Task Force says no to OTC nasal steroids

A panel set up by two allergy associations has come out against making steroid nasal sprays available without a prescription.

Intranasal corticosteroids used for treating allergies and hay fever can have serious side effects, as well as serious adverse interactions with other medications. For these reasons, the Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology issued a position statement, warning of the dangers of over-the-counter access to these medications.

The position statement is published in the Annals of Allergy, Asthma and Immunology.

The Joint Task Force reviewed published medical studies to assess the frequency and severity of adverse events related to the use of intranasal corticosteroids. They found the risks are significant, and include bone resorption, growth suppression and an increase in pressure in the eye, which could be a serious problem for people with glaucoma.

Task Force chairman Dr. Leonard Bielory of the University of Medicine and Dentistry of New Jersey, Newark, and colleagues point out that individuals often exceed the recommended dose of over-the-counter medications. This could pose a significant problem with nasal steroids, which can have significant adverse effects even at recommended doses.

The Task Force stresses that patients using these drugs should be under the direct, close supervision of a doctor. Adverse effects of intranasal corticosteroids can be insidious, only becoming evident many years later, Bielory warns.

Based on their findings, the Task Force urges the U.S. Food and Drug Administration not to approve over-the-counter access to intranasal corticosteroids. "These drugs should remain a prescription-only entity," they write.

SOURCE: Annals of Allergy, Asthma and Immunology, April 2006.