What over the counter medicine is best for sinus infection

Topic Overview

Medicines available without a prescription may help relieve pain and promote sinus drainage. Be safe with medicines. Read and follow all instructions on the label. You can:

• Try a pain reliever such as acetaminophen or ibuprofen to relieve facial pain and headache.
• Use a decongestant nasal spray, gel, or drops (such as Claritin Allergy or Drixoral) to help a stuffy nose. Don't use a nasal decongestant longer than the label says. Overuse can cause rebound congestion. It makes your mucous membranes swell up more than before you used the spray.
• Try an oral decongestant for a stuffy nose or head. It provides longer relief than the ones that are used in the nose, but it may cause more side effects.
• Try using a medicine that thins mucus and improves sinus drainage (mucolytic). Guaifenesin is a commonly used mucolytic. Mucolytics are often combined with other medicines such as cough suppressants.
• Acetaminophen can be found in many forms and comes in different doses. Be safe with medicines.
• Read and follow all instructions on the label.
• Do not take more than the maximum dose recommended on the label.
• Be careful when taking over-the-counter cold or flu medicines and acetaminophen (Tylenol) at the same time. Many of these medicines already contain acetaminophen. Too much acetaminophen can be harmful.

Be careful with cough and cold medicines. They may not be safe for young children or for people who have certain health problems, so check the label first. Do not give cough and cold medicines to a child younger than 6 unless your child's doctor has told you to. If you do use these medicines, always follow the directions about how much to use based on age and weight.

Be careful when taking over-the-counter cold or flu medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not taking more than the recommended dose. Too much acetaminophen can be harmful.

Many doctors do not recommend using antihistamines unless your symptoms are related to having allergies. Antihistamines and decongestants may dry out the mucous membranes in your nose and sinuses and slow the movement of the cilia (the tiny hairs that line the nose, sinuses, and the air passages inside the lungs and that remove irritants). This can make mucus thicker, adding to drainage problems. But other experts believe antihistamines may help treat sinusitis by reducing the amount of mucus that builds up in the sinus cavities. Don't give antihistamines to your child unless you've checked with the doctor first.

Credits

Current as of: September 8, 2021

Author: Healthwise Staff
Medical Review:
Patrice Burgess MD - Family Medicine
Anne C. Poinier MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
Donald R. Mintz MD - Otolaryngology
Martin J. Gabica MD - Family Medicine

If you've ever had a sinus infection, you know all about sinus pressure's aching, throbbing, stabbing pain.

Unfortunately, sinus infections aren't the only reason behind nagging sinus pressure—allergies, environmental changes, and even anatomical differences can leave you feeling pain and pressure, Christopher Thompson, MD, an ear, nose, and throat (ENT) specialist at Providence Mission Hospital in Mission Viejo, Calif., told Health.

Regardless of what's causing your sinus pressure and pain, one thing's for sure: You want it gone. Here's what you need to know about what causes sinus pressure and seven ways to relieve aches and pains.

Pressure in your sinuses is essentially swelling in response to any of three different causes: A pressure change between the air inside your sinuses and the air outside your sinuses (for example, when flying); when irritants invade your sinuses (through allergies or illnesses); or when you have an anatomical issue (like a deviated septum or nasal polyps).

Unfortunately, you can't cater your sinus pressure treatment to the exact cause. Still, the good news is that most available remedies can work to reduce sinus inflammation and swelling regardless of what's causing it.

Here's a guide, according to experts, on the best ways to treat sinus pressure so you can start feeling better as soon as possible.

Steam

Steam—whether from a humidifier or a hot shower—can provide some symptomatic comfort, but isn't a long-term solution, Mas Takashima, MD, chair of Houston Methodist ENT Specialists, told Health.

"Certain areas are moist anyway, and you can cause an overgrowth of mold [which can worsen allergies or swelling]," added Dr. Takashima. But, for people who feel dry air or excessively dry sinuses are contributing to their suffering, steam can be helpful.

Nasal Irrigation

Dr. Takashima described your nose as an air filter for your lungs. It filters out particulates, like allergens and irritants. If you are allergic to the particulates trapped in your nose, it will always feel irritated (swollen, congested, and uncomfortable).

Nasal irrigation is a quick way to rinse out those irritants and feel some relief. However, some formulas can provide more lasting effects. There are three main methods, according to Dr. Takashima:

• Saline irrigation: Saline irrigation works excellently as a short-term solution for all sinus problems. It flushes out your nose to eliminate any irritants stuck there. It can also clear nasal blockages of mucus and thin out mucus overall to make breathing much more manageable.
• Steroid irrigation: Mixing saline with a steroid (often budesonide) to get deep into your sinuses allows the steroid to get to the root of the problem and reduce swelling in harder-to-reach sinus cavities. Steroid sprays are the best medication to treat allergies, so steroid irrigation should work well for seasonal allergy sufferers.
• Xylitol irrigation: Using the sugar alcohol xylitol, which has both antibacterial and antiviral effects, xylitol irrigation flushes out sinuses. It draws water out of nasal tissues, so it decongests better than saline irrigation. Xylitol is beneficial in helping to ward off respiratory illnesses and infections generally. Hence, it's a good irrigation approach for people with chronic sinus issues.

Staying Hydrated

You already know you should be drinking more water, but there's an additional reason why when it comes to your sinuses. 

"The way the nose protects the body is by recognizing irritating things trapped there," explained Dr. Takashima. "The brain then sends a signal to your body [to] get rid of it, and your body produces mucus to clear out the foreign irritant."

If you are dehydrated, your mucus will be too thick to help clear out irritants. Instead, mucus will become clogged in your sinuses, causing congestion, pressure, and possibly infection from bacterial growth. So hydrate, hydrate, hydrate.

Decongestants

While decongestant tablets or nasal sprays can effectively reduce sinus pressure and pain, it's important to remember that these are short-term solutions.

"In an acute infection, a decongestant can be useful. But Afrin [oxymetazoline] can become addicting if used for more than a few days, and oral decongestants used regularly can have cardiovascular effects," explained Dr. Thompson. "These are targeted for short-term use."

Also, patients with hypertension shouldn't use over-the-counter (OTC) decongestant products, which can increase blood pressure. And people who are sensitive to stimulants, like caffeine, might have trouble sleeping when using them, added Dr. Takashima.

NSAIDs

Suppose your sinus pressure is causing you severe discomfort. In that case, you can try taking an OTC nonsteroidal anti-inflammatory drug (NSAID) for pressure and pain relief. 

NSAIDs, like Aleve (naproxen) or Advil and Motrin (ibuprofen), typically work better than Tylenol (acetaminophen), said Dr. Takashima. That's because NSAIDs are designed to reduce swelling and inflammation. And Tylenol might numb the pain, but it won't actually help with the cause of the pain.

Nasal Steroids

For allergy sufferers, Dr. Takashima strongly recommended nasal steroids for people with allergy-related sinus pressure. If you are not already using an OTC spray (like Flonase, Nasonex, or Nasacort), you might consider trying one.

"The only thing to keep in mind is that these don't work well if you only use them occasionally," clarified Dr. Takashima. "You need to use it on a consistent basis."

Dr. Takashima recommended that allergy sufferers figure out when their allergies are nasty (during October, for example). Then, pre-medicate before symptoms appear and continue to use a nasal steroid throughout the season to avoid symptoms.

Sinus Surgery

The word "surgery" is daunting. But if you have chronic or recurrent sinusitis, you may consider seeing an ear, nose, and throat specialist to discuss the possible benefits of sinus surgery.

Chronic sinusitis is defined as having sinus symptoms for more than three months. And recurrent sinusitis is defined as greater than four sinusitis episodes in one year.

"Surgery can be helpful in opening up the sinuses to allow better drainage," explained Dr. Thompson. "You can use as much saline as you want, but if you need surgery and you're using saline, you're only flushing out your nose, not your sinuses."

Research has found that success rates of endoscopic sinus surgery (ESS) range from 76% to 97.5%.

Dr. Thompson noted that facial pain, including pain in your sinuses, can also be related to migraines, neck tension, or bruxism (teeth grinding). 

So, if you're having zero luck remedying pain with traditional sinus treatments, you should talk with your healthcare provider. You may suffer from a condition unrelated to sinus pressure or congestion.

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