Flonase

[Apappy]

Like many others I have a problem with stuffy nose at night, and have read that Flonase is a possible remedy. My pharmacist tells me that I shouldn't take it "too long," though, whatever that means. I don't think I have allergies but have been carrying some sort of bug that seems to travel up and down from my sinuses to my bronchials. Tried antibiotics weeks ago, which helped but didn't get rid of it, and I suspect the lingering symptoms are related to the sleep apnea or just plain lack of good sleep. I've been on APAP for a month now, and I'm hoping that once I get used to the mask -- which includes doing something about the stuffy nose problem -- I will be able to sleep well and that this will get rid of the mysterious bug.

My question is how long you can use Flonase without causing problems, and also can you use it in just one nostril (that is, would half the dose be less harmful that a full dose?). I do have a deviated septum but do not want to resort to an operation unless it proves absolutely necessary. I have read that pharmacological remedies should be tried first.

[Richard]

I use Beconase nasal spray and find it most effective. Many of these sprays contain a steroid element in their composition, to which the user can become addicted. So long as you use it sparingly you should be OK.

Remember, it is treating the symptoms rather than the cause, so it is worhwhile taking anti-biotics to get to the cause of the stuffy nose.

Richard

[Fredxx]

Technically, the problem with Steroids is the effect of Rebound and a case that overuse can cause physical problems such as polyps.

Rebound is caused by long term use, and is where the effect of using the nasal spray steroid fools the body into thinking that it is producing too much natural steroid, so when the effect wears off the body doesn't have enough to deal with the problem meaning the body doesn't have enough to fight the inflammation by itself and making it more prone to infection, and so causing more of a stuffy nose. As well, the body gets used to having the steroid present, meaning you need a higher and higher dose to treat the inflammation...vicious circle. For nasal sprays this can be from as little as 7-14 days continuous use

Longer term use affects the blood flow in the nose and can promote frequent nosebleeds or even the growth of polyps, causing further problems.

When it comes to treating the cause, often antibiotics aren't the solution. They are only effective at treating a Bacterial Rhinitis, and these are the minority of cases. Much more common causes are Viral (the common cold), Allergic and effects from hormones, light sensitivity, dryness and many other effects; Antibiotics have no effect on these.

The important thing is to understand the cause and find a solution that resolves that, rather than treating the symptom. Of course, if the cause is a minor infection or just a cold, the use of a nasal spray for a few nights is exactly the right solution while the body fights the infection, just as long as a few nights isn't drifting on to a week or more. I also tend to think about rebound by only using it at night when I need to use it at all, which reduces the rate the body builds up resistance; that doesn't mean I would ever use it for more than a week continuously, or even take it for a few days, then a few days off, then use it again in a cycle.

I use Beconase during the hay-fever season as it has antihistamine to reduce the allergic reaction, but for a cold I find Beconase gives little relief, but Otravine does the trick.