Rhinitis Medicamentosa

What is rhinitis medicamentosa (rebound congestion)?

Rhinitis medicamentosa is a type of nasal congestion that occurs when you overuse nasal sprays. It causes irritation and inflammation in your nasal passages.

In rhinitis medicamentosa, you have a stuffy or runny nose, but no other cold, flu or allergy symptoms. Rhinitis medicamentosa is also called “rebound congestion.”

Who does rebound congestion affect?

Rhinitis medicamentosa can affect anyone who uses nasal decongestant sprays, drops or gels. It usually affects people who use these sprays for seven to 10 days or longer.

What are the symptoms of rhinitis medicamentosa?

The main symptom of rhinitis medicamentosa is nasal congestion. You may experience:

• Itchy nasal passages.
• Runny nose.
• Sneezing.
• Stuffy nose.

Most types of rhinitis cause other symptoms that affect your eyes, ears or throat. However, rhinitis medicamentosa only affects your nasal passages.

What drugs cause rebound congestion?

Overusing nasal sprays can cause rhinitis medicamentosa, including:

• Oxymetazoline (Afrin®, Zicam®).
• Phenylephrine (Neo-Synephrine®).

How is rhinitis medicamentosa diagnosed?

Healthcare providers can often diagnose rhinitis medicamentosa by asking you about your symptoms and whether you use nasal sprays. It’s important to be honest with your healthcare provider about how often you’re using spray decongestants. Your provider may examine your nasal passages and throat to confirm or rule out a cold or other conditions.

How is rhinitis medicamentosa treated?

The first step in treatment is gradually reducing your use of nasal sprays. Stopping abruptly can worsen your symptoms. Your healthcare provider will give you instructions to wean off the medications slowly.

When you’re no longer using nasal sprays, your provider may recommend other treatments to ease congestion, such as:

• Glucocorticoid nasal sprays, which contain steroids that reduce inflammation.
• Oral decongestants, medicines you take by mouth that decrease swelling and congestion.
• Saline sprays, nasal sprays that don’t contain chemicals.

How do I stop nasal spray rebounding?

You can significantly reduce your risk of rhinitis medicamentosa by using nasal sprays only as directed. Read the package carefully if you use over-the-counter (OTC) nasal sprays to relieve congestion. All medications come with instructions for how much to take and how often.

See your healthcare provider if nasal sprays don’t reduce congestion. They can recommend other congestion treatments that don’t lead to rhinitis medicamentosa.

What’s the outlook for rhinitis medicamentosa?

Most people experience symptom relief after they stop overusing nasal sprays. You increase your risk of developing small growths called polyps in your nasal passages if you continue using nasal sprays. If you develop polyps, you may need surgery to remove them.

After your symptoms go away, speak with your healthcare provider about alternate treatments for congestion. They can give you recommendations to avoid using nasal sprays in the future.

What questions should I ask my doctor?

If you have rhinitis medicamentosa or think you could, you may want to ask your healthcare provider:

• What’s the most likely cause of my symptoms?
• Could I develop rhinitis medicamentosa even if I don’t overuse nasal sprays?
• What other treatments for congestion do you recommend?
• What are the chances that I’ll develop rhinitis medicamentosa again?

What’s the difference between rhinitis medicamentosa and other types of rhinitis?

The word “rhinitis” means inflammation in your nose. In rhinitis medicamentosa, using specific drugs causes the inflammation.

Different triggers cause inflammation in other types of rhinitis. For example:

• Allergic rhinitis occurs because of specific allergens, such as pollen or dust.
• Infectious rhinitis, also known as the common cold, occurs because of a virus.

Is rhinitis medicamentosa reversible?

Yes. Most people don’t experience further symptoms after reducing how often they use nasal sprays.

How long does rebound congestion last?

Rhinitis medicamentosa typically lasts for as long as you overuse nasal sprays. The more you continue to use nasal sprays, the worse your symptoms could get.

A note from Cleveland Clinic

Rhinitis medicamentosa is a type of nasal congestion resulting from overusing nasal sprays. It may cause an itchy, stuffy or runny nose. Unlike other types of rhinitis, rhinitis medicamentosa doesn’t affect your eyes or throat. Treatment for rhinitis medicamentosa involves gradually decreasing how often you use nasal sprays. Most people don’t experience any further symptoms after weaning off these medicines.