Medications Directory

Approved indications: Nazal is an OTC nasal decongestant indicated for temporary relief of nasal congestion due to the common cold, hay fever (allergic rhinitis), or sinusitis-associated congestion in adults and children 12 years and older.

Off-label uses: Off-label use of intranasal naphazoline is uncommon, and there is limited high-quality evidence for other indications, so clinicians generally prefer alternative therapies when longer-term or different treatment is needed.

Efficacy expectations: Nasal stuffiness usually begins to improve within minutes of a dose, with relief lasting a few hours and resulting in easier nasal breathing; however, symptoms often return as the medicine wears off, and if used longer than about 3 days it can cause rebound congestion that may feel worse than the original symptoms.

Comparison to similar drugs: Compared with other topical nasal decongestants such as oxymetazoline, Nazal offers similar short-term relief but tends to have a somewhat shorter duration of action, with a comparable risk of rebound congestion and systemic side effects if misused.

Typical dosing: Adults and children 12 years of age and older use 1 to 2 sprays in each nostril, not more often than every 6 hours; children under 12 years should not use Nazal unless specifically directed by a doctor.

How to use: Gently blow your nose, keep your head upright, insert the spray tip into one nostril while closing the other, spray as you breathe in gently through the nose, repeat for the other nostril, then wipe the tip and replace the cap; Nazal is for nasal use only and can be used with or without food at any time of day.

Duration and special instructions: Use Nazal only for short-term relief and do not use it for more than 3 consecutive days; if congestion persists, returns quickly, or worsens, stop using the spray and contact a healthcare professional instead of increasing the dose or frequency.

Missed doses: Because Nazal is taken as needed for symptoms rather than on a fixed schedule, simply use it when congestion occurs, making sure that doses are spaced at least 6 hours apart.

Overdose: If more than the recommended amount is used or if a child swallows the medicine, seek emergency medical help or contact a Poison Control Center (1-800-222-1222 in the United States) right away.

Common side effects: Temporary burning, stinging, sneezing, increased nasal discharge, or dryness inside the nose can occur soon after spraying and are usually mild and brief; using Nazal too often or for more than a few days can lead to worsening or rebound nasal congestion.

Serious or rare adverse effects: Accidental swallowing or significant overuse—especially in children—can cause excessive sleepiness, low body temperature, slowed breathing, changes in heart rate or blood pressure, or loss of consciousness, and severe allergic reactions with rash, swelling, or trouble breathing can also occur; any of these require immediate medical attention.

Warnings and precautions: Do not use Nazal in children under 12 years old unless directed by a doctor, and ask a healthcare professional before use if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating due to prostate enlargement; do not exceed the recommended dose and do not use for more than 3 consecutive days.

Pregnancy and breastfeeding: Because some medicine can be absorbed into the bloodstream, people who are pregnant or breastfeeding should consult a healthcare professional before using Nazal and, if approved, use the lowest effective dose for the shortest possible time.

Comparative safety: Like other topical nasal decongestants, Nazal is generally safe for short-term use in healthy adults but is less suitable than saline sprays or steroid nasal sprays for long-term control of congestion because of the risk of rebound symptoms and cardiovascular or nervous system effects with overuse.

Reporting and safety updates: Suspected side effects can be reported to the FDA MedWatch program or to the manufacturer, and updated safety information can be found through FDA safety communications and online drug-information resources such as DailyMed.

Drug interactions: Although Nazal is applied in the nose, it acts as a sympathomimetic decongestant, so using it together with monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, or other decongestants (oral or nasal) may increase the risk of elevated blood pressure or heart rhythm changes, and people taking these medicines should consult a healthcare professional before use.

Other medicines, supplements, food, and alcohol: There are no major known interactions with specific foods, but combining Nazal with other stimulants (such as high doses of caffeine or certain weight-loss or cold products) can add to nervousness or blood-pressure effects, and swallowing the spray along with alcohol or sedating medicines may increase drowsiness or other systemic side effects.

Medical conditions and precautions: Use Nazal cautiously and under medical advice if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating from an enlarged prostate, or if you are elderly or unusually sensitive to stimulant medicines.

Monitoring: Routine lab testing is not required, but people with cardiovascular disease or on interacting medications may be advised to monitor blood pressure and heart rate and to stop using Nazal and seek care if they experience chest pain, severe headache, palpitations, marked dizziness, or other concerning symptoms.

Q: How quickly does Nazal start to work?
A: Most people notice easier nasal breathing within a few minutes of using Nazal, although the relief is temporary and typically lasts only a few hours.

Q: How many days in a row can I safely use Nazal?
A: You should not use Nazal for more than 3 consecutive days, because longer use increases the risk of rebound nasal congestion that can be harder to relieve.

Q: Is Nazal safe if I have high blood pressure or heart disease?
A: Nazal can raise blood pressure or affect heart rate in some people, so you should talk with your doctor before using it if you have high blood pressure, heart disease, or are taking heart or blood-pressure medicines.

Q: Can I use Nazal together with allergy medicines like antihistamines or steroid nasal sprays?
A: Nazal is often used short term in addition to oral antihistamines or prescription steroid nasal sprays, but you should follow the directions for each product and consult a healthcare professional if you are unsure about combining them.

Q: Can children use Nazal?
A: Nazal is labeled for adults and children 12 years and older, and it should not be used in younger children unless a doctor specifically recommends and supervises its use because swallowing even small amounts can cause serious side effects.

Storage: Store Nazal at room temperature away from excessive heat and moisture, keep the bottle tightly closed, and keep it out of the reach of children.

Use hygiene: Do not share the spray bottle with others and avoid touching the nozzle to the inside of the nose to help prevent contamination and the spread of infection.

Disposal: When the product is expired, contaminated, or no longer needed, discard it in household trash in a way that children and pets cannot access, and ask a pharmacist or local waste authority about drug take-back options; do not routinely pour it down the sink or toilet.