When a nasal spray travels down the back of the nose and into the throat, the medication has bypassed its intended site of action in the nasal passages. This dripping often happens when the spray is administered incorrectly, as the nose and throat are physically connected. For most common over-the-counter nasal sprays, swallowing the small amount that drips down is generally not harmful for an adult because the dosage is minimal. The medication is designed to work locally on the nasal lining; when swallowed, it primarily enters the digestive tract.
The Immediate Sensory Experience
The most immediate sensation is an unpleasant or medicinal taste, often described as bitter or chemical. This flavor occurs as the active drug ingredients and their preservative solutions, such as benzalkonium chloride, coat the taste buds and mucous membranes of the pharynx. This sensation is a sign of post-nasal drip, where the liquid streams down the throat, triggering irritation or a mild burning. Some individuals may experience a slight itching or scratchy discomfort in the throat, which can sometimes lead to a temporary cough. This irritation is a direct result of the solution irritating the sensitive tissues of the throat and resolves quickly as the liquid is swallowed and diluted by saliva.
Safety Profile and Toxicity Risk
The safety of a swallowed nasal spray dose largely depends on the type of medication involved, though the amount is usually minimal. Swallowing a small amount of saline nasal spray, a simple mixture of salt and water, is essentially harmless since the solution is similar to the body’s natural fluids.
For steroid nasal sprays, such as Fluticasone, the risk is also low because the medication is poorly absorbed through the gut. The primary action of these corticosteroids is local, and the tiny swallowed dose is unlikely to cause systemic side effects. However, decongestant sprays containing ingredients like oxymetazoline or naphazoline present a different concern. While rare with a single, small swallowed dose, ingesting larger quantities can potentially cause systemic effects, including an increased heart rate or mild jitters in sensitive individuals. Accidental ingestion of even 1–2 milliliters of these vasoconstrictors by young children can lead to serious adverse events requiring hospitalization, such as decreased breathing or decreased heart rate.
Immediate Action Steps
If you notice the spray dripping into your throat, the immediate step is to dilute the solution to minimize the unpleasant taste and irritation. Rinse your mouth and gargle with plain water to clear the pharynx of the residual medication. Drinking a glass of water or milk can help wash the remaining product down and further dilute it in the stomach.
While accidental swallowing incidents are generally not medically concerning for adults, you should seek medical attention if severe symptoms occur. These warning signs include significant difficulty breathing, a rapid or irregular heart rate, severe vomiting, or sudden confusion. Such severe reactions are extremely rare with a single swallowed dose but warrant immediate contact with a poison control center or emergency services.
Ensuring Effective Spray Technique
Improper aiming and excessive sniffing cause the spray to go down the throat. To ensure the medication stays in the nasal cavity where it can be absorbed, gently blow your nose to clear any mucus first. When positioning the spray, hold your head upright or slightly tilted forward, not backward.
The nozzle should be inserted just inside the nostril and aimed away from the nasal septum, the center wall of the nose. A good technique is to use the right hand to spray into the left nostril and vice versa, pointing the tip toward the ear on the same side. As you squeeze the pump, inhale slowly and gently, only enough to keep the medication in place, avoiding a hard snort which pulls the liquid directly to the back of the throat. Swallowing the medication reduces its intended effectiveness.