What is the treatment for clear sinus drainage?

From the Guidelines

Treatment for clear sinus drainage typically involves a combination of over-the-counter medications and home remedies, with a focus on symptomatic relief and management of underlying causes, as clear secretions are often associated with viral upper respiratory infections or allergies, rather than bacterial infections 1. The approach to managing clear sinus drainage should prioritize measures that reduce inflammation, thin mucus, and remove irritants.

• Antihistamines like loratadine (Claritin) 10mg daily or cetirizine (Zyrtec) 10mg daily can help reduce drainage if allergies are the cause.
• Decongestants such as pseudoephedrine (Sudafed) 30-60mg every 4-6 hours (not exceeding 240mg daily) can temporarily reduce drainage by shrinking swollen nasal tissues, but should not be used for more than 3-5 days to avoid rebound congestion.
• Nasal saline rinses using a neti pot or squeeze bottle with sterile saline solution once or twice daily can flush out irritants and thin mucus, as recommended for chronic rhinosinusitis (CRS) symptom relief 1.
• Staying hydrated by drinking 8-10 glasses of water daily helps thin secretions.
• Using a humidifier in your bedroom can moisten dry air that may irritate nasal passages.
• Elevating your head while sleeping with an extra pillow can prevent mucus from pooling in your sinuses. It's essential to note that if symptoms persist beyond 10 days or are accompanied by fever, severe headache, or facial pain, medical attention should be sought, as this could indicate a bacterial infection requiring antibiotics, following the guidelines for acute bacterial rhinosinusitis (ABRS) diagnosis and management 1.

From the FDA Drug Label

CLINICAL TRIALS A total of 13 randomized, double-blind, parallel-group, multicenter, vehicle placebo-controlled clinical trials were conducted in the United States in adults and pediatric patients (4 years of age and older) to investigate regular use of Fluticasone Propionate Nasal Spray, USP, in patients with seasonal or perennial allergic rhinitis The trials included 2,633 adults (1,439 men and 1,194 women) with a mean age of 37 (range, 18 to 79 years). Three randomized, double-blind, parallel- group, vehicle placebo-controlled trials were conducted in 1,191 patients to investigate regular use of Fluticasone Propionate Nasal Spray, USP, in patients with perennial nonallergic rhinitis 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

The treatment for clear sinus drainage may include the use of Fluticasone Propionate Nasal Spray, USP.

• The recommended dosage is 100-200 mcg per day, administered as 1-2 sprays in each nostril once daily.
• Patients should use the spray at regular intervals for optimal effect, and the dosage may be decreased to 100 mcg once daily after adequate control is achieved.
• It is essential to follow the instructions provided by the doctor or pharmacist and to use the spray as directed to achieve the best results. 2

From the Research

Treatment for Clear Sinus Drainage

• The treatment for clear sinus drainage often involves the use of saline nasal irrigation, which has been shown to be effective in reducing symptoms of acute and chronic rhinosinusitis 3, 4, 5, 6, 7.
• Saline nasal irrigation can be performed using various devices, such as nasal douches, neti pots, or sprays, and can be used with either isotonic or hypertonic saline solutions 3, 4.
• Hypertonic saline solutions have been shown to be more effective than isotonic solutions in some studies, particularly in the treatment of chronic sinusitis 6.
• The use of saline nasal irrigation has been recommended by large medical associations and has been shown to be a useful addition to the treatment of chronic rhinosinusitis symptoms 3.
• In addition to saline nasal irrigation, other treatments such as intranasal corticosteroids or oral antihistamines may be used to treat allergic rhinitis, which can cause clear sinus drainage 7.
• It is essential to clean the nasal douche thoroughly and use the proper salt concentration (2-3.5%) to prevent infections 3.
• Patient education regarding precautions and disinfection of the device is crucial to ensure safe and effective use of saline nasal irrigation 4.

Types of Saline Solutions

• Isotonic saline solutions have the same concentration of salt as human tears and are often used for nasal irrigation 3, 4.
• Hypertonic saline solutions have a higher concentration of salt than human tears and have been shown to be more effective in some studies 6.
• The choice of saline solution and device used for nasal irrigation may depend on individual preferences and needs, as well as the specific condition being treated 3, 4, 7.

Safety and Efficacy

• Saline nasal irrigation has been shown to be safe and effective in reducing symptoms of acute and chronic rhinosinusitis, as well as allergic rhinitis 3, 4, 5, 6, 7.
• Minor side effects such as nasal discomfort or irritation may occur, but are generally rare and temporary 5, 7.
• The use of saline nasal irrigation has been recommended as a cheap, safe, and acceptable alternative to other treatments such as intranasal steroids and antihistamines 7.