RPS: Nasal decongestant sprays must carry clear seven-day warning
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The Royal Pharmaceutical Society has urged manufacturers to ensure the packaging for their nasal decongestant sprays clearly warns users not to use the products for more than seven successive days because doing so can worsen symptoms and lead to an over-dependency on them.
Pharmacy’s professional leadership body called for the seven-day limit after releasing the results of a survey of over 300 community pharmacists which revealed nearly 60 per cent think patients are unaware of the risk.
The RPS said using nasal decongestant sprays for more than seven days in a row can lead to rebound congestion or rhinitis medicamentosa, a preventable condition where symptoms worsen and a cycle of dependency develops on the spray.
Nearly 60 per cent of pharmacists said patients were unaware of the risk
During its survey, which was carried out between November 25 and December 5 last year and focused on sprays containing the decongestants xylometazoline or oxymetazoline, 59 per cent of pharmacists said patients were unaware of the risk of rebound congestion.
Seventy-four per cent said products’ packaging could be clearer about the seven-day limit and 63 per cent said they intervened when they suspected a patient was over-using a spray, often recommending alternatives or refusing a sale.
The RPS said signs patients might be overusing nasal sprays include needing to use the spray more often, feeling their congestion is worse when they stop and buying multiple bottles or exceeding the recommended dose.
The RPS urged the public to seek advice from a pharmacist or another healthcare professional if those things happen.
“Nasal decongestant sprays can be helpful for short-term relief but using them for longer than seven days can make your congestion significantly worse,” said the RPS’s chief scientist professor Amira Guirguis.
“Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realising they could be prolonging their symptoms. We’d like to see clearer warnings on the packaging which you can’t miss and greater awareness of the seven-day limit.”
NPA: Other medicines, from painkillers to laxatives, should be sold with caution
The National Pharmacy Association said it supported the RPS’s warnings and urged patients to talk to pharmacists if they have any concerns about a medication.
“As (the RPS) report rightly says, overusing nasal decongestant sprays increases the risk of side effects, which is why pharmacists may refuse to supply them in circumstances where they judge there to be a risk of misuse or abuse of the product,” the NPA said.
Its chair Olivier Picard said many other medicines “should only be sold with caution because they may be abused or risk addiction or in other ways cause harm, from painkillers to laxatives”.
He added: “We are concerned that when a patient buys medication off the shelf in places such as a supermarket or a petrol station, they may be unaware of the potential side effects of what they are taking or how to safely take the medicine.”
PAGB: Press coverage risks patients' confidence in self-care
The Proprietary Association of Great Britain (PAGB), which represents manufacturers of branded OTC medicines, self-care medical devices and food supplements in the UK, said it was "concerning that reporting on nasal decongestant spray usage has been proliferated across the national press during peak winter demand".
It warned widespread press coverage risked patients' confidence in self-care and "appropriate use of over-the-counter medicines".
"Our members and the medicines regulator, the Medicines and Healthcare products Regulatory Agency prioritise patient safety," the PAGB said. "The information that is currently on nasal decongestant spray product packs highlight the importance of not using these products for more than seven days.
"OTC nasal decongestant sprays enable people to self-care for minor ailments such as nasal congestion, sinus pressure, cold and flu symptoms and allergy relief, which millions of people experience each year, especially during the winter season."
The PAGB also said the patient information leaflet which comes with "all nasal decongestant sprays" includes instructions and "outlines the risks of taking the medication for longer than it's indicated use".
"OTC medicines manufacturers provide comprehensive accessible information to support people to make responsible informed decisions about the right product to self care," the PAGB said. "People can also speak to their pharmacist if they have any questions or concerns about how to use a medicine or whether it is suitable for them to use."