Q. I have suffered with severe, chronic nasal congestion and sinus headaches for decades. Periodically I get addicted to over the counter nasal sprays and have a terrible time weaning myself off. Sleeping with a stuffy nose is the pits.
What can you recommend besides antihistamines, which leave me groggy?

A. Many people have reported dependence upon vasoconstrictors found in nasal sprays like Afrin and NeoSynephrine. A safe alternative involves saline (salt water) nasal sprays. One reader offered the following:
“I have found that the nasal saline spray my ear nose and throat doctor recommended really helps me. The brand name is Ocean. If someone has head pain due to nasal congestion or sinuses, I definitely recommend giving this 
non-habit-forming remedy a try.”
This is a terrible time of year for people with nasal congestion. Allergies have been especially bad this spring, probably because of the mild winter. There are so many allergens in the air it is hard to know how to cope.
We have a thorough chapter in our book Best Choices From The People’s Pharmacy about dealing with allergies. First, you will want to think about improving your home environment! A really good HEPA-type air filter to capture pollen and other sensitizing particles can be a worthwhile long-time investment. You will find our 4 star choice is Aprilaire and why on page 52. Which vacuum cleaners are best and which could make your life miserable? Hint: think Gutersloh, Germany.
Non-drug approaches for allergy treatment include nose cleaning with a neti pot. Be sure to boil your water, though before turning into the right saline solution. We do NOT want anyone forcing germs, viruses or fungi into the upper reaches of the nose or sinuses! Consider vitamin C, stinging nettle (Urtica dioica), butterbur, and cromolyn (derived from the fruit of bishop’s weed). Details on pages 54-59. Learn about the pros and cons of corticosteroid nasal sprays such as Beconase AQ, Rhinocort, Nasarel, Flonase, Nasonex and Nasacort AQ on pages 62-63.
You can survive the allergy season if you approach the congestion with a full court press that involves modifying your environment and using a variety of treatments thoughtfully! We hope Best Choices can help.

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  1. David
    Reply

    Yes, Saline drops are really helpful in relieving a stuffy nose. I tried them and they worked like a charm. I wonder sometimes how even some simple medications can be so helpful.

  2. John
    Reply

    How I got away from OTC vasoconstrictor nasal sprays that cause almost unbearable rebound congestion was to see my physician and get a prescription for one of the steroid nasal sprays such as fluticasone (generic Flonase) or similar. Some were available in both aqueous sprays and propellant based sprays.
    I found the aqueous versions more effective for me. They take a couple days to start to work, at which point I could drop the Afrin. There was still some rebound congestion, but, by then the steroid was working and the rebound was much more bearable for that few days. There is always some discomfort; the piper has to be paid.
    After about a week off the Afrin, I could drop the steroid spray. It doesn’t fix the original problem, but it gets me off the Afrin and I am free to look to the many alternatives available today. I keep some fluticasone around for when I have more severe nasal congestion, and now use that rather than reaching for something like Afrin.

  3. Rol
    Reply

    I use Distilled water or Boiled water and I do use a (NeilMed) SinuFlo Ready Rinse bottle..(it`s an 8oz squeeze bottle). I`ve used the nettie pot but I think the bottle works much better and so easy to use… I`d recommend the bottle anytime, with the doctors mixture.. I think that the mixture that comes with the nettie pot & Bottle are too strong… (At least that is for me) I`ve been using this for quite a few years and up to now, that`s the best I`ve found….Thanks for reading this and hope you have success as I did…

  4. Jane E.
    Reply

    Allergies run in my family. Dad used Afrin every 4 hours, and it looked like I’d be in the same fix. Almost every year, starting in the late 1960s I’d have miserable “hay fever” in late summer which would progress to a nasty cough in the fall that would progress to bronchitis and linger on until I’d go to the doctor for an antibiotic or an inhaler.
    I started using “Xlear” nasal spray (at the health food store – saline with grapefruit seed extract & xylitol) 10 or so years ago and experienced a decrease in the severity. Then I began using a netti pot 2 years ago and, although I still have some congestion and drainage, I have not developed the cough and am comfortable. I can breathe through my nose at any time! I end up using it 3-4 times a week. Probably would be even better off if I used it every day or every other day…
    I ALWAYS USE DISTILLED WATER TO MAKE MY SALINE SOLUTION – VERY IMPORTANT! – AND KOSHER SALT, WITHOUT IODINE. I also add a few sprinkles of xylitol and a few drops of Lysterine, which contains Eucalyptol. I don’t swallow the solution.

  5. gabriele
    Reply

    I tolerate very few medications, especially the over-the-counter ones and when I lived in San Francisco is a somewhat polluted area, I’d wake every morning with post nasal drip (everyone in the area did, it seemed). Having read Adele Davis, I found zinc tablets really helped alleviate the problem.
    We moved to a small town (almost 30 years ago)which benefited greatly from a pharmacist who truly cared about his customers. I had a head cold that I couldn’t get rid of and he knew I preferred vitamin or minerals to medications. He told me he had recently read about a study in the New England Journal of Medicine about the effect of zinc on rhino-tracheo problems, and suggested I try it.
    It worked, and it has been part of my life ever since. I don’t know the number of times I have recommended it to friends or co-workers for nose colds as a decongestant (with few side effects) but advised it for use with allergies as well.
    I had been advised by a friend to take saline solution for my nose when traveling by air and it certainly helped–so much so that I’ve bought small bottles as traveling presents for friends.
    Also, there are house plants which help clean the air (I remember spider plants being one of them), the original writer might consider looking into that as well.

  6. RC1956
    Reply

    We have used the saline rinses for several years. My daughter had twice yearly sinus infections resulting in 3 months at a time on 3 different antibiotics. This went on for over 10 years with recurrent infections and treatments to no avail. Finally after so many years, the sixth allergy test revealed an allergy to two molds, epicoccus which appears in the fall in decaying leaves and soil, and Botritis, which is grey mold in the spring. Her allergy doctor recommended stopping the antibiotics treatments and rinsing the heck out of her nose. Following sinus surgery for congenital problems with her sinuses, the nasal rinses worked well to keep the sinuses clearer.
    Also I like grapefruit seed extract nasal spray. It works very well to clear my nose with the effects of the OTC nasal sprays.

  7. mmu
    Reply

    I have used Ocean for years for nasal congestion, with good results and no adverse effects. It brings back memories of my dear aunts, who used to dunk us in the ocean for almost every ailment when we were children!

  8. SB
    Reply

    We have found a wonderful nasal spray called Xlear. This sinus nasal spray has helped fight sinus infections and keep the morning stuffiness under control. It contains XYLITOL and can be used as often as needed according to the label.

  9. Dave A.
    Reply

    Great tip! I’ve been “addicted” to Afrin for years. I spray into my nose multiple times per day. I’ve wanted to wean off, but wasn’t sure where to start.
    An allergy tip: avoid anti-histamines like Allegra or Claritin/Zyrtec if possible; I’ve found them to be “addictive” as well. If I take for any extended period of time, any attempt to stop results in horrible itching of the hands and feet. Many people on the web report same. I managed to break that habit by just taking smaller and smaller doses over a couple of weeks

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