From the Guidelines
Post nasal drip treatment should start with nasal corticosteroids, as they have been shown to be effective in reducing total symptom score in adults suffering from acute post-viral rhinosinusitis, although the effect is small 1.
Treatment Options
- Nasal corticosteroids, such as fluticasone, can be used to reduce inflammation and mucus production, but may take 1-2 weeks for full effect 1.
- Saline nasal sprays or rinses, like NeilMed Sinus Rinse or a neti pot, can be used 1-2 times daily to flush mucus and irritants from nasal passages.
- Over-the-counter antihistamines, such as loratadine (10mg daily) or cetirizine (10mg daily), can help if allergies are causing symptoms.
- Decongestants, such as pseudoephedrine, can provide temporary relief but shouldn't be used for more than 3 days to avoid rebound congestion.
Additional Measures
- Staying hydrated (at least 8 glasses of water daily) can help thin mucus, making it easier to clear.
- Using a humidifier in the bedroom can moisten dry air that irritates nasal passages.
- Elevating the head while sleeping can help prevent mucus accumulation in the back of the throat.
When to Seek Medical Attention
If symptoms persist beyond 10 days or are accompanied by fever, facial pain, or discolored discharge, it is essential to see a doctor, as a bacterial infection may be present, requiring antibiotics 1.
Underlying Cause
Identifying and addressing the underlying cause of post nasal drip, such as allergies, infections, or irritants, is crucial for effective treatment 1.
From the FDA Drug Label
These trials evaluated the patient-rated TNSS (nasal obstruction, postnasal drip, rhinorrhea) in patients treated for 28 days of doubleblind therapy and in 1 of the 3 trials for 6 months of open-label treatment Two of these trials demonstrated that patients treated with Fluticasone Propionate Nasal Spray, USP, at a dosage of 100 mcg twice daily exhibited statistically significant decreases in TNSS compared with patients treated with vehicle.
Postnasal drip treatment with Fluticasone Propionate Nasal Spray, USP, at a dosage of 100 mcg twice daily has been shown to be effective in reducing symptoms, including postnasal drip, in patients with perennial nonallergic rhinitis 2.
- The recommended dosage for adult patients is 100 mcg twice daily (one 50-mcg spray in each nostril twice daily) or 200 mcg once daily (two 50-mcg sprays in each nostril once daily).
- Pediatric patients (4 years of age and older) should be started with 100 mcg (1 spray in each nostril once daily).
From the Research
Post Nasal Drip Treatment
- The management of postnasal drip (PND) involves evaluating and addressing the underlying cause of the condition, which can be challenging due to the lack of objective testing and vague symptoms 3.
- Studies have shown that the traditional understanding of PND related to sinonasal disease may not be the primary cause of chronic cough, and that airway sensory hypersensitivity may play a role in the development of cough in PND patients 3.
- Current recommendations for the evaluation and management of PND include:
- Identifying and treating underlying conditions such as sinonasal disease
- Considering new therapies and hypotheses regarding the pathophysiology of PND
- Evaluating the patient's symptoms and medical history to develop an individualized treatment plan 3
- It is essential to note that PND is a common complaint in primary care and ear-nose-throat offices, and its symptoms can be variable, making it a challenging condition to diagnose and treat 3.