Symptomatic management of hayfever involves the use of different over the counter antihistamines and nasal sprays. There is plenty of option when it comes to nasal sprays. In this post, I will list common nasal sprays for hayfever available over the counter from pharmacies and larger shops. I will briefly divide nasal sprays into two categories: steroids nasal sprays and non-steroid nasal sprays. I will also summarise:
- Possible side effects associated with their use
- Any important, relevant information
- Use of nasal sprays in pregnancy
Steroid nasal sprays for hayfever
Most steroid nasal sprays for hayfever, which are prescribed by GP, are now available over the counter without a prescription. The supply of steroid nasal sprays is, however, limited to the adult population aged 18 and over. Steroid nasal sprays available over the counter contain one of the following steroid medication:
- Beclomethasone (brand name: Beconase Hayfever)
- Fluticasone (brand name: Pirinase Allergy)
- Budesonide (brand name: Benacort)
- Triamcinolone (brand name: Nasacort Allergy)
- Mometasone (brand name: Clarinaze)
Steroid nasal sprays for hayfever help to control the following symptoms:
- Nasal congestion
- Itchy nose
- Eyes symptoms including itching, redness and eye-watering
The advantages of the treatment with steroid nasal sprays are the safety and effectiveness of the treatment.
Steroid nasal sprays can be used in addition to other hayfever treatments, such as antihistamines. A patient who fails to control their symptoms within 14 days of nasal steroid treatment should seek advice from their doctor. Always read the product information leaflet.
Steroid nasal sprays: common side effects
Steroid nasal sprays have similar, localised side effects, regardless of the brand/drug used. Side effects which may be experienced by patients include (Trangsrud et al, 2012):
- Nasal dryness
- Stinging and burning
- Nose bleeds
Steroid nasal sprays: use in pregnancy and breastfeeding
The use of steroid nasal sprays in pregnancy is restricted under the advice from a GP. Pregnant women who wish to use steroid nasal sprays need to speak to a doctor to get appropriate advice.
NHS informs that steroid nasal sprays are safe to use when breastfeeding and during pregnancy; however, patients should get medical advice in the first instance.
List of steroid nasal sprays for hayfever
1. Beclomethasone steroid nasal spray for hayfever
Beclomethasone nasal spray is mostly known under its branded name of Beconase. Over the counter Beconase can be used by adults aged 18+. Beconase can be purchased off the shelf from larger supermarkets and pharmacies in a pack size of 100 sprays (GSL license). Larger size Beconase (180 sprays) is licensed as a pharmacy only product (P medicine), which is only sold from pharmacies, including online chemists.
How long does it take for Beconase to work?
Although Beconase starts to work quickly, it may take 2-3 days before the full effect of treatment is achieved. Over the counter, Beconase is limited to 3-month use, unless it is used on the advice of a doctor.
Many pharmacy and supermarket chains also sell their version of beclomethasone steroid nasal spray, which are typically cheaper than branded Beconase, for example:
- Boots Hayfever Relief
- Tesco Hayfever & Allergy Relief
- Lloyds Pharmacy Hayfever Relief Nasal Spray
When prescribed, beclomethasone steroid nasal spray can be used in patients under 18 years of age. There is no difference between prescribed and purchased beclomethasone nasal sprays.
Beconase steroid nasal spray: the dose
The recommended adult dose of beclomethasone nasal spray is TWO sprays in each nostril twice daily, usually in the morning and evening (daily dose of 400 mcg of beclomethasone). Once the condition is under control, it may be possible to reduce the number of sprays, for example, one spray in each nostril twice a day.
2. Fluticasone steroid nasal spray
Fluticasone nasal spray is available over the counter as Pirinase Allergy (P medicine) and Pirinase Hayfever Relief (GSL medication) for adults aged 18 years and over. GSL version of the product (available outside the pharmacy) contains 60 sprays, whereas the ‘P’ product contains 120 sprays.
How long does it take for Pirinase to work?
According to the product information, it may take 3-4 days to achieve maximum benefit from the treatment.
Pirinase Hayfever Relief Budesonide nasal spray: the dose
Pirinase Hayfever nasal spray is used once daily, usually in the morning, with two sprays instilled into each nostril. The dose may be reduced to once spray into each nostril once daily once symptoms are under control.
Pirinase nasal spray for hayfever should not be used continuously for longer than 1 month without the advice of a GP.
3. Budesonide steroid nasal spray
Budesonide steroid nasal spray is available as a branded product called Benacort nasal spray. As with all other steroid nasal sprays, Benacort is available only for adults aged 18+. Benacort is only available as pharmacy-only medicine.
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Benacort nasal spray: the dose
Benacort can be used once or twice daily:
- Once-daily dose: Two sprays into each nostril each morning
- Twice daily dose: One spray into each nostril in the morning and evening
How long does it take for Benacort nasal spray work?
It may take up to 3-4 days of the recommended dose to achieve a maximum effect.
Treatment with Benacort nasal spray should not exceed 3 months.
4. Triamcinolone steroid nasal spray
Nasacort Allergy contains triamcinolone as an active ingredient, another steroid. Nasacort is a pharmacy-only product, licensed for adults (18+) for the management of hayfever symptoms.
Nasacort Allergy: the dose
The recommended dose for Nasacort nasal spray is 2 sprays in each nostril once daily. Patients can reduce the dose to one spray into each nostril once symptoms improve.
Nasacort nasal spray should not be used longer than 3-month without consulting a doctor.
How long does it take for Nasacort to work?
Patients may see improvements in symptom control on the first day of use; however, like with other steroid nasal sprays, patients may need to wait 3-4 days to achieve the best effects.
5. Mometasone steroid nasal spray
Clarinaze (mometasone) nasal spray is the newest addition to steroid sprays available over the counter without a prescription.
Clarinaze nasal spray is licensed for the treatment of the nasal symptoms of allergies for adults aged 18+. Clarinaze is a pharmacy-only medication available from conventional or online pharmacies.
Clarinaze nasal spray: the dose
The usual dose for Clarinaze is two sprays into each nostril once daily. Once symptoms are controlled, it is possible to reduce the dose to one spray into each nostril once daily.
Can you use Clarinaze nasal spray in pregnancy?
As with other similar products, the advice is given to speak to a doctor or a pharmacist when treatment is considered in pregnancy.
What is the difference between steroid nasal sprays for hayfever?
Is one steroid nasal spray better than the other?
Over the counter steroid nasal sprays work in the same may with similar effectiveness. Additionally:
- There is no data so suggest that one steroid nasal spray is better than another
- All steroid nasal sprays have the risk of similar localised side effects
One noticeable difference between steroid nasal sprays is the recommended frequency of use (dose). For example, beclomethasone nasal spray is used twice daily, fluticasone (Pirinase), triamcinolone (Nasacort), and mometasone (Clarinaze) once daily, whereas budesonide (Benacort) can be used once or twice daily.
In terms of price per unit, generic beclomethasone nasal spray is the most cost-effective as compared to other steroid nasal sprays. Many pharmacies and larger supermarkets sell their own, generic versions of beclomethasone nasal spray at a much lower cost as compared to Beconase or other brands of steroid nasal sprays.
Non-steroid nasal sprays for hayfever
Non-steroid nasal sprays for hayfever include isotonic solution nasal sprays such as Sterimar Hayfever & Allergy Relief and allergy barrier nasal sprays for hayfever.
The advantage of both groups of products is the wider age group licensing and safe use in pregnancy. There is little evidence to support the effectiveness of those products; however, it does not mean they do not work.
Sterimar Hayfever & Allergy Relief nasal spray
Sterimar Hayfever nasal spray is free of drugs and preservatives. Key benefits advertised for Sterimar Hayfever & Allergy Relief include:
- Helping to clear and cleanse nasal passages
- Elimination of allergens
Sterimar contains a 100% natural, purified sweater. This product can be used by pregnant, breastfeeding mothers and by children.
It is not fully understood how isotonic nasal sprays, such as Sterimar work; however, it is believed that saline makes mucus thinner allowing to remove allergens more easily. Although there is limited evidence supporting the use of isotonic nasal sprays in hayfever saline, nasal sprays can reduce the severity of the condition treated (Head et al, 2018).
How often can you use Sterimar Hayfever & Allergy Relief?
Sterimar Hayfever & Allergy Relief nasal sprays can be used as often as requires.
Sterimar nasal sprays can be used alongside other hayfever treatments such as antihistamines.
Barrier nasal sprays for hayfever
There are few products in the UK market which work as barrier nasal sprays to stop the symptoms of allergies. The principle behind barriers nasal sprays is simple: a fluid dispersion which settles in the nose prevents contact between allergens and nasal lining. Additionally, this type of nasal spray support faster clearance of allergens and prevent nasal irritation.
Barrier nasal sprays are drug-free, non-drowsy, and can be used by pregnant and breastfeeding women.
Becodefence Adult Nasal Spray
Becodefence Adult Nasal Spray is licensed for children and adults from 12 years of age. A younger population can use Becodefence Kids, which works with the same principle as the adult product.
Advertised benefits for the Becodefence Adult Nasal Spray:
- Start to work in 3 minutes
- Fast and effective defense against allergy symptoms
- Can be used by pregnant and breastfeeding women as it is drug-free product
Benadryl Allergy NaturEase Nasal Spray
Benadryl Allergy NaturEase Nasal Spray is licensed for adults and children who are 6 years of age or over.
Benadryl Allergy NaturEase Nasal Spray work in a similar way to previously discussed Becodefence nasal spray. It cleans and soothes the irritated nasal lining. Additional, advertised benefits of Benadryl Allergy NaturEase Spray:
- Does not contain drugs
- Free from chemicals and preservatives
- Reduce contact allergen contact with the nasal lining
Benadryl Allergy NaturEase Nasal Spray can be used several times a day when required with a dose of 1-2 sprays into each nostril.
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Hayfever management: an overview
Hayfever can be managed successfully with different products which are available over the counter without a prescription. Patients can manage hayfever symptoms with the following:
- Non-sedative antihistamines such as loratadine and cetirizine
- Additional use of steroid nasal sprays
- Use of antihistamine eyed drops such as sodium cromoglicate alongside other products to control specific symptoms of hayfever such as watery and irritated eyes
- Use of saline nasal products such as saline rinse, spray or squirt bottle
Lastly, patients need to be aware of different techniques to help to minimise exposure to allergens which cause hayfever symptoms, for example:
- Keeping windows closed in buildings and cars
- Avoidance of areas with high pollen count such as grassy areas
- Use of sunglasses to stop pollen getting into the eyes
- Avoid drying the clothes outside when pollen is high
- Use of pollen filters in the car
Head K, Snidvongs K, Glew S, Scadding G, Schilder AGM, Philpott C, Hopkins C. Saline irrigation for allergic rhinitis. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No.: CD012597. DOI: 10.1002/14651858.CD012597.pub2 Available at: https://doi.org/10.1002/14651858.CD012597.pub2 Accessed on 16/03/2020
Trangsrud, A.J., Whitaker, A.L. and Small, R.E. (2002), Intranasal Corticosteroids for Allergic Rhinitis. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 22: 1458-1467. doi:10.1592/phco.22.16.1458.33692 Available at: https://doi.org/10.1592/phco.22.16.1458.33692 Accessed 15/03/2020