Why Australians with Covid, flu and cold symptoms should avoid decongestant nasal sprays

Popular decongestant nasal sprays have been labelled “bad” and likened to heroin by a top surgeon. Here’s why, and what you should use instead.

Nasal sprays containing oxymetazoline can be addictive “like heroin” and should be avoided according to an expert.

A top Melbourne surgeon has warned of the dangers of decongestant nasal sprays as winter looms and flu and Covid cases rise across Victoria, comparing them to heroin.

Head and neck surgeon Eric Levi said nasal sprays with the decongestant oxymetazoline were “bad, bad, bad”, and addictive like hard drugs.

If used for more than the recommended three days in a row, they could lead to “nasal dependency on oxymetazoline”, Mr Levi tweeted.

“Unfortunately we see lots of rhinitis medicamentosa in ENT (ear, nose and throat treatment). Nasal dependency on oxymetazoline,” he said.

“If they (people) use for only three days that’s OK. But it’s like heroin, three days now, then three days later another three days. Then it becomes repeated for years.”

Oxymetazoline is a decongestant that shrinks blood vessels in the nasal passages, and used in many popular long lasting, nose-clearing sprays.

Dependency on nasal sprays containing oxymetazoline is very hard to break.

Mr Levi said dependency on nasal sprays containing oxymetazoline was “extremely hard to break”, and damaging to the nasal mucosa.

Commenting on his recent Twitter thread on the subject, a pharmacist said decongestant nasal sprays were commonly recommended and their sale was “going on everywhere”.

Mr Levi said saline and sesame seed sprays, as well as instranasal corticosteroids such as mometasone, got the thumbs up, with the sesame seed spray Nozoil having helped many of his patients.

Mr Levi is a Melbourne-based specialist otolaryngologist (ear, nose and throat), head and neck surgeon consulting for St Vincent’s and The Royal Children’s hospitals, and is prolific on Twitter.

He is also a honorary Fellow at the Murdoch Children’s Research Institute and a clinical senior lecturer at Melbourne University.