Saline nasal spray is a simple, over-the-counter remedy used to relieve nasal congestion and dryness. It is essentially a sterile mixture of salt and water designed to cleanse and moisten the nasal passages. Since the nasal cavity connects directly to the throat, accidental ingestion of small amounts is common during normal use. The solution is formulated to be harmless when swallowed in the small volumes typical of a few sprays.
The Composition and Safety of Saline Solution
The core ingredients in saline nasal spray are sodium chloride and purified or sterile water. The safety of the product when ingested is based on these non-toxic components. Saline solutions are generally classified based on their salt concentration relative to the body’s natural fluids, which is approximately 0.9% sodium chloride.
An isotonic saline solution contains this 0.9% salt concentration, making it gentle and well-tolerated. Hypertonic solutions contain a higher concentration, typically ranging from 2% to 3% sodium chloride, and are used to draw fluid out of swollen nasal tissues.
A single spray delivers a very small volume of liquid, often less than one milliliter. The small amount of sodium chloride poses no toxicity risk to the digestive system. Some commercial sprays also contain small quantities of buffering agents or preservatives, but these are not considered toxic in the minute doses delivered by a few accidental sprays.
Immediate Effects of Accidental Ingestion
When saline spray drains from the nasal passages down the back of the throat, the immediate experience is usually a noticeable salty taste. This taste is more intense with hypertonic formulas due to their higher sodium content. This taste is temporary and can be managed by rinsing the mouth or drinking water.
Swallowing the liquid may cause a brief, mild irritation in the throat. If a slightly larger volume is ingested, minor and transient stomach upset or nausea may occur. These symptoms are generally short-lived and resolve quickly as the solution is diluted by the body’s natural fluids and stomach contents.
When Swallowing Saline Spray Becomes a Concern
While accidental ingestion of a few sprays of plain saline is safe, the most significant risk comes from confusion with sprays containing active medications. Sprays containing decongestants like oxymetazoline or naphazoline are chemically distinct from plain saline and are toxic if swallowed, especially by children.
Ingestion of even a small amount, such as 1 to 2.5 milliliters of a 0.05% oxymetazoline solution, can cause severe reactions. These medicated sprays can lead to central nervous system depression, a dangerously slow heart rate, and decreased breathing. If a medicated spray is swallowed, or if there is any doubt about the type of spray ingested, immediate professional assistance is necessary.
Ingesting Large Volumes of Saline
A less common concern is the ingestion of very large volumes of plain saline, such as drinking an entire bottle. Though the salt concentration is lower than seawater, consuming excessive amounts could potentially lead to hypernatremia, or salt poisoning. Symptoms of severe salt overdose include intense thirst, vomiting, confusion, and in extreme cases, seizures. If a large volume of any nasal spray is swallowed, or if the product is expired or visibly contaminated, immediately contact Poison Control for guidance.