hEALTH

PARANASAL SINUS

Rarely known side effects

Preservatives in nasal spray may destroy immune cells

Nasal sprays are used as a decongestant compound for the treatment of a blocked nose. The preservation agent benzalkonium chloride which is often used to prevent the growth of bacteria destroy cells in the nasal mucosa.
Neutrophil cells are a first barrier against germs. However, when neutrophils are brought into contact with benzalkonium chloride, they become affected and may be destroyed. As a consequence, a sinusitis may develop. The same problem also exists for glucocorticosteroid formulations used for the treatment of hayfever (allergic rhinitis).
However, newer data suggest that benzalkonium chloride appears to be safe and well tolerated for both long- and short-term clinical use. To be on the safe side, nasal spray without benzalkonium chloride may be a reasonable alternative.

Safety review of benzalkonium chloride used as a preservative in intranasal solutions: an overview of conflicting data and opinions.
Marple B, Roland P, Benninger M.
Otolaryngol Head Neck Surg. 130:131-41 (2004).

Is the use of benzalkonium chloride as a preservative for nasal formulations a safety concern? A cautionary note based on compromised mucociliary transport.
Bernstein IL.
J Allergy Clin Immunol 105: 39-44 (2000).

Benzalkonium chloride as a preservative in nasal solutions: re-examining the data.
Graf P.
Respir Med 95: 728-33 (2001).

Safety review of benzalkonium chloride used as a preservative in intranasal solutions: an overview of conflicting data and opinions.
Marple B, Roland P, Benninger M.
Otolaryngol Head Neck Surg. 130: 131-41 (2004).

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