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NHS ‘seven day’ rule on common medicine to avoid making things worse

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Last updated: January 12, 2026 7:36 am
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Published: January 12, 2026
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Millions of people turn to nose sprays each year as a quick fix for congestion brought on by colds, flu and other ailments. But what many don’t realise is that improper use of this everyday medication could result in dependency or even addiction.

Certain nose sprays shouldn’t be used for longer than seven days at a stretch, with the NHS cautioning: “using them for too long can make your stuffiness worse. Speak to a GP if your symptoms do not improve after this time.”

This worsening of symptoms is referred to as rebound congestion. Because it mimics the very symptoms nose sprays are designed to relieve, many users end up reaching for the spray even more frequently, inadvertently making their congestion worse. Over time, this can create a vicious cycle of dependency, with people convinced they must keep using the nose spray just to breathe through the blockage.

Only nose sprays containing xylometazoline and oxymetazoline carry the risk of rebound congestion. Other varieties containing steroids or saline solution generally don’t pose this risk and may be safer for extended use.

Figures from the Royal Pharmaceutical Society revealed that nearly 60% of pharmacists believe patients are unaware of these potential dangers.

The Royal Pharmaceutical Society lists several warning signs of nose spray overuse, including: needing to use it more frequently, experiencing worse congestion when you stop using it, having to purchase multiple bottles, and exceeding the recommended dosage.

The NHS advises using decongestant sprays between one and four times daily for a maximum of one week. It also encourages people to refer to the patient information leaflet included with their medicine for specific dosage advice.

Professor Amira Guirguis, RPS Chief Scientist, warned: “Nasal decongestant sprays can be helpful for short-term relief but using them for longer than seven days can make your congestion significantly worse.”

She added: “Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realising they could be prolonging their symptoms.

“We’d like to see clearer warnings on the packaging which you can’t miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms.”

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