Brief Answer: you need additional medication Detailed Answer: Hello and welcome again to health care magic, I do understand that this is very inconvenient and difficult for you when the medications become less effective. This is a common problem as in many cases the local sprays will not tackle the nose block which is due to adenoids. You can consider these: -try normal saline nasal drops which are not having any chemicals and they do not have any side effects. You can spray them in the night and this will definitely take care of the nose block -In addition I also advice my patients to use the nasal saline drops along with a locally available nebuliser which can further relieve block to an extent -In consultation with your doctor you can also consider using antihistamine and anti leukotriene medication which I routinely use for my patients -Continue steam inhalation especially in the night with a good vaporiser. -Just remember that if your child is otherwise normal and the block is not very prominent during the day then you have nothing to worry about. -If the block persists even after these measures and is all the time present and if you do feel it is very severe then you can consider surgery also but that is the last choice for less than five years Hope the above helps to certain extent and I will be more than happy to answer any more questions that you may have regards Dr Sriram XXXXXXX

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