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

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

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 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.

SCIENCE PHOTO LIBRARY/getty images

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.

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.

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 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 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 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, 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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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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.

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