An advisory panel to the FDA just recommended that a drug called Nasacort AQ be permitted to be sold over the counter. This will be the first intranasal corticosteroid to ever be sold without a prescription.
The drug is meant to help people deal with the symptoms of hay fever, like runny noses and stuffiness. It is a spray that is inhaled through the nostril, and almost 2 million people got a prescription for it last year in the United States, including many in Utah.
In fact, the nature of this medication is why making it available over the counter is risky. Most every patient incorrectly uses a nasal spray, which results in problems. When the incorrect technique is used to spray and inhale into the nostrils, burning and bleeding can occur. There is even a risk of perforating the nasal septum, which means putting a hole through the nose, which results in the collapse of the nose.
Furthermore, when a drug is sold over the counter, a patient often misses out on important monitoring and follow-up. Dosages may need to be altered, and a trained allergy specialist will be able to best identify if the patient should continue or stop taking the medication. This is especially important for Nasacort.
Also, your medical history is very important when considering this medication. A history of infections, nose injury, asthma and tuberculosis all indicate that you might not be a good candidate for Nasacort. But people who are at the store might not consider this when they go to buy something for their hay fever.
The risks of making the drug available without prescription have led both the American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI) to release statements opposing the change. The American Academy of Pediatrics also opposes the change. Intranasal corticosteroids have been linked to growth suppression in children, these groups say, which makes correct monitoring and management vital.
If the FDA does make Nasacort AQ available over the counter, make sure you only take it under the supervision of an allergy specialist who is certified by the appropriate boards.