Treatments in Respiratory Medicine

, Volume 4, Issue 1, pp 21–29 | Cite as

Rhinitis Medicamentosa

A Review of Causes and Treatment
  • Peter GrafEmail author
Review Article


Rhinitis medicamentosa (RM) is a drug-induced, nonallergic form of rhinitis that is associated with prolonged use of topical vasoconstrictors, i.e. local decongestants. Symptoms are exacerbated by the preservative benzalkonium chloride (BKC) in the nasal preparations. Nasal stuffiness is caused by rebound swelling of the mucosa when the decongestive effect of the drug has disappeared. To alleviate this symptom, patients gradually start using larger doses of the vasoconstrictor more frequently. In many cases, the patient is unaware of the condition, thus entering a vicious circle of self-treatment. Careful questioning is required during consultation to establish diagnosis. The pathophysiology of the condition is unclear; however, vasodilatation and intravascular edema have both been implicated. Management of RM requires withdrawal of topical decongestants to allow the damaged nasal mucosa to recover, followed by treatment of the underlying nasal disease. Topical corticosteroids such as budesonide and fluticasone propionate should be used to alleviate rebound swelling of the nasal mucosa. Where possible, avoiding exposure to BKC is recommended.


Rhinitis Fluticasone Propionate Nasal Mucosa Nasal Spray Nasal Blockage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review.


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Authors and Affiliations

  1. 1.Karolinska University Hospital, SolnaStockholmSweden

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