There are several nasal steroid formulations available and all are effective at treating inflammation in the nose and to some extent the sinuses. Studies have shown that the structure of the nose lining actually improves as inflammation decreases. Any medicine should only be used if the benefits outweigh the risks from the drug. If the absorption of the drug from the nose/sinuses is minimal then only negligible amounts enter the bloodstream and cannot therefore lead to distribution to the rest of the body. In addition, if the drug is broken down to inactive compounds by the body (usually via the liver), then the little amount of active drug that maybe absorbed from the gut is rapidly destroyed. This leads to what is termed ‘low bioavailability’ of the drug. The bioavailability of the commonly used steroids is so low that detection requires careful blood analysis. We therefore feel that such nasal steroids confer more long-term benefits than harm to patients. Not all nasal steroids have low bioavailability so if you are uncertain always ask your pharmacist or doctor to check.
Perhaps surprisingly there are wrong and right ways. Many people take their nasal spray incorrectly which may lead to the medicine not having contact with the right area of the nose.
- Shake the bottle or device to ensure the drug is not sitting at the bottom of the spray.
- Remind yourself of the structure of the nose.
- The middle of the nose is the septum. This must be avoided. The sides of the nose are where the structures of the nose called the turbinates are found. The sinuses drain to the side of the nose. Aim the nozzle of the spray gently towards the sides of the nose.
- Using your right hand hold the spray and aim towards the side of the left nostril.
- Using your left hand hold the spray and aim towards the right nostril.
- Do NOT sniff after the spray as this will push the medicine down your throat away from the nasal lining. Instead bend your head down for about 10 seconds and breathe through your mouth.
The correct method of taking an intranasal spray-hitting the target is essential and is illustrated.