MHRA Alert – Nasal Decongestant Sprays: Rebound Congestion and Overuse Risk

MHRA Safety Update: Nasal Decongestant Sprays and Drops

The MHRA has issued a safety alert regarding nasal decongestant sprays and drops containing xylometazoline hydrochloride and oxymetazoline hydrochloride. Reports indicate an increased risk of rebound congestion, rhinitis medicamentosa, and tachyphylaxis when these products are overused.

What You Need to Know

• Rebound congestion: Nasal congestion worsens when the decongestant effect wears off, potentially leading to a cycle of continued use.
• Rhinitis medicamentosa: Chronic inflammation of the nasal mucosa caused by prolonged or excessive use of topical decongestants.
• Tachyphylaxis: Reduced effectiveness of the medication with repeated use, prompting patients to increase frequency or dose.
• These risks are heightened with overuse beyond recommended dosing intervals.

Affected Medications

Any nasal spray or drop formulation containing xylometazoline hydrochloride or oxymetazoline hydrochloride is covered by this alert. Check product labels for these active ingredients.

Recommended Actions

• Review patient counselling on correct use and duration of nasal decongestants.
• Advise patients to adhere strictly to dosing instructions and not exceed recommended frequency.
• Consider alternative treatments for prolonged nasal congestion (e.g. saline rinses, intranasal corticosteroids).
• Monitor patients for signs of rebound congestion or medication overuse.

Further Information

For the full MHRA safety alert and detailed guidance, visit the MHRA Drug Safety Update.