Rebound nasal congestion

Nasal formulations of modern sympathicomimet-ics like oxymetazoline and xylometazoline are effective. Rebound nasal congestion after withdrawal of sympathicomimetic-containing nose sprays or drops is a common phenomenon and patients should be advised to use these medicaments no longer than 3-5 days. Older per oral drugs like ephedrine and pseudo-ephedrine have no place in the therapy of rhinitis due to the risk of serious adverse reactions which are not in proportion to the indication. 

Mr JA is showing symptoms of seasonal allergic rhinitis (hay fever) but has been using cold remedies for eight weeks which has resulted in rebound nasal congestion, worsening his symptoms and complicating his hay fever. 

Rebound nasal congestion occurs when decongestants are used for more than 5 days and the patient becomes tolerant of the medication. 

Topical intranasal decongestants (e.g., oxymetolazine, xylome-tolazine, phenylephrine, and naphazoline) are OTC options that provide prompt relief of nasal congestion. Nasal decongestants are dosed multiple times daily.15 Tachyphylaxis, rebound congestion, and rhinitis medicamentosa may occur with chronic use therefore, use should be limited to 3 to 5 days.8,12 These may be used 5 to 10 minutes before administration of intranasal corticosteroids in patients with blocked nasal passages.15... 

Continuous use of nasal sprays or drops that contain adrenergics may result in nasal congestion rebound (inflamed and congested nasal tissue). 

Rhinitis medicamentosa—Nasal congestion associated with tolerance to and resulting overuse of topical decongestants. Also known as rebound vasodilation or rebound congestion. 

Afrin is recommended for short-term relief of nasal congestion for clients older than the age of 6 years. Longer use can cause a rebound congestion that can be difficult to resolve. 

Nasal decongestant sprays such as phenylephrine and oxymetazoline that reduce inflammation by vasoconstriction are often used in sinusitis. Use should be limited to the recommended duration of the product to prevent rebound congestion. Oral decongestants may also aid in nasal or sinus patency. To reduce mucociliary function, irrigation of the nasal cavity with saline and steam inhalation may be used to increase mucosal moisture, and mucolytics (e.g., guaifenesin) maybe used to decrease the viscosity of nasal secretions. Antihistamines should not be used for acute bacterial sinusitis in view of their anticholinergic effects that can dry mucosa and disturb clearance of mucosal secretions. 

Due to the reduced supply of fluid, secretion of nasal mucus decreases. In coryza, nasal patency is restored. However, after vasoconstriction subsides, reactive hyperemia causes renewed exudation of plasma fluid into the interstitial space, the nose is stuffy again, and the patient feels a need to reapply decongestant. In this way, a vicious cycle threatens. Besides rebound congestion, persistent use of a decongestant entails the risk of atrophic damage caused by prolonged hypoxia of the nasal mucosa. 

Nasal Dry mouth, dyspepsia, rebound congestion, rhinorrhea, loss of taste Inhalation Back pain, vomiting, altered taste, voice changes, abdominal pain, nausea, dyspepsia... 

Nasal Burning, stinging, runny nose, dryness of mucosa. Prolonged use may result in rebound congestion. 

Manage rebound congestion by stopping ephedrine one nostril at a time, substitute systemic decongestant and/or nasal steroid... 

Do not use nasal products for more than 3-5 days to prevent rebound congestion... 

Intranasal. Mild nasopharyngeal irritation nasal burning, stinging, or dryness rebound congestion rhinorrhea loss of taste Occasional... 

Overuse or misuse of OTC products may induce significant medical problems. A prime example is rebound congestion from the regular use of decongestant nasal sprays for more than 3 days. The improper and long-term use of some... 

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