The alternative is to start using a steroid (cortisone) type nasal spray, of which there are many different brands. They all require a prescription. Since they take four to seven days to reach maximal effectiveness, a person may need to continue using the sympathomimetic nasal spray for a few days or can switch to oral pseudophed if that is not contraindicated. Use the steroid spray after the congestion has been reduced by the decongestant spray, so that the steroid will reach all the membranes. After three to four days, stop the decongestant spray and use the steroid alone. The nasal steroid sprays are generally quite safe, although they may raise the intraocular pressure in people prone to glaucoma, and occasionally will facilitate fungal infections of the nose. When used to come off the decongestant spray, a person will only need them for a couple of weeks.
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An excessive level of corticosteroids may cause Cushing's disease. When a pet is on long-term, high doses of glucocorticoids, there is an increased risk that it will develop a condition called iatrogenic (medication induced) Cushing's disease. The clinical signs of Cushing's disease include increased thirst and urination, an increase in UTI's and skin and ear infections, a "pot-bellied" appearance, thinning skin and hair loss. In the treatment of some diseases, the risk of iatrogenic Cushing's disease is unavoidable. To minimize this risk, corticosteroid doses are tapered down over time, or several different drugs may be used in combination.