MHRA limits use of common nasal decongestant sprays to five days

The Medicines and Healthcare products Regulatory Agency (MHRA) has limited the use of nasal decongestant sprays containing xylometazoline and oxymetazoline to a maximum of five days, due to risks associated with excessive application.

The sprays and drops are widely available over the counter without prescription and are commonly used to relieve a blocked nose caused by colds, flu and allergies.

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However, excessive use can lead to rebound congestion – a temporary swelling of the nasal lining – which in some cases can develop into rhinitis medicamentosa, a chronic condition associated with severe congestion and tissue damage.

Under the updated guidance, all new packaging and patient information leaflets for products containing xylometazoline and oxymetazoline will state that use should not exceed five days. Warnings will also be strengthened to highlight the risks of longer-term use.

The MHRA said it would take several months for the updated information to be reflected across all products, meaning some existing stock will continue to carry advice permitting use for up to seven days.

However, patients are being advised to follow the revised five-day limit to reduce the risk of side effects.

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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.’

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Amira Guirguis, chief scientist at the Royal College of Pharmacy, said: ‘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 said suspected side effects linked to these medicines can be reported through its Yellow Card scheme.