Nasal Spray For Allergies: Types, Side Effects And Effectiveness (2024)

Nasal sprays for allergies are a type of medication sprayed into the nose to help relieve nasal congestion, runny nose, itchy nose and sneezing due to allergies. Some are available at your local pharmacy without a prescription, while others are available with a valid prescription from your doctor.

“There are different groups of nasal sprays with different effects and medications within them to target specific symptoms,” says Shawn Nasseri, M.D., a board-certified ear, nose and throat specialist in Beverly Hills, California. “Nasal sprays are frequently effective at reducing sneezing, stuffiness and postnasal drip like oral medications, and the dose is much smaller since it’s working where it needs to be—your nose.”

Nasal allergies are caused by a reaction to airborne particles such as pollen, dust or pet dander. When these particles enter the nose, they trigger the release of histamines and other chemicals that cause the symptoms of an allergic reaction.

Allergy nasal sprays work by delivering a small amount of medication directly to the lining of the nose. This helps reduce inflammation and relieves symptoms such as sneezing, itching and runny nose. They’re typically used daily and can provide relief for people with mild-to-moderate allergies.

When it comes to effectiveness, nasal sprays are some of the best, although different types might be better than others. According to a 2017 study in Integrated Pharmacy Research and Practice, intranasal corticosteroids were the most effective for treating allergy-related congestion, sneezing, runny nose and nasal itching—followed by intranasal antihistamines and then oral antihistamines^[2]Brudgeman M. Overcoming Barriers to Intranasal Corticosteroid Use in Patients With Uncontrolled Allergic Rhinitis. Integrated Pharmacy Research and Practice. 2017. .

For people with more severe allergies, other medications may be necessary. However, most nasal sprays for allergies are safe and effective. Sometimes, they’re used in combination with oral medications to provide maximum relief.

There are several types of allergy nasal sprays including steroids, antihistamines, decongestants and mast cell inhibitors, along with others.

Steroid Sprays

Steroid nasal sprays are one of the most common types of nasal sprays for allergies. They work by reducing inflammation in the nose and sinuses. This helps relieve symptoms such as congestion, runny nose, itchy nose and sneezing.

Steroid nasal sprays are available over-the-counter or by prescription. They are typically used daily and can provide relief for people with mild-to-moderate allergies.

OTC steroid nasal sprays include:

• Nasacort AQ (triamcinolone acetonide)
• Flonase (fluticasone propionate)

Prescription steroid nasal sprays include:

• QNasl (beclomethasone dipropionate)
• Rhinocort (budesonide)
• Omnaris or Zetonna (ciclesonide)

Antihistamine Sprays

Another common type of nasal spray for allergies is an antihistamine. Antihistamines work by blocking the effects of histamines, which are chemicals that cause the symptoms of allergies. While antihistamines are also available in oral form, nasal sprays are a great option for people who have trouble swallowing pills.

Antihistamine nasal sprays are available over-the-counter or by prescription. They can provide relief from symptoms such as congestion, runny nose, itchy nose and sneezing.

OTC antihistamine sprays include:

• Astepro OTC (azelastine)

Prescription antihistamine sprays include:

• Astelin (azelastine)
• Patanase (olopatadine)

Decongestant Sprays

Decongestants provide short-term relief from nasal congestion. They work by narrowing the blood vessels in the nose, which help relieve inflammation and allow air to flow more freely through the nose.

While great for temporary relief, decongestants shouldn’t be used for more than a few days at a time. If used longer, they could cause rebound congestion, a return or worsening of symptoms that results from overuse.

Decongestant nasal sprays are available over-the-counter. They are typically used when needed and provide relief from symptoms such as congestion, runny nose and sneezing, and should only be used for a short time because of their potential side effects (such as developing a tolerance).

OTC decongestant sprays include:

• Afrin, Sinex (oxymetazoline hydrochloride)
• Neo-Synephrine (phenylephrine hydrochloride)

Anticholinergic Sprays

Anticholinergic nasal sprays work by blocking the action of a chemical called acetylcholine. This helps reduce inflammation and dry up mucus, relieving a runny nose.

Currently, there’s only one FDA-approved anticholinergic nasal spray, which is available by prescription only. Due to their ability to dry up excess mucus, they work best for a runny nose associated with allergies.

Prescription anticholinergic sprays include:

• Atrovent (ipratropium bromide)

Mast Cell Inhibitor Sprays

Mast cells are a type of immune cell that releases histamines when they come into contact with allergens. By blocking the action of mast cells, mast cell inhibitors help prevent the release of histamines and provide relief from allergy symptoms.

Currently, there’s only one available mast cell inhibitor nasal spray for allergies, which is available without a prescription.

OTC mast cell inhibitor nasal sprays include:

• NasalCrom (Cromolyn nasal)

Combination Sprays

There are a few combination nasal sprays that contain a mixture of allergy medications such as steroids, antihistamines or mast cell inhibitors. These sprays provide maximum effectiveness by targeting multiple symptoms.

Combination nasal sprays are available by prescription. They can provide relief from symptoms such as congestion, runny nose, itchy nose and sneezing.

Prescription combination nasal sprays include:

• Dymista (azelastine and fluticasone)
• Ryaltris (olopatadine and mometasone furoate)

Saline Sprays

Saline nasal sprays are made up of salt water (saline). They help loosen mucus and clear allergens from the sinus cavity. They are available over-the-counter and can be used for long-term relief from nasal dryness and inflammation. They’re also commonly available in gel form.

People of all ages can use saline nasal sprays, and they are a great option for pregnant people or those who are breastfeeding, says Dr. Nasseri. “A sterile saline spray is a good option to use while pregnant or breastfeeding when it is formulated with only all-natural ingredients such as purified water, sodium chloride (salt) and sodium bicarbonate (for pH balance),” he adds.

According to Dr. Nasseri, it’s important to “check the ingredient labels on any products before use, as some will include preservatives or harsh chemicals. Especially in pregnancy, most mothers wish to minimize chemicals and pharmaceuticals.”

OTC saline nasal sprays include:

• Simply Saline Nasal Mist
• BEE&YOU Propolis Nasal Spray (saline and Anatolian propolis extract)
• Euka Infused Cold & Allergy Saline Spray

Nasal sprays are a popular treatment for allergies, but they can also have some risks and side effects.

Saline sprays are safe with minimal downsides, according to Dr. Nasseri. “For everyday use, saline nasal sprays are a great option as they are drug-free,” he says. “They can help to moisten the nose, loosen mucus, [and] some can displace pathogens or wash them away, and most help the nose drain more easily.”

Here, Dr. Nasseri outlines risks and side effects of common nasal sprays for allergy relief:

Steroid nasal sprays can cause:

• Nosebleeds, especially when the nose is dry, which can be prevented by pre-moistening the nose with a saline spray or ointment
• Headaches
• Post-nasal drip
• Infections (rare)

Antihistamine nasal sprays can cause:

• Headaches
• Drowsiness
• Nasal discomfort
• Red eyes

Decongestants can cause:

• An increase in blood pressure
• An increase in eye pressure (in those at risk for glaucoma)
• Burning or stinging irritation
• Dryness in the nose
• Rebound congestion, a condition in which symptoms get worse after the use of a decongestant for more than three days

Nasal sprays are generally safe and effective for most people. However, some people shouldn’t use them. Talk to your doctor if you have diabetes, high blood pressure or glaucoma.

You should also talk to your doctor before using allergy nasal sprays if you’re pregnant or breastfeeding. Some medications used to relieve allergy symptoms, such as phenylephrine, are category C drugs according to the U.S. Food and Drug Administration. This means they may not be safe for pregnant people or those who are breastfeeding. A traditional saline spray is a safe option for daily relief.

“If you suffer from congestion, a runny nose or sneezing, I recommend using a nasal spray to help fight allergy symptoms,” concludes Dr. Nasseri. “Most doctors feel it’s better to treat the nose topically and holistically than flush the whole body with decongestants, antihistamines and drying agents—it’s just a more direct path to the problem.”