Hay fever nasal sprays

Antihistamine and steroid nasal sprays for hay fever relief available to buy online from Dr Fox Pharmacy. Can be combined with eye drops and antihistamine tablets.

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About nasal sprays for hay fever

Nasal sprays are used on their own or combined with tablets and eye drops. They control sneezing and runny nose. Very little active drug is absorbed into the body.

There are three types of nasal sprays available from Dr Fox:

• Steroid nasal spray: Avamys and Beconase, need to be used for a few days before they start to work. They are for continuous daily use through the hay fever season. NOT to be used together or at the same time as Dymista or Ryaltris nasal sprays. An antihistamine tablet can be combined with a steroid nasal spray, if the nasal spray alone is not completely effective.
• Antihistamine nasal spray: Rhinolast and Azelair work within 15 minutes and can be used on an as needed basis, not more that twice a day. NOT to be used together or at the same time as Dymista or Ryaltris nasal sprays.
• Combination nasal sprays containing an antihistamine and a steroid in one spray. They are more convenient and likely to be more effective than a steroid or an antihistamine spray on its own. Dymista and Ryaltris should NOT be used together or at the same time as other hay fever nasal sprays.

Using both a steroid nasal spray and an antihistamine spray, individually or combined in Dymista or Ryaltris, is usually more effective than either one alone.

How to use a nasal spray

Specific instructions on how to use nasal sprays are included in patient leaflets supplied with sprays. See also video from AsthmaUK - how to use a nasal spray.

1. Remove dust cap which protects the nozzle and keeps it clean

2. For first use or if you have not used the spray for several days, shake the bottle and press the pump until you get a fine spray.

3. Blow your nose gently before using. Close one nostril & put nozzle in the other nostril. Use left hand for right nostril, and right hand for left nostril. Tilt head forward slightly & keep bottle upright. Aim bottle at outside wall of nostril. Breathe in slowly & squirt a spray into nostril.

4. Remove the nozzle from this nostril and breathe out through your mouth.

5. Swap hands and repeat steps 3 & 4 for the other nostril. If the required dose is two sprays to each nostril, swap hands again, and repeat for first nostril, and finish by swapping hands and repeating the spray for the second nostril.

6. To clean the spray - take off dust cap, and also nozzle if possible, and wash in warm water.

Possible side effects from nasal sprays

Troublesome side effects are unlikely from using a nasal spray. The most common are a bitter taste in the mouth, slight nasal irritation and very occasional nose bleeds. If using a steroid nasal spray regularly there is a small risk of developing thrush within the nose. If you think you may have thrush, stop the nasal spray and consult your regular doctor.

Beconase, Avamys, Dymista, and Ryaltris contain steroids which on rare occasions could damage the eye. Any vision problems or disturbances should be checked by an optician.

More information in the patient information leaflets supplied by the manufacturers with your medication.

Alternative treatments for hay fever

Other medical treatments for hay fever include eye drops and antihistamine tablets.

If there is asthma linked to the hay fever, montelukast tablets may be prescribed. If hay fever triggers asthma which doesn't settle with your usual asthma treatment, please consult your regular doctor.

Where there are severe hay fever symptoms which are not responding to antihistamine tablets with nasal sprays and eye drops, a short course of a few days of steroid tablets can bring things back under control. Dr Fox cannot provide this. Please consult your regular doctor.

Many hay fever sufferers used to have an annual long acting steroid injection of Kenalog (triamcinolone). This is very effective at damping down the overactive immune response causing hay fever, for the duration of the hay fever season. However, it is no longer recommended by NICE or licensed as a hay fever treatment, as there are health risks from lowering your immune responses, and there can also be serious long term side effects. Some private clinics do, however, still offer this injection 'off label' after a careful assessment of personal risks.

Pollen desensitisation using allergen immunotherapy as either a vaccine or oral preparation is available from some hospital specialists. There is a potential for life threatening anaphylactic reactions during desensitisation treatments and so they are rarely used.

How to avoid exposure to pollen

• Using vaseline around your nostrils. This can trap pollen and stop it getting into your nose.
• Avoid grass cutting and places where pollen counts are known to be high.
• Vacuum regularly, preferably using a vacuum cleaner with a HEPA filter.
• Keep pets out of the house during the hay fever season.
• Stay indoors when pollen counts are high. You can check the pollen forecast or there are many helpful apps available.
• Keep windows and doors closed.
• Wraparound sunglasses can reduce pollen contact with the eyes.
• Shower after going outside.

Further information

• NHS - Steroid nasal sprays
• AllergyUK - Hay Fever and Allergic Rhinitis
• Ryaltris (manufacturer's website)

Patient Information Leaflets

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine and must be read before taking the medicine. It is written for patients and gives information about taking or using a medicine.

• Beconase Aqueous
• Avamys
• Rhinolast
• Dymista
• Azelair
• Ryaltris

This page written and reviewed by doctors

Authored 08 May 2013 by Dr Tony Steele
MB ChB Sheffield University 1983. Former hospital doctor and GP. GMC no. 2825328

Reviewed by Dr Amanda Wood, Dr Claire Pugh, Dr Barbara Babor
Last reviewed 13 November 2023
Last updated 28 November 2023