctly, but it’s important to use the right type for your symptoms. Always check with your healthcare provider first, especially if you are pregnant or nursing.

There are six types of nasal sprays, some of which can be purchased at a drugstore and some that are only available by prescription. What works for one person may not work for another.

Antihistamine Sprays

As the name suggests, antihistamine sprays block histamine. This is especially helpful for those with a runny nose caused by allergies. Prescription antihistamine sprays include Patanase (olopatadine) and Astelin (azelastine), and there's also an OTC form of Astelin called Astepro.

Decongestant Sprays

The main purpose of decongestant nasal sprays, which are available OTC, is to give you temporary relief from nasal congestion. They do this by constricting the blood vessels in your nose, reducing swelling and thus congestion.

Brand names of these nasal sprays include:

• Afrin
• Zicam
• Sinex
• Dristan

These sprays are meant to help when you have a brief cold or allergy flare-up and should not be used for more than three consecutive days. If used for longer than that, they can cause rebound congestion, leading to your needing more of the nasal spray, causing a vicious cycle.

Steroid Nasal Sprays

Some steroid nasal sprays are only available with a prescription. However, many others can be bought OTC and are often the first treatment used to address allergies. They can reduce nasal inflammation and congestion as well as help with runny nose and sneezing.

To get the benefits of the medication, you'll need to use it once or twice a day for several weeks. Common steroid nasal sprays include:

• Rhinocort (budesonide)
• Flonase (fluticasone)
• Nasonex (mometasone)
• Nasacort (triamcinolone)
• Veramyst (fluticasone furoate)
  

Saline Sprays

Saline sprays are different from the other sprays on this list because they aren't meant to relieve congestion or other allergy symptoms. Instead, their main function is to help keep your nasal passages moist, which in turn can help prevent nosebleeds due to dryness. Brands of these sprays include Simply Saline, Xlear, and Ayr.

Anticholinergic Sprays

Anticholinergic nasal sprays, such as Atrovent (ipratropium bromide HFA), help to treat a runny nose for those who have allergic rhinitis and nonallergic rhinitis. They work by blocking a neurotransmitter called acetylcholine that triggers nasal secretions. This type of nasal spray can only be obtained with a prescription.

Mast Cell Inhibitor Sprays

Mast cell inhibitor sprays, such as Nasalcrom (cromolyn sodium), work by stabilizing mast cells so they don't release substances that cause inflammation (swelling) in the air passages of the nose. This results in fewer allergy symptoms.

Mast cell inhibitor sprays are available without a prescription.

Side Effects of Nasal Sprays

Ask your healthcare provider about any possible side effects of the nasal spray you are using. Common side effects can include:

• Bitter taste in the mouth
• Dry mouth
• Nasal burning
• Rebound effect (with nasal decongestants), causing more congestion
• Nosebleeds

Are Nasal Sprays Addictive?

Nasal sprays don't produce cravings or highs and are not addictive based on the clinical definition. That said, it is possible to misuse them. Overuse of nasal sprays can lead to rebound congestion (which results in you needing more and more of the spray to get relief), nosebleeds, headaches, and reduced effectiveness of the medication.

In particular, the OTC nasal decongestant spray Benzedrex (propylhexedrine) has the potential to be dangerous if misused. Benzedrex abuse can cause heart problems, such as high blood pressure, and mental health problems, such as paranoia. Always take the nasal spray as directed. If you do not have any relief after using it as stated, talk with your healthcare provider.

Alternatives to Nasal Sprays

If you don’t want to use a nasal spray for your symptoms, sometimes nasal irrigation can be helpful. This involves using a mixture of sterile water and salt (and sometimes baking soda) and flushing it into the nose to rinse mucus out. This can be done with a bulb syringe or a neti pot. It’s important to only use sterile water, not tap water.

Other alternatives to treat your allergies include oral medications like antihistamines, decongestants, and corticosteroids.

Summary

Many different kinds of nasal sprays are available, both over the counter and by prescription only. Talk with your healthcare provider about your symptoms and which nasal spray might be best for you.