The bigger concern typically comes from using non sterilized/distilled water. Overall, and with proper use and cleaning, it’s an effective and safe method of sinus cleansing.

Don’t miss a day once you start taking it. It’s not an instant relief med, but has to build in your system for about 24 hours. In my experience, for example, missing Tuesday meant a headache on Wednesday.

Zyrtec and Allegra, I believe, provide same day relief. But I still prefer Claritin myself, for various reasons.

To my knowledge, US states may use different terms for municipalities, collections of homesteads, etc. as they wish because of the 10th amendment in the US Constitution, i.e. it’s not explicitly given to the fed government to prescribe the hierarchy. But I’m no expert on this subject, so I could be mistaken.