One of the symptomatic treatments of the common cold with the least side effects consist of a short term treatment with a decongestant nasal spray or drops.
There are a number of decongestant nasal sprays/drops on the market. These contain amongst others Oxymetazoline, Xylometazoline, Phenylephrine. They open up the nasal passages by constricting bloodvessels and in the process eleviating stuffiness. The label often recommends the spray to be used 8 hourly or 12 hourly but it is recommended to be used less frequently.
These substances do however not help against watery secretions of the nose. Ipratropium nasal spray may reduce the symptoms of a watery nose but has little effect on stuffiness.
Some nasal sprays contain menthol. Menthol increases the perception of nasal patency due to it's cooling effect without actually improving airflow through the nose. This effect is however valuable to the patients overall feeling of well being. Menthol also thins mucous which may aid in clearing a stuffy the nose.
Nasal sprays or drops should only be used for about three days or so as they quickly become less effective and may cause a condition called rhinitis medicamentosa (rebound effect) , a drug induced congestion of the nose. For patients working from home it may be recommended to only use the nasal spray at bedtime
Half strength (0.025%) oxymetazoline decongestant drops can be given to small children (age 2 to 6) for short periods. These products do not seem to be readily available in all countries.
Damage to nasal membranes has been reported with prolonged use.
When using a nasal spray the following should be kept in mind:
Clear your nasal passageway by blowing your nose. Take the cap off the bottle and follow directions for shaking or priming the bottle if necessary. Before you spray the medication into your nose, block one nostril by pressing a finger against it lightly. Put your thumb at the bottom of the pump bottle. The hole at the top of the bottle should be underneath your open nostril. Squeeze the pump and breathe in gently. Then switch to the other nostril and repeat the process. In order to keep the medication in your nose, don't blow your nose right away, and try not to sneeze. It may help to tilt your head backwards afterwards to prevent the medication from running out. You may blow your nose gently after a few minutes.
For nose drops the following:
Blow your nose gently. Tilt the head back while standing or sitting up, or lie down on a bed and hang the head over the side. Place the drops into each nostril and keep the head tilted back for a few minutes to allow the medicine to spread throughout the nose. Rinse the dropper with hot water and dry with a clean tissue. Replace the cap right after use. To avoid spreading a cold or infection, do not use the container for more than one person and throw the container away after your cold is better.
People who have trouble using a nasal spray can mostly use the watery non-metered decongestant nasal sprays similarly to a nose drop providing the dosage entering the nose is about equal to the spray (few drops).
Although decongestant sprays and drops are usually well tolerated within normal dosages, the following should be kept in mind: The active ingredients of decongestant sprays are related to adrenaline (nor-epinephrine) and can have similar effects on the body. These nasal sprays may increase blood pressure, increase heart rate, cause nervousness and may interfere with diabetes and other medications e.g. mono-amine oxidase inhibitors. (This list is not exhaustive and there are more side effects and other precautions. )
References:
Mayoclinic
Wikipedia
Webmd
Menthol and nasal patency
