Rhinitis Medicamentosa: Causes, Symptoms, Treatment, Diagnosis, Prevention

What is Rhinitis Medicamentosa?

Rhinitis medicamentosa, also known as RM, is a diseased state of rebound nasal congestion occurring due to an extended use of topical decongestants and some oral medications that constrict the blood vessels found in the nasal lining.

What is Rhinitis Medicamentosa?

What Causes Rhinitis Medicamentosa?

Rhinitis medicamentosa is caused due to prolonged or excessive use of OTC nasal decongestant containing topical vasoconstrictors like Phenylephrine hcl, Oxymetazoline hcl, and Xylometazoline hcl.

As mentioned above, this condition is caused due to an excessive use of drugs or medications. Nasal decongestants reduce the swelling of the blood vessels present inside our nose. If these decongestants are used for more than 7 days, they can lead to an inflammation in the nose, even if the original problem may be gone.

This inflammation of the nose results in rhinitis. When rhinitis is caused because of allergies, it is known as allergic rhinitis, or hay fever. Rhinitis medicamentosa is a less common form of this condition, which occurs due to overuse of drugs.

There are a number of risk factors of developing rhinitis medicamentosa. Some of them include, irritants like smoke from tobacco, smog, airplane fuel, exhaust fumes, solvents and also some other substances. Apart from this, certain diseased conditions like cystic fibrosis, lupus, some hormonal disorders, and also asthma increases the chance of developing rhinitis medicamentosa.

Symptoms of Rhinitis Medicamentosa

Usually, nasal congestion is the only symptom in case of rhinitis medicamentosa. This congestion in nose can last for weeks or even for months if you continue using the nasal decongestant sprays. There may also be some other symptoms experienced at times in case of rhinitis medicamentosa; which include sneezing, runny nose, nasal pain and nasal pressure. However, there is usually no itchy nose, throat or eyes in such type of rhinitis.

Diagnosis of Rhinitis Medicamentosa

In case of rhinitis medicamentosa, your doctor would ask you about the use of decongestants or other medications and the duration of their use.

A CT scan may be done for confirming the diagnosis and also to check for any changes in the nasal cavities. This CT scan can also rule out the condition of sinusitis, where there may be similar symptoms as in case of the rhinitis.

In order to detect and rule out the condition of allergic rhinitis, there may be a skin prick test done to check for any reaction and a blood test can be used to detect the levels of antibody.

Treatments for Rhinitis Medicamentosa

Before we talk about the treatments for rhinitis medicamentosa, we must mention that the triggers that are causing the conditions must be avoided. The rhinitis medicamentosa can be treated in the following ways.

Medical Treatments For Rhinitis Medicamentosa

Antihistamine Nasal Sprays:

One must try taking a prescription antihistamine nasal spray, like azelastine and olopatadine hcl. It must be noted that oral antihistamines do not really help non-allergic rhinitis; however, nasal decongestant sprays that contains an antihistamine, may be helpful in reducing the symptoms of non-allergic rhinitis.

Corticosteroid Nasal Sprays:

Your doctor may prescribe you with a corticosteroid nasal spray, such as Triamcinolone or Fluticason. These medications help in preventing as well as treating inflammation that are associated with some types of rhinitis that are not caused by allergens. It must be noted that there may be certain side effects of corticosteroid nasal sprays, such as nosebleeds, nasal dryness, headaches and also throat dryness.

Saline Nasal Sprays:

Saline nasal spray available over-the-counter or homemade saline solution can be used to flush the nose and help in thinning of the mucus and soothing the nasal membranes.

Anti-drip Anticholinergics Nasal Sprays:

The prescription medication Ipratropium or Atrovent is generally used as an asthma inhaler medication. However, it is now available as a decongestant nasal spray and it can be beneficial if you have complaints of runny or drippy nose. There may however, be some side effects of this medications, which may include drying on the inside of your nose or even nosebleeds.

Oral Decongestants:

Oral nasal decongestants are available over-the-counter or with doctor’s prescription. Some of these decongestants include pseudoephedrine- containing medications (Sudafed) and Phenylephrine(Such as Neo-Synephrine, Afrin).There drugs assist in narrowing the blood vessels, thus reducing the nasal congestion. There may be some possible side effects of these oral decongestants, which may include high blood pressure, palpitations and restlessness.

Surgery. In certain cases, surgery may be required for treating complicating problems, such as deviated nasal septum or persistent nasal polyps.

Lifestyle Modifications And Natural Treatments for Rhinitis Medicamentosa:

Rinse Nasal Passage:

Using a specially designed squeeze bottle to irrigate the nasal passage is a kind of home remedy that can be used to keep your nose free from irritants. This remedy is called as nasal lavage. This could be one of the best home treatments for non-allergic rhinitis if used on a regular basis.

In order to prevent infection, you need to make use of distilled water, previously boiled and cooled water or water that is filtered well using a filter for making the irrigation solution. You also must be very much careful and pay strict attention to rinse the irrigation devices after each use with distilled or filtered water and allow it to air-dry.

Blow Your Nose:

It is essential for you to blow your nose regularly and also in a gentle manner, in case there is a presence of mucus or irritants.

Use Humidifier:

You need to set up a humidifier where you sleep. However, make sure to clean the humidifier on a regular basis. You can even breathe in the stream from a warm shower so as to help loosen the mucus in the nose and also clear the stuffiness in head.

Alternative Medicines:

Some studies have shown that certain ingredients found in hot pepper can ease the nasal congestion. This alternative treatment is to be given several times in a day.

You can also prepare a steam inhalation using a few drops of tea tree oil or eucalyptus oil in a bowl of hot and clean water.

Acupuncture may also help in this case. However, there is very little evidence regarding its effectiveness.

Preventing Rhinitis Medicamentosa

Rhinitis medicamentosa is a condition that cannot be preventable. However, patients diagnosed with this condition must avoid the triggers in case they are known about it. Regular irrigation of your nasal passages could be a great preventive practice for this condition.


You need to consult with your doctor if you suspect having rhinitis medicamentosa. Your doctor would help you diagnose the condition and also help you find relief from the symptoms. It is to be noted that you must reduce the inflammation as soon as possible so as to avoid serious complications caused due to the conditions.