Nasal irrigation / saline decongestant (non-pharmacological adjunct) Pregnancy: Completely safe in pregnancy — no systemic absorption.

Sodium Chloride 0.9% Nasal Irrigation / Spray

Brand names: Sterimar, NeilMed Sinus Rinse, Nasodren, Physiomer

Adult dose

Dose: 1–2 sprays per nostril as required (spray); or 240 mL nasal rinse once to twice daily (high-volume irrigation)

Route: Intranasal

Frequency: 2–6 times daily (spray); once to twice daily (irrigation)

Max: No defined maximum — as needed

Allergic rhinitis, acute and chronic rhinosinusitis, post-nasal drip, post-operative nasal care (septoplasty / FESS), saline rinse for mucociliary clearance. High-volume nasal irrigation (Neil Med / SNOT) is preferred over simple spray for rhinosinusitis. Isotonic (0.9%) for general use; hypertonic (2.3% Sterimar Blocked Nose) may be more effective for congestion.

Paediatric dose

Route: Intranasal

Frequency: 2–6 times daily

Max: As required

Safe from birth. Baby-specific formulations available (Sterimar Baby). Infants: 1–2 sprays per nostril before feeding. Children: 1–2 sprays per nostril 2–4 times daily. High-volume irrigation from age 4–6 years with appropriate paediatric kit.

Dose adjustments

Renal

No adjustment required.

Hepatic

No adjustment required.

Clinical pearls

High-volume saline nasal irrigation (240 mL) is superior to simple spray for chronic rhinosinusitis symptom control — NICE endorses as adjunct
Isotonic (0.9%) is less irritating; hypertonic (2.3%) may give better decongestion but more stinging
Post-FESS (functional endoscopic sinus surgery): high-volume saline irrigation is standard post-op care — reduces crusting and improves healing
No systemic effects — completely safe in pregnancy, elderly, hypertension
Technique for irrigation: head tilted 45°, breathe through mouth, allow saline to drain — do not sniff back

Contraindications

Hypersensitivity to any excipient (rare)
High-volume irrigation: contraindicated with CSF rhinorrhoea (risk of intracranial spread of infection)

Side effects

Nasal stinging (hypertonic formulations)
Mild rhinorrhoea immediately post-rinse
Rare: exacerbation of ear symptoms if Eustachian tube dysfunction (irrigation pressure)

Interactions

No pharmacological interactions

Monitoring

Symptom response
Post-operative healing (sinus surgery)

Reference: BNFc; BNF; NICE NG120 Sinusitis; ENT-UK Saline Irrigation Guidelines; EPOS 2020. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways