Effects of nasal sprays

One of the self evident truths about medicine is that we as consumers and professionals will learn new things about them daily, as more people take them. The side effect list may get longer or shorter as time goes on.

It is becoming more important that the pharmacist keeps abreast and up to date concerning medicines, even the ones that we consider “over-the-counter”. Over-the-counter medicines are the ones you can purchase from the front store and without the pharmacists help.

Women who use decongestant nasal sprays in the first three months of pregnancy can increase the risk of their children developing certain rare birth defects.

Over-the-counter decongestants containing phenylephrine, pseudoephedrine and the imidazoline class, which are commonly used by hay fever sufferers, were linked to rare birth defects of the digestive tract, ear, and heart, new research seems to suggest.

Dr. Allen Mitchell of Boston University stated: “Major birth defects of any kind affect about two to three percent of live born infants, so they are rare.”

He continued: “The associations we identified involved defects that generally affect less than one per 1,000 infants. Some may require surgery, but not all are life-threatening.”

Phenylephrine used in the first three months of pregnancy, has been linked to an eight-fold risk of a heart defect called endocardial cushion effect (where the walls between the heart chambers are poorly formed).

The authors of the study also found links between first-trimester use of pseudoephedrine and limb defects. Other decongestants such as oxymetazoline and antazoline also have been implicated in an abnormal connection between the trachea (voice box) and oesophagus (swallow pipe).

This study was done between 1993 and 2010 and the analysis is ongoing.

My advice would be, unless directed by their doctor, pregnant women, should restrict their topical decongestant use, and rely on normal saline drops and other methods, to clear nasal congestion during the first trimester of their pregnancy.

It is also interesting to note that some of these ingredients are also found in cough syrups and the same precautions should be taken during the first three months of your pregnancy.

NSAIDs like ibuprofen, diclofenac and naproxen should not be taken during this period either.

Simple antihistamines can also cause problems to persons, if they just opt to buy anything off the shelve, without engaging their pharmacist. Some antihistamines will react with prescribed medicines with pretty strange effects. Simple dimenhydrinate (Gravol) is a popular anti-vomiting product, but if a patient suffering from schizophrenia buys with consulting, they may be at risk because it will react with their medicines.

Persons with hypertension are at great risk, when they self medicate, especially if they are suffering with the flu or are congested as the basic ingredient in all anti-decongestants can raise the blood pressure to dangerous levels .

The moral of the story here is that there is a select group of highly trained professionals at the public’s disposal. The wise person would utilise this group when making choices for their over-the-counter medicines.

Oh I forgot to name this group — yes they are your pharmacists.

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