Having said that, he did emphasize the need to place the approval in the context of all medical treatments—namely, the risks and benefits of making these sprays OTC must be weighed. “Any time someone is using a topical corticoid steroid, there is a potential for adverse effects to the nasal cavity and, ideally, you have a clinician to oversee that and look for those types of problems,” he said. “On the other hand, there may be some people who don’t have access to these types of medication who now will have access.”
Explore this issue:September 2014
For Thomas B. Casale, MD, executive vice president of AAAAI and professor of internal medicine in the division of allergy and immunology at the University of South Florida’s Morsani College of Medicine in Tampa, the biggest concern with OTC use of these sprays is not the safety of the drugs themselves but the lack of clinician oversight of the disease process the drugs are used to treat.
While saying that the drugs themselves are fairly safe, Dr. Casale emphasized that optimal treatment of allergies requires consultation with a physician. “Trivializing the disease by using over-the-counter medications may result in impaired quality of life and poorer outcomes for patients,” he said. “Consultation with a physician … would help identify things that the patient can do in addition to medications.”
What Time May Tell
Dr. Smith highlighted the fact that more time will need to pass before otolaryngologists and other clinicians know the full extent of how these OTC sprays will affect their practice. “I imagine there is only a very small proportion of patients who are accessing this nasal spray OTC,” he said. “We have not seen the peak of this, not even close. As other comparable sprays start to go OTC, we will see a shift and then may or may not see an increase in adverse effects from these OTC medications because of the lack of clinician oversight.”
Mary Beth Nierengarten is a freelance medical writer based in Minnesota.