I have narrow nasal passages, a deviated septum, and the smog gets to me in Bangkok. Thus my nose is bunged up quite often. Sometimes not a problem, but if it goes on long enough I experience a wicked pain in one of my sinus'- it feels like it's around and behind my left eye socket in the corner. The pain eases as soon as I decongest.

Recently a friend advised Otravin nasal spray, and I must say it is a bit of a miracle for me.

Q1. Can I use this often, say once every few days?

I have also used pernazene oxy (oxymetazolene) to good effect.

Q2. can I also use this in rotation with Otravin, perhaps alternating every week?

I was once prescribed nasocort as a mid- term solution, every day for 1 month, then a break.

Q3. Is it safe to self prescribe given that it is not a new drug for me.?

Finally,

Q4. Does anyone know of any safer drugs (it really has to be something direct like a nasal spray).

I use a tablet produced locally called CETEC for sinus blockage and find it to be very effective. It does cause drowsiness however. About B20 for a package of 10 at local pharmacy's. I forget the active compound.

The use of nasal decongestants over a longer period than 3-5 days or so (regularly) may cause a "rebound" effect with increased nasal congestion after stopping it which may last for some days after. It may also cause atrophy of the nasal mucosal lining with its own side effects such as dryness and irritation. Constant use may also cause a vasomotor rhinitis where nasal congestion increases with posture; in other words, when lying down, nasal blockage or congestion increases. This is usually treated with a nasal decongestant/cortisone combination such as Nasocort.

Most of the Oxymetasoline hydrochloride preparations, such as Otrivin can cause this effect. Try a pediatric Iliadin spray or drop, the lowest concentration of medication that works which will have less of the above side effects or a preparation such as Vibrocil which has a slightly different mode of action with less longterm side effects than the Oxymatasoline preparations.

Also try nasal rinses with a saline solution or a saline/bicarbonate of soda combination; 500ml or 1l saline solutions are commonly available here from Boots. Use about a teaspoon of bicarbonate of soda per litre of saline; aim is to use a physiological concentration which should not cause any irritation or burning when using it.