The Royal Pharmaceutical Society (RPS) has urged manufacturers and regulators to introduce clearer warnings on nasal decongestant spray packaging, after new survey data revealed widespread public confusion and risky overuse across the UK.
Community pharmacists say many people are unknowingly making their congestion worse by using these sprays for too long, often believing they are harmless cold remedies.
Why is nasal decongestant spray overuse becoming a concern in the UK?
A recent RPS survey of 309 community pharmacists across the UK, conducted in 2024, paints a worrying picture of how commonly nasal decongestant sprays are misused.
Key findings from UK pharmacists
- 63% said they have intervened when they suspected a patient was overusing a nasal decongestant spray
- 59% believe patients are unaware of rebound congestion risks
- 74% want clearer warnings on packaging about the seven-day usage limit
Pharmacists report that many customers return repeatedly for the same spray, unaware that their blocked nose may actually be caused by the product itself.
What happens if you use a nasal decongestant spray for too long?
Most over-the-counter nasal decongestant sprays sold in the UK contain xylometazoline or oxymetazoline. According to NHS guidance, these should not be used for more than seven consecutive days.
The main risk: rebound congestion
Using these sprays beyond a week can lead to rhinitis medicamentosa, more commonly known as rebound congestion.
In simple terms:
- The spray initially clears the nose
- Over time, blood vessels become dependent on it
- Stopping the spray causes worse congestion than before
This can trap people in a cycle of daily use, sometimes lasting months or even years.
What are UK health experts saying about the risks?
Amira Guirguis, Chief Scientist at the Royal Pharmaceutical Society, warned that many people are unintentionally extending their illness.
“Using these sprays beyond seven days can worsen congestion. Many individuals remain unaware of this risk, potentially extending their symptoms unwittingly.” Amira Guirguis, RPS
Nasal decongestant sprays can quickly relieve a blocked nose but are only for short-term use. Using them for more than 7 days can worsen congestion.
Professor Amira Guirguis, RPS Chief Scientist, explains how to use them safely and when to seek advice: https://t.co/AI1dg29W0Z pic.twitter.com/PMtQ8HQ1KC
— Royal Pharmaceutical Society (@rpharms) January 8, 2026
She stressed that nasal sprays are safe only when used correctly, and problems arise when guidance is overlooked or unclear.
Should nasal spray packaging have clearer warnings?
Pharmacists overwhelmingly think so. Currently, the seven-day limit is often printed in small text, easily missed by shoppers rushing through cold and flu aisles.
What pharmacists want to see
- Larger, front-facing warnings
- Clear language explaining rebound congestion
- Advice is to speak to a pharmacist if symptoms persist
Olivier Picard, Chair of the National Pharmacy Association, said overuse has become so common that pharmacists sometimes take action at the counter.
“The risks of side effects increase with overuse, which can lead pharmacists to refuse sales to protect patients from harm.” Olivier Picard, NPA
What should you do if your congestion lasts longer than seven days?
Pharmacists say many people assume a blocked nose always needs stronger medication, but that is not always the case.
Safer UK-approved alternatives include
- Saline nasal sprays or rinses
- Steam inhalation
- Treating underlying allergies with antihistamines
- GP advice for chronic sinus issues
If symptoms last longer than a week, NHS guidance recommends speaking to a pharmacist or GP rather than continuing spray use.
Real-world UK example: when cold relief backfires
Community pharmacists report regular cases where customers:
- Have used a nasal decongestant spray daily for months
- Believe it is “safer than tablets.”
- Are shocked to learn the spray is causing their blockage
Once advised to stop gradually and switch to alternatives, many see improvement, but withdrawal congestion can last days or weeks.
