Rhinitis medicamentosa

The long-term use of cocaine and topical nasal decongestants

(cause rebound congestion) leads to rhinitis medicamentosa.
„. Treatment: It consists of withdrawal of topical decongestant,
oral and/or topical steroid therapy, and surgical reduction
of hypertrophied turbinates are usually effective.

Diseases of Ear, Nose and Throat, 1st Edition 2013 331

What is rhinitis medicamentosa and how is it treated?

Rhinitis medicamentosa is rebound congestion that occurs with long-term use of
intranasal decongestants that contain α-adrenergic compounds such as
phenylephrine, oxymetolazine, or xylometolazine.

2016 ENT SECRETS FOURTH EDITION 168

Rhinitis medicamentosa
This is an acquired sensitivity of the nasal lining
in response to the prolonged use of topical nasal
decongestant substances. The root of the problem
lies in the fact that, once the effect of a nasal
decongestant has worn off, there is a rebound
vasodilation. This leads to further nasal congestion,
and the patient feels the need for relief and so uses
the decongestant again. The whole process rapidly
becomes self-perpetuating and results in turbinate
hypertrophy with chronic, unresponsive nasal
obstruction.
Essential ENT by Rogan J Corbridge MB BS, BSC, 2nd ed 2011 137
Sympathomimetics
Ephedrine hydrochloride
Xylometazoline.
These sympathomimetics cause vasoconstriction
of the nasal mucosa, leading to a reduction in its
thickness and reduced nasal decongestion. As their
effect wears off, rebound vasodilation occurs and can lead to worse but temporary congestion. Long-term
use of these drugs can cause rhinitis medicamentosa; therefore their application should be limited to short courses of
7–10 days.
Essential ENT by Rogan J Corbridge MB BS, BSC, 2nd ed 2011 2 170

RHINITIS MEDICAMENTOSA
This term is used to describe the iatrogenic disorder resulting from
the widespread overuse of nasal drops and sprays.
Logan Turner_s Diseases of the Nose, Throat and Ear (8th Ed.) 48