Selecting the Correct Dosage Form for Topical Nasal Decongestants: An Expert Opinion

Nasal congestion is a bothersome symptom of allergic rhinitis (AR), common cold, and sinusitis, and can significantly impact quality of life (QoL). In options available for managing nasal congestion, oral decongestants have a slower onset of action compared with topical nasal decongestants like oxymetazoline and xylometazoline, which have an onset of action within 2 minutes. It is important to select the correct dose form for topical drug delivery. A panel discussion was conducted with eight ear, nose, and throat (ENT) specialists in India to discuss the burden of nasal congestion and its impact on QoL, management options for nasal congestion, and the overdose and underdosing of medications through topical administration; the advantages of metered-dose spray for patients with nasal congestion; and opinion on the use of nasal decongestant sprays. The panel members concluded that topical nasal decongestants can be highly effective when administered at the correct dosage, which is important due to dose-dependent responsiveness. Squeeze bottles and dropper-based formats can lead to overdosing, which has adverse effects. The potential risks with the use of nasal decongestants must be explained to patients. Metered-dose nasal sprays are effective and reduce the risk of overuse. It is also necessary to provide educational materials to patients stating that prolonged use of nasal decongestants is harmful.