UK Warns: Nasal Spray Use Beyond 5 Days Risks Addiction

Britons using nasal decongestant sprays to relieve blocked noses caused by allergies and colds have been urged to limit their use to just five days or risk becoming addicted. The sprays, sold under brands such as Vicks, Sudafed, and Otrivine, are available for around £4 at high street chemists. They work by shrinking swollen blood vessels in the nose, helping to open airways and ease breathing in the short term.

However, the Medicines and Healthcare products Regulatory Agency (MHRA) has warned that the active ingredients in these sprays can cause 'rebound congestion', a phenomenon where the blood vessels become dependent on the medication. This makes congestion worse, creating a vicious cycle that leaves patients reliant on the medication to breathe, and in some cases, leads to a psychological addiction.

Medically known as rhinitis medicamentosa, this condition can affect anyone who overuses nasal sprays, triggering irritation, runny nose, sneezing, and congestion. Some patients with a history of the condition have even required surgery to address damage caused by chronic swelling, which can lead to breathing problems and facial disfigurements.

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The health watchdog is now urging people not to use sprays containing xylometazoline and oxymetazoline—the active ingredients in decongestants—for more than five days. The MHRA stated that it will update packaging and patient leaflets to reflect this guidance, although full implementation may take several months. In the meantime, officials are urging people to take heed of the guidance immediately.

Thao Huynh, head of respiratory imaging and critical care at the MHRA, said: 'If your nose is still blocked after five days of using a nasal spray, it could be caused by overuse of the product, rather than your original symptoms. Continuing to use it could make the problem worse. Instead, talk to a healthcare professional about stopping use of the product and whether alternative treatments could help. These nasal sprays are safe and effective treatments when used as directed. It is important to always read the Patient Information Leaflet that comes with your medicine and information on the outer packaging.'

Professor Amira Guirguis, chief scientist at the Royal College of Pharmacy, added: 'We support clearer product information and improved packaging, alongside consistent public messaging, to improve awareness that these products are for short-term use only and to avoid preventable harm.'

The MHRA's update comes just months after the Royal Pharmaceutical Society (RPS) issued a similar warning, following findings that nearly 60 per cent of pharmacists believe patients are unaware that these sprays should not be used long-term. Research conducted by ITV and Ipsos also revealed that more than a fifth of adults who have used the sprays have done so for longer than a week, meaning around 5.5 million people in the UK have risked becoming addicted.

In January, the RPS called for the risks of overusing these medications to be clearly labelled on packaging. Others affected by the problem have previously called for the medications to be made available by prescription only, so GPs can monitor and limit supply.

One patient trapped in a cycle she calls 'addiction' is Charlotte Johnstone, 30, who first started using the nasal sprays at just seven years old. She told ITV that at the height of her 23-year health battle, she was reaching for the decongestant eight times a day. 'I can't sleep without having it, I wake up and the first thing I do is have my nasal spray,' she said. Now, her addiction-related anxiety is so severe that she dreams about not being able to breathe and will not go anywhere that restricts her access to the spray.

After decades of using the spray, a habit that costs her around £30 a month, Ms Johnstone worries that it has had a permanent effect on her health. She said: 'I go through stages of losing my sense of smell. I know it's doing something but I don't know what. But for the sake of having a clear nose, and avoiding feeling claustrophobic, I'll just take it.' According to Ms Johnstone, even some GPs are not fully aware of the extent of the problem, with some allegedly searching her symptoms online in front of her.

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Most patients hooked on nasal sprays can successfully wean themselves off the drug and suffer no long-term nasal damage, experts say. However, others suffering from the condition may need to use a stronger, steroid-based spray before symptoms improve. For many, starting this rehabilitation process can be daunting. Ms Johnstone told ITV: 'Going cold turkey is very scary to think about. You've got to be really brave for that and I'd have to book a lot of time off work.' She has been shocked by the number of people in similar situations and now wants to raise better awareness of the risks of overuse.

Rebound congestion is only caused by excessive use of decongestant nasal sprays containing oxymetazoline and xylometazoline, rather than saline or steroid sprays.