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Considerations: Proper spray technique (appropriate angle, avoiding the septum) Alternating nostrils per dose Using a saline rinse periodically to support nasal mucosal health Discontinuation and route change if persistent irritation develops Patients with allergic rhinitis, chronic sinusitis, or significant septal deviation may be poor candidates for nasal delivery and should be considered for injection or oral spray instead

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10.1016/S0955-0674(97)80068-3 49 KellerG