Best Allergy Nasal Sprays 2026 Reference Edition

EXPLAINER

How to Use a Nasal Spray Correctly: 9-Step Technique Guide

Head forward, aim outward, breathe gently: the nine steps that matter.

By BestAllergyNasalSprays Editorial Team — Clinical Pharmacy, Editorial Pool Reviewed by BestAllergyNasalSprays Editorial Team — Adult Allergy & Immunology, Editorial Pool
Content updated Evidence reviewed First published

Literature review current through

The 2-minute version

  1. Shake gently.
  2. Prime (new bottle or unused 1+ week).
  3. Blow your nose.
  4. Tilt head slightly FORWARD.
  5. Insert nozzle just inside one nostril; close the other with a finger.
  6. Aim outward toward the ear on that side, never at the septum.
  7. Spray with a gentle inhale. Not a hard sniff.
  8. Repeat on the other side.
  9. Don’t blow your nose for 15 minutes.

The mistakes that matter

Head tilted back

This sends the spray straight down your throat: the dose is wasted and you taste it. Bitter taste is the most commonly reported side effect of azelastine nasal sprays, occurring in roughly 6–10% of patients in placebo-controlled trials of Astepro 0.15% versus 1–2% on placebo. It typically occurs when spray drains into the throat and can be reduced by tilting the head downward during use 4 Expert Head forward eliminates most of it.

Aim at the septum

Spray technique matters: an Otolaryngology–Head and Neck Surgery panel (Benninger 2004) recommends aiming the nozzle outward toward the ear (away from the nasal septum) and avoiding direct septum contact, which may reduce nosebleeds and septal irritation 2 Expert Nasal septum perforation is a very rare complication of intranasal corticosteroid use; the risk is generally attributed to the local vasoconstrictor activity of corticosteroid molecules, and patients are commonly counseled to aim the spray slightly outward (away from the septum) 3 Expert

Sniffing hard

A hard sniff pulls the spray past the mucosa into the throat where it does nothing. A gentle inhale is enough.

Blowing right after

You just delivered a dose. Give it 15 minutes to settle before blowing.

Skipping priming

Per the FDA Drug Facts label, Flonase Allergy Relief (fluticasone propionate 50 mcg/spray) may begin to relieve symptoms on the first day of use, with full effect after several days of regular, once-daily use 1 Expert , but only if each spray is fully primed.

Prime counts by product
ProductNew-bottle primesUnused-1-week re-primes
Flonase61
Nasacort51
Astepro61
Rhinocort81
Sensimist61

The 9 steps in detail

1. Shake gently

Nasal suspensions contain drug particles in water. Gentle shaking re-suspends the drug for consistent per-dose content.

2. Prime (only for new / unused bottles)

Point the bottle away from your face and pump until a fine mist appears. A liquid jet means the pump chamber hasn’t built pressure; keep priming.

3. Blow your nose

Clear mucus so the dose lands on the nasal mucosa, not a glob of snot.

4. Head forward

Oral sprays go back. Nasal sprays go forward-and-out. Look at your shoes.

5. Nozzle in one nostril, close the other

Finger closes the opposite nostril. This creates a slight natural inhale that guides the mist.

6. Aim outward toward the ear

Imagine a line from your nostril to the ear on the same side. That’s the angle. Never toward the center of your face; that’s the septum.

7. Spray + gentle inhale

Full actuator press. Breathe in gently at the same moment. A slight draw, not a sniff.

8. Swap to the other nostril

Repeat the same sequence.

9. No blowing for 15 minutes

Give the mucosa time to absorb the dose. Blowing immediately expels most of it.

Tips for kids

  • Use Sensimist or Nasacort (both ages 2+): scent-free, alcohol-free.
  • Let the child hold the bottle while you place it. Agency reduces resistance.
  • Count to three so the timing is predictable.
  • For very young kids, nozzle goes just barely inside; do not insert deeply.

Tips to reduce Astepro’s bitter taste

In a placebo-controlled trial of azelastine nasal spray 0.15%, onset of symptom relief was reported within 30 minutes of dosing (Shah 2009) 4 Expert If the bitter taste is bothering you:

  1. Tilt head forward more aggressively.
  2. Gentle inhale only.
  3. Don’t dose right after eating.
  4. A sip of water after rinses residual taste.

Side-effect expectations

Common side effects of intranasal corticosteroids include nasal irritation or burning, sneezing, nosebleeds (epistaxis), headache, and sore throat, per FDA labels; severe or frequent nosebleeds should prompt clinician review Expert Most are mitigated by technique. Mild stinging in the first few seconds is common with alcohol-containing sprays (Flonase). If sores develop, or bleeding exceeds a light streak, stop for 48 hours, improve technique, and consider switching to an alcohol-free formulation (Nasacort, Sensimist, Rhinocort).

When to see a doctor

  • Persistent nosebleeds more than once a week
  • Scab formation on the septum
  • A sense that the spray comes out the other side (possible perforation; stop and see an ENT)
  • No improvement after 4 weeks of consistent daily use

Summary & recommendations

Summary & Recommendations

  1. Tilt forward. Aim outward. Breathe gently. That's 80% of correct technique.
  2. Prime every new bottle or one that's been idle for a week.
  3. Don't blow your nose for 15 minutes after dosing.
  4. Bitter taste usually means head-back angle, correct to head-forward.
  5. If nosebleeds persist despite good technique, switch to an alcohol-free spray.
  6. Any sense of bilateral spray passthrough = stop + ENT visit (possible septum injury).

Publish history

Publish history

  • Quarterly refresh; added product-specific prime counts.
  • Initial publication.

References

Regulatory & label

  1. DailyMed: Flonase SPL · FDA DailyMed https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a10a4ba9-86e0-4e3b-9cc2-eab1fa0dac0c

Guidelines

  1. Dykewicz 2020: Rhinitis practice parameter · JACI (2020) https://pubmed.ncbi.nlm.nih.gov/32707227/

Primary literature

  1. Benninger 2004: INCS spray technique · PubMed (2004) https://pubmed.ncbi.nlm.nih.gov/15461942/
  2. Septum perforation risk: technique · PubMed https://pubmed.ncbi.nlm.nih.gov/17720021/
  3. Azelastine tolerability data · PubMed https://pubmed.ncbi.nlm.nih.gov/22486595/

Related

This page is grounded in primary literature, reviewed by the BestAllergyNasalSprays editorial team. See our editorial methodology and the public claims library.