What are the treatment options for post nasal drip?

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From the Guidelines

Treatment options for post nasal drip include both over-the-counter and prescription medications, as well as home remedies, with the most recent and highest quality study 1 recommending against the use of antibiotics for adults with acute post-viral rhinosinusitis and suggesting nasal corticosteroids only when reduction of symptoms is considered necessary. For mild cases, start with saline nasal sprays or rinses like NeilMed Sinus Rinse or a neti pot to flush out mucus and irritants. Some key points to consider:

  • Over-the-counter antihistamines such as loratadine (Claritin) 10mg daily or cetirizine (Zyrtec) 10mg daily can help if allergies are causing your symptoms 1.
  • Decongestants like pseudoephedrine (Sudafed) 30-60mg every 4-6 hours (not exceeding 240mg daily) can temporarily reduce congestion, but shouldn't be used for more than 3-5 days to avoid rebound congestion 1.
  • For persistent symptoms, prescription nasal corticosteroids like fluticasone (Flonase) or mometasone (Nasonex), typically 1-2 sprays per nostril daily, reduce inflammation and mucus production 1.
  • Lifestyle modifications are also important: stay hydrated with 6-8 glasses of water daily, use a humidifier to moisten air, elevate your head while sleeping, and avoid known triggers like cigarette smoke or strong fragrances 1. These treatments work by either thinning mucus, reducing inflammation in the nasal passages, or addressing underlying causes like allergies or infections that lead to excessive mucus production. It's also worth noting that the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 1 provides evidence-based recommendations for the treatment of acute post-viral rhinosinusitis, including the use of nasal corticosteroids and saline irrigation. Overall, the best approach will depend on the individual patient's symptoms and medical history, and it's always best to consult with a healthcare professional for personalized advice.

From the FDA Drug Label

The 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.

The treatment options for post nasal drip include the use of Fluticasone Propionate Nasal Spray, USP, at a dosage of 100 mcg twice daily. This has been shown to exhibit statistically significant decreases in TNSS (nasal obstruction, postnasal drip, rhinorrhea) compared with patients treated with vehicle 2.

  • Key points:
    • Dosage: 100 mcg twice daily
    • Medication: Fluticasone Propionate Nasal Spray, USP
    • Efficacy: Statistically significant decreases in TNSS compared with vehicle

From the Research

Treatment Options for Post Nasal Drip

  • The treatment of post nasal drip often involves addressing the underlying cause, such as allergic rhinitis.
  • For allergic rhinitis, studies have shown that combination therapy with corticosteroid nasal spray and antihistamine (oral or local spray) can be effective in managing symptoms 3.
  • Specifically, the combination of intranasal corticosteroid and intranasal antihistamine has been shown to be superior to solo intranasal corticosteroid, solo intranasal antihistamine, and placebo in improving total nasal symptom scores 3.
  • Another study found that the combination of azelastine hydrochloride nasal spray and fluticasone propionate nasal spray was more effective than either agent alone in reducing nasal symptoms in patients with seasonal allergic rhinitis 4.
  • The use of antihistamines, either oral or nasal spray, can help alleviate symptoms of post nasal drip, especially in cases of allergic rhinitis 3, 4.
  • Corticosteroid nasal sprays can also be used to reduce inflammation and swelling in the nasal passages, which can contribute to post nasal drip 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Concomitant corticosteroid nasal spray plus antihistamine (oral or local spray) for the symptomatic management of allergic rhinitis.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2016

Research

Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis.

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2008

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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