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Nasal sprays come in a variety of forms. Medicated such as Astelin, Afrin and Nasonex and natural such as Sinusoothe and Sterimar. Although delivery methods vary, most nasal sprays function by instilling a fine mist into the nostril by action of a hand-operated pump mechanism. Excessive histamine function is the primary cause of allergic reactions in people. Histamine is a chemical naturally produced by the body which creates an inflammatory effect to help the immune system remove foreign substances. Antihistamines work by competing for receptor sites to block the function of histamine, thereby reducing the inflammatory effect. Astelin (azelastin hydrocholoride) and Patanase (olopatadine hydrochloride) are the only local antihistamines available as a nasal spray. They are available by prescription only and have gained popularity with sufferers of allergic rhinitis. Oxymetazoline hydrochloride decongestant nasal sprays such as Afrin and Vicks Sinex, along with phenylephrine hydrochloride nasal sprays such as Neo Synephrine and Dristan, which are available over-the-counter in the United States and the UK, work to very quickly open up nasal passages by constricting blood vessels in the lining of the nose.