Intranasal corticosteroids may reverse rhinitis medicamentosa

Chronic use of intranasal decongestants like oxymetazoline leads to tachyphylaxis of response and rebound congestion, due to alpha-adrenoceptor mediated down-regulation and desensitization of response

In a randomized, double-blind, placebo-controlled trial 19 healthy subjects received intranasal oxymetazoline tid for 14 days, followed by addition of fluticasone bid for a further 3 days.

Oxymetazoline-induced tachyphylaxis and rebound congestion was reversed by intranasal fluticasone.

Fluticasone Reverses Oxymetazoline Induced Tachyphylaxis of Response and Rebound Congestion. Vaidyanathan S, Williamson P, Clearie K, Khan F, Lipworth B. Am J Respir Crit Care Med. 2010 Mar 4. Link via @wheezemd
Pseudoephedrine used in allergic rhinitis improved stuffy nose but decreased sexual activity
Oxymetazoline for 1 month adds to nasal steroid effect in perennial allergic rhinitis, without development of rhinitis medicamentosa. JACI, 2011.
Image source: Amazon, used for illustrative purposes only - NOT a suggestion to purchase any medications.

Afrin - Costco
Afrin - Costco.

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