Types of Nasal Sprays
Nasal sprays have different active ingredients and sometimes come in over-the-counter (OTC) as well as prescription formulations. Which one you choose depends on the cause of your child’s allergies, as well as their specific symptoms. The most common active ingredients in nasal sprays include the following:
Antihistamines
Antihistamines block the effects of histamines, a chemical released by the body in response to allergy-causing substances (allergens).
Sprays available by prescription include:
Azelastine (generic only)Patanase (lopatadine)
Astepro (azelastine) is currently the only antihistamine nasal spray approved for nonprescription use in children ages 6 and up.
Antihistamine nasal sprays usually take effect within an hour, but work best if used routinely.
Steroids
Nasal corticosteroids reduce the inflammation caused by allergic and non-allergic rhinitis. These nasal sprays help prevent and relieve sneezing and a runny, stuffy, or itchy nose.
OTC sprays in this category include:
Children’s Flonase (fluticasone propionate) and Children’s Flonase Sensimist (fluticasone furoate)Nasacort (triamcinolone acetonide)Rhinocort (budesonide)
Prescription sprays include:
Nasonex (mometasone furoate monohydrate)Omnaris (ciclesonide)
Corticosteroid nasal sprays need to be used routinely to have any benefit. These medications take many hours to start working, and typically need to be used for a few days before they reach maximal effect.
Anticholinergics
Anticholinergics work by drying the nasal passages. Atrovent Nasal Spray (ipratropium bromide) is available by prescription.
Mast Cell Stabilizer
The active ingredient in this drug, called NasalCrom, is cromolyn sodium. It prevents immune cells (called mast cells) from releasing histamines into the bloodstream. This is an option for families who prefer not to use steroids, but it has to be administered four times per day for best coverage. NasalCrom is available over the counter.
Saline Sprays
To help soften mucus, saline saltwater sprays can be used, which will cause the mucus to drain more easily—but don’t use them right after administering the medicated sprays, as they may rinse out the drug before it has time to take effect.
Side Effects
The Pediatric Allergies in America Survey found that nearly half of children who used nasal sprays complained that the medication dripped down their throats, causing throat irritation. Other common side effects that children reported in this study included bad taste, drying or burning within the nose, headaches, drowsiness, and nosebleeds.
Many patients find that they achieve better allergy symptom control by taking both an oral antihistamine and an intranasal corticosteroid.
Incorrect technique results in many of the side effects from nasal sprays, including nose bleeds.
How to Use a Nasal Spray
Your child may resist having liquid squirted into their nose. To minimize discomfort, follow these step-by-step instructions for administering nasal spray:
Hold your child on your lap and support them with one arm. Use the other arm to squirt the nasal spray. Have your child lean head forward as if reading. Administer one nasal dose to each nostril.
A Word From Verywell
Always consult with your child’s pediatrician before using a nasal spray for your child. Not all formulations are appropriate for all ages. Your healthcare provider can advise you on which ones are safe for your child, and on the correct dosage.
