Migraineurs may need to watch their use of steroid nasal sprays—turns out these prescription sprays may trigger or worsen migraine attacks in some people. The sprays are used to treat the stuffy nose and post-nasal drip caused by allergic rhinitis. A recent review of the World Health Organization’s global database found 38 cases in which migraine was suspected to be related to their use.

The steroid sprays include fluticasone, beclomethasone, budesonide, mometasone, flunisolide and triamcinolone. For most patients, these were the only drugs used prior to getting a migraine. Nasal steroid sprays are typically taken daily over a period of weeks to months. In three-fourths of the cases in which the time of onset of migraine was recorded, migraine attacks began within the first four days of treatment.

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