Resource Center

Medications

• Antibiotics
  Antibiotics may play a significant part in the treatment of sinus patients.

Cold Remedies

Decongestants and/or antihistamines are the principal ingredients in “cold” remedies, but drying agents, aspirin (or aspirin substitutes) and cough suppressants may also be added.

Choose the remedy with ingredients best suited to combat your own symptoms. If the label does not clearly state the ingredients and their functions, ask the pharmacist to explain them. Some novel treatments such as zinc, megadose vitamin C, echinacea pills, and nasal gel (Zicam®) have been introduced, but they still lack scientific proof of effectiveness.

Combination Remedies

Theoretically, if the side effects could be properly balanced, the sleepiness sometimes caused by antihistamines could be cancelled by the stimulation of decongestants .

Numerous combinations of antihistamines with decongestants are available; for example:

• Actifed®
• Allegra-D®
• Chlor-Trimeton D®
• Claritin D®
• Contac®
• Co-Pyronil 2®
• Deconamine®
• Demazin®
• Dimetapp®
• Drixoral®
• Isoclor®
• Nolamine®
• Novafed A®
• Ornade®
• Sudafed Plus®
• Tavist D®
• Triaminic®
• Trinalin®

A patient may find one product quite helpful for several months or years, but may need to switch to another one when the first loses its effectiveness. Since no one reacts exactly the same as another to the side effects of these drugs, patients may wish to try their own ideas on adjusting the dosages. You might take the antihistamine only at night and take the decongestant alone in the daytime, or take them together, increasing the dosage of antihistamine at night (while decreasing the decongestant dose) and then doing the opposite for daytime use. For example, take Chlor-Trimeton,®* 4mg, one tablet three times daily and two tablets at bedtime.

Over-the-Counter (OTC) Medications

Over-the-Counter medications are available without a prescription and can alleviate certain symptoms.

• Antihistamines
  Antihistamines are administered to alleviate “allergy” symptoms, but too much use may magnify a more underlying sinus ailment.

• Decongestants
  Decongestants cause constriction or tightening of the blood vessels in the membranes of the nose and air passages, which forces much of the blood out of the membranes so that they shrink.

Mucolytics

Mucolytics are medications designed to make the nasal secretions more watery. That is to make that thick, tenacious, or viscous mucous thinner and more serous so it drains easier. Everyone makes a liter of “snot” or nasal secretions per day, so drainage is the norm; however, it seems to be more noticeable and problematic when those secretions are thicker. Those secretions are necessary to warm, filter, and humidify the air you breathe, so we do not want to disrupt the normal functions of the nose.

Typically we place patients on the maximally tolerated dose of Guifenesin. This is the active ingredient in Mucinex and Humabid. There are some extended release formulations available; however, we generally strive to give patients 2400 mg per day of guifenesin. We prescribe this as Humabid LA or Mucinex 1200 mg PO BID or Mucinex 600 mg PO QID.

Adequate hydration cannot be overstressed. Avoiding dehydrating fluids such as soft drinks or coffee and trying to drink as much water as the person can stand can be incredibly helpful for the sinus patient. The primary limiting symptom for high dose mucolytics seems to be nausea.