Ease out of nasal spray habit

Q. I have been using a nasal spray like Afrin for at least six years. I cannot break this cycle of congestion. If I don’t use the spray, I can’t sleep and can’t eat. Sometimes it’s even difficult to have a conversation because I am so stopped up.

My doctor prescribed a steroid nasal spray, but it wasn’t enough. If you have any helpful suggestions for breaking my addiction, I would be grateful.

A. Others who have gone through a similar predicament have come up with some creative suggestions that might be worth trying. Here’s one:

Buy two bottles of nasal spray. Use one full-strength in one nostril. In the other nostril use a progressively diluted spray. Begin by adding a small amount of saline solution (Ayr Saline, Breathe Free or Ocean) and gradually increase the proportion of salt water to nasal spray. When you are using pure saline in that nostril, you can begin to follow the same process for the other one. This allows for a gentle withdrawal that should not interfere with your sleep or your conversation. Keep using the steroid spray your doctor prescribed to ease the discomfort until you have kicked your habit.

Q. My Medicare Part D plan does not have Prevacid in its formulary. I cannot take Prilosec or similar drugs. Is there another alternative for acid reflux?

A. In theory, all acid suppressors in this class (Aciphex, Nexium, Prevacid, Prilosec, Protonix) are supposed to be interchangeable. In reality, some people do better on one medicine than another. Ask your doctor to help you petition the insurance company for an exception.

If you are not successful, ask your doctor whether Pepcid or Zantac would work in higher doses than you can purchase over the counter. These drugs were the standard treatment for acid reflux before Prilosec (omeprazole) was developed.