If you have nasal congestion, seasonal allergies, cough, sore throat, ear congestion & pain then this is the plan for you. I’ve seen excellent results with this plan.
General Instructions: These medications are topical medications and exert little to no systemic effects.
- Because of the anatomy of the nose, you want to get the medication to the lateral (outside) wall of your nose. The best way to do this is to ensure that you spray the medication at a 45o angle up and 45o angle out – you don’t want to spray the medicine toward the middle of your nose. I generally recommend using your right hand to spray the left nostril and vice versa – this helps to achieve the proper angle.
- Lean slightly forward and take a very small sniff as you spray the medicine. If you can taste the medicine, you sniffed too hard or sprayed too flat.
Afrin: This is a topical decongestant that you can purchase over-the-counter (OTC) or may have been prescribed and available at the pharmacy. The generic is as effective as the brand name. In my experience, Neo-Synephrine, Afrin, and Oxymetazoline are all equally effective though you may find one that you prefer.
- Follow the “General Instructions” above for the proper procedure
- Use one spray in each nostril, wait about 5 minutes and then repeat. The purpose is that the nasal respiratory tissue is congested and the medication can’t get to all of the surfaces. Using 1 spray starts the decongestion so that when you spray the 2nd, after several minutes, the tissues have started to open up and the medication can then get to more of the tissues and you have a better effect.
- This medicine is extremely effective and starts to work immediately. You may use it up to twice daily for a maximum of 3 days!! It may not last a full twelve hours but don’t use it more than twice daily. You don’t have to follow a strict 12 hour schedule and you can use it at the times when you’ll benefit from the decongestion the most, such as just before going to bed.
- Take at least 3 days off before you start to use it again if needed.
- Use of this medication for more than 3 days can lead to worsening congestion that requires more and more decongestants – a condition called Rhinitis Medicamentosa. This is a difficult condition to treat.
- You may take oral decongestants in addition to this medication without interactions.
Neilmed Sinus Rinse: One of my favorites. It is available OTC at pharmacies but may also have been prescribed. It is merely a saline solution and is a “bath for your nose.” It has some good research that backs up its effectiveness and I have never had a patient tell me that they didn’t benefit from it. It may feel a little weird but is not painful. I generally recommend using the Afrin and then waiting for about 30 minutes if you are congested to help open things up before rinsing. I recommend 2-3 times per day but may be used as often as you wish.
Flonase: or other inhaled topical steroid. Most of these are now available over-the-counter. There are others on the market but this one is the most potent steroid – personal preference may dictate a different steroid. The instructions below apply to all of them.
- Follow “General Instructions” above – this should prevent one of the adverse effects of chronic use, nasal septal perforation.
- This medication is for chronic use and should not be used on an “as needed” basis because it takes 4-6 weeks to get full effect from it
- You should either wait about 30 minutes after using this to rinse your nose with the Sinus Rinse or use this after rinsing your nose.
- You may start with 2 sprays per nostril but you can probably cut down to one spray per nostril per day after a couple/few weeks.