One Nostril or Two?


Some medicines come as a nasal spray. While a spray in each nostril is the typical way to take a single dose, there are some exceptions. Some medicines are meant to be given as a single spray into one nostril for each dose. One prime example is calcitonin salmon (Fortical or Micalcin), a medicine used to treat women with osteoporosis (bone thinning) after menopause.

A single spray of this medicine into one nostril delivers the full dose. (Spraying the medicine into the opposite nostril the next day is recommended.) Several medicines used to treat migraine headaches also come as nasal sprays intended to be sprayed into just one nostril, including Imitrex (sumatriptan) and Zomig (zolmitriptan).

Some people have given themselves double doses by spraying these medicines into both nostrils. Some-times, patients have forgotten their doctors’ instructions to use a single spray of the medicine. Other times, the pharmacy has applied a label on the medicine container with the wrong directions to deliver a spray into each nostril. This happens if the computer in the pharmacy has been set up to automatically print labels for nasal sprays with the more common directions: “spray in each nostril.” So, don’t assume that any nasal spray you use is supposed to be sprayed into both nostrils. Ask your doctor or pharmacist to be certain you understand the directions for use.

Created on July 1, 2006

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