Benzalkonium

Benzalkonium
The preservative Benzalkonium Sodium causes problems with nasal sprays. Around 1985, it was noted that the number and severity of cases of rhinitis medicamentosum was increasing with increased use of benzalkonium, an antibacterial preservative found in most over-the-counter prepared saline nasal spray products. Rhinitis medicamentosum means that the nose gets stuffy and congested after use of nose drops such as oxymetazoline (Afrin™). The more the nose drops are used, the more "rebound" when the drug wears off, that is, the worse the patient gets after the drops wear off, requiring more and more use of the drops. The drops become effectively addictive, and worse, the nose is always stuffy anytime the drug is not active in the nose.

Next, it was discovered that you could get rhinitis medicamentosum just form the Benzalkonium alone, as well as saline with Benzalkonium. So, it wasn't the nasal medication oxymetazoline that was responsible, but the Benzalkonium. The oxymetazoline did shrink the nose nicely, but the benzalkonim caused a rebound congestion.
These additive problems are so important that the Dannemiller Memorial Educational Foundation gives special training to doctors on this subject. This training emphasizes that if you are allergic or have an infection, the additives can be more irritating than when you are "normal".

Recent articles on the negative effects of Benzalkonium include:

Berg: Mucosa exposed to benzalkonium chloride showed squamus cell metaplasia ( the normal cells changed to undesirable cells). Benzalkonium chloride appears to be potentially toxic to the mucosa.

Steinsvag: benzalkonium chloride has toxic effects on human respiratory mucosa and human neutrophils. It destroyed mucosa and inhibited human neutrophil action.Benzalkonium chloride induces mucosal swelling, which explains why the presence of this preservative in a decongestant spray aggravates rhinitis medicamentosa.

Hoffman An irreversible cessation of ciliary movement was observed in ciliary cells exposed to nasal sprays containing Benzalkonium chloride As benzalkonium chloride can cause complete standstill of ciliary beat frequency in vitro in human nasal mucosa, we recommend that this preservative should not be used anymore in topical nasal medications.

Thanks for the good info. I use a neti pot with salt and water for nasal congestion. The price is right, and no fear of other chemicals. Less is more!

I was shocked to see that Benza. can cause rebound congestion all by itself. i just bought some "simply saline" nasal spray. It comes in a spray can.

Gary