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The 5 Best Over-the-Counter Nasal Sprays

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.

A Guide to Nasal Sprays

Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.

Published on June 14, 2022

John Carew, MD, is board-certified in otolaryngology and is an adjunct assistant professor at New York University Medical Center.

Table of Contents
Table of Contents

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.

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Allergies occur when the immune system mistakes a harmless substance for an invader, and overreacts. The body produces immunoglobulin-E (IgE) antibodies, which then signals 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.

Read on to find out more about the six kinds of nasal sprays and how they work, plus possible side effects.

Best Nasal Sprays

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, and Dristan. They 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

Steroid nasal sprays were once only available with a prescription. Today, they 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.

In order 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), and 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 is prescription only.

Mast Cell Inhibitor Sprays

Mast cell inhibitor sprays, such as Nasalcrom (cromolyn sodium), work by stabilizing mast cells so that they don’t release chemicals like histamine and leukotrienes that trigger inflammation. This results in fewer allergy symptoms. They are available without a prescription.

Side Effects of Nasal Sprays

Ask your provider about any possible side effects of the 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, one OTC nasal decongestant spray called 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 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 is when a mixture of sterile water and salt—and sometimes baking soda—is flushed 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.

A Word From Verywell

Allergies can be incredibly uncomfortable, and nasal sprays can help. But if you find yourself using them more than you should—or you aren’t getting the relief you need—your healthcare provider can help find something that works better for you.

Frequently Asked Questions

Is nasal spray bad for you?

Nasal spray is not bad for you when used appropriately and as directed. If you have any medical conditions or are pregnant or nursing, talk with your healthcare provider before using nasal sprays, even OTC ones.

How often can you use nasal sprays?

It depends on which kind you are using. Always follow the instructions from your provider or the ones on the box. If you are using a decongestant nasal spray, do not use it for more than three consecutive days.

How do nasal sprays compare to oral allergy medications?

Because nasal sprays are a type of targeted therapy—meaning they work directly on the area that is symptomatic—they can provide faster relief than a systemic therapy like an oral allergy medication, which circulates throughout your body.

Do you need a prescription for certain nasal sprays?

Yes, you do. Atrovent anticholinergic nasal spray can only be obtained with a prescription. Some steroid nasal sprays are prescription only, as well. Many others can be bought over the counter without a prescription.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Academy of Allergy, Asthma, & Immunology. Allergies overview.
The American Academy of Otolaryngic Allergy. You want me to spray what up my nose? Understanding the different types of nasal sprays.
American Academy of Allergy, Asthma, & Immunology. Over-the-counter allergy nasal steroid sprays – what does it mean for patients?
Minutello K, Gupta V. Cromolyn Sodium. StatPearls. 2022.
FHE Health. Afrin & other nasal spray addiction.
US Food & Drug Administration. FDA warns that abuse and misuse of the nasal decongestant propylhexedrine causes serious harm.

The 5 Best Over-the-Counter Nasal Sprays

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Best overall nasal spray:Afrin Pump Mist Maximum Strength
Best nasal spray for kids:Children’s Flonase
Best nasal spray for sinus infection:Mucinex Sinus-Max Nasal Spray
Best nasal spray for allergies:Flonase Allergy Relief Spray
Best saline nasal spray:Arm and Hammer Simply Saline Nasal Care

Nasal sprays are medications that you spray directly into your nose. These products are sometimes recommended to treat symptoms of sinus pressure and inflammation, which can be caused by allergies or a sinus infection.

These sprays can apply active ingredients directly to the site of your discomfort, which can help to provide quick relief for pressure and congestion.

Pricing guide

Best overall nasal spray

Afrin Pump Mist Maximum Strength

Price: $
Who it works for: The active ingredient in this spray is oxymetazoline, a nasal decongestant. That makes Afrin Pump Mist a good choice if you’re experiencing congestion related to allergies, a sinus infection, or a combination of both. One dose (two to three pumps) of Afrin lasts 12 hours.
What to know: This product shouldn’t be used for more than 3 consecutive days. It contains polyethylene glycol, which some people may be allergic to. Afrin can be habit forming. If you’re still having symptoms after 3 days, speak with a doctor and switch to another treatment.

Best nasal spray for kids

Children’s Flonase

Price: $$
Who it works for: The children’s formulation of Flonase contains glucocorticoid, a medication that relieves congestion caused by allergies. It’s also nondrowsy, so your child can take a dose before they’re off to school or a game. Glucocorticoid is an anti-inflammatory, but not an antihistamine, which may make it more effective at treating congestion. One spray per day in each nostril is enough.
What to know: This product isn’t approved for kids under 4. Note that continuous use or overuse of Flonase can affect your child’s growth, so it shouldn’t be used as a long-term solution. Be sure to supervise your child when using this product, and make sure they take the recommended dosage. Note that this spray won’t treat congestion that’s caused by a cold or sinus infection.

Best nasal spray for sinus infection

Mucinex Sinus-Max Nasal Spray

Price: $$
Who it works for: Oxymetazoline chloride is the active ingredient in this spray, which is meant to treat mild to moderate sinus congestion. As a bonus, this spray contains cooling menthol, which can help soothe inflamed nasal passages and give you a burst of clean, cool sensation. Reviewers say this formula works immediately.
What to know: This spray should only be used once every 12 hours, and it’s not a long-term treatment for ongoing sinus and allergy issues, as it can be habit forming. If your symptoms haven’t subsided after 3 days, speak with a doctor and switch to another treatment.

Best nasal spray for allergies

Flonase Allergy Relief Spray

Price: $$$
Who it works for: Flonase is a nondrowsy formula that contains fluticasone, which is meant to treat hay fever symptoms. Fluticasone is a corticosteroid treatment that can reduce inflammation in your sinuses without the sleepy side effects of an antihistamine. Unlike other nasal sprays, Flonase is non-habit forming, so you can use it year-round. In addition to sinus congestion, it addresses watery eyes and itching.
What to know: You only need two sprays in each nostril daily to get the full impact of Flonase. Some known side effects include nosebleeds and a sore throat. These side effects become more likely with overuse.

Best saline nasal spray

Arm and Hammer Simply Saline Nasal Care

Price: $$
Who it works for: This saline nasal spray adds moisture to clogged nasal passages. It loosens mucus with the help of baking soda, instead of constricting nasal passages. Some reviewers who live in dry climates use it to irrigate their nose.
What to know: Unlike other nasal sprays, it’s safe to mix this saline spray with other types of cold and allergy medication. If you need relief from severe cold, flu, or allergy symptoms, try one of the stronger sprays on this list. Note that this spray is more of a fine mist and can take some getting used to.

The best nasal spray for you depends on what you need the product to do. Aim to treat your symptoms based on the underlying cause. If you need a nasal spray because of seasonal allergies, look for a spray that contains a steroid. If you’re treating a sinus infection, look for one with decongestant ingredients.

Start with a product that has a lower amount of active ingredients before trying something with a higher amount.

How to use

Most nasal sprays are used the same way.

First, blow your nose to get your nasal passages as clear as possible. This will ensure you’re not simply blowing mucus back into your sinus cavity.
Next, make sure that the spray cap is off and the spray is open. You may need to shake the bottle or release a small amount of spray from the pump to get it ready to use.
Point the end of the nasal spray directly under one of your nostrils. Close your mouth before you gently spray and inhale. Your goal is to get the spray into your sinuses, not to feel it in the back of your throat.

Always carefully read the packaging of any product that you use before you start using a nasal spray. Dosage may vary according to what you are using. Most nasal sprays are only meant to be used once or twice per day for a maximum of three consecutive days.

Using nasal spray too much can give you nosebleeds or cause rebound congestion.

Nasal sprays aren’t typically intended as a long-term solution for allergies and frequent sinus congestion. Some people report that nasal sprays can be habit-forming, and side effects such as rebound inflammation and nosebleeds can occur if you overuse these products. Alternatives to consider include:

Run a cool-mist humidifier or essential oil diffuser in your home to keep sinus congestion to a minimum.
Consider a HEPA-filter air filtration device if environmental allergies are a problem indoors.
Apply a warm compress to your forehead and nasal passages to soothe painful congestion.
Keep oral allergy medications in mind as an alternative to nasal sprays.
Breathe in steam or take a warm shower to loosen mucus that’s inflaming your sinus passages.
Drink an herbal tea with peppermint.

Nasal sprays can help you manage hay fever or sinus infection symptoms. But there are times when you may need to see a doctor about your symptoms.

Talk with a doctor about your congestion if you have one or more of the following symptoms:

nasal congestion that lasts for 2 weeks or more
a high fever that lasts for over 72 hours
nasal discharge that appears green and comes with a recurring fever or headache

How do OTC nasal sprays compare with prescriptions?

In general, OTC nasal spray options have many of the same active ingredients as their prescription-strength counterparts. The main difference is the dosage that’s included in the spray. Prescription-strength sprays are also more likely to contain corticosteroid ingredients.

How do nasal allergy sprays compare with oral allergy medication?

Nasal allergy sprays tend to take several days to start working, while oral allergy medications can start working within a few hours. However, in the long run, nasal sprays may be more effective than taking oral medication. Generally, however, they both have the same effects.

Are nasal allergy sprays safe to use?

Nasal allergy sprays are safe to use occasionally for the treatment of a runny nose or nasal congestion. Nasal decongestant sprays can cause what’s called rebound congestion if used for 3 consecutive days. Before using any type of nasal spray, read package instructions carefully.

Shopping for the right nasal spray starts with learning a thing or two about the active ingredients they contain. Once you know the basics, it’s much easier to narrow down which symptoms you need to treat and which nasal spray might work best.

Some nasal sprays can be habit-forming and aren’t appropriate for long-term use. Speak with your doctor about a longer-term treatment plan if nasal sprays aren’t giving you symptom relief.

Last medically reviewed on August 29, 2022

The 5 Best Over-the-Counter Nasal Sprays

A Guide to Nasal Sprays