From the Guidelines
Treatment for nasal polyps typically involves a combination of medications and sometimes surgery, with the primary goal of reducing inflammation and improving symptoms, as noted in the study by 1. The initial treatment usually starts with corticosteroid nasal sprays like fluticasone (Flonase), mometasone (Nasonex), or budesonide (Rhinocort), used daily to reduce inflammation and shrink polyps.
- Key points to consider:
- For more severe cases, oral corticosteroids such as prednisone may be prescribed, typically at doses of 20-40mg daily for 5-7 days, as suggested by 1.
- Biologic medications like dupilumab (Dupixent) are newer options for patients with chronic sinusitis and nasal polyps, administered as subcutaneous injections every 2-4 weeks.
- If medications don't provide sufficient relief, endoscopic sinus surgery may be recommended to remove polyps and improve sinus drainage, as indicated by 1 and 1.
- Post-surgery management is crucial, with continued use of nasal steroids essential to prevent recurrence, and saline nasal irrigation with devices like neti pots helping to manage symptoms by clearing mucus and irritants.
- Treating underlying conditions like allergies or asthma is also important, as these can contribute to polyp formation through chronic inflammation of the nasal and sinus linings, as discussed in 1 and 1.
- Even with treatment, nasal polyps often recur, so ongoing management is typically necessary, emphasizing the need for a long-term treatment plan, as noted in 1.
From the FDA Drug Label
What if I’m having severe sinus pain If you feel severe pain in your face, have thick nasal discharge, or think you may have a sinus infection, stop using Fluticasone Propionate Nasal Spray, USP and see your doctor. Your doctor may want to consider if other medicines are needed. The treatment for nasal polyps may include Fluticasone Propionate Nasal Spray, USP as it is used to control symptoms every day, all day and all night 2.
- It is essential to use Fluticasone Propionate Nasal Spray, USP regularly, once a day, to help get lasting relief.
- If symptoms aren’t better after one week, stop use and ask your doctor, as you may have an infection.
- For severe sinus pain, stop using Fluticasone Propionate Nasal Spray, USP and see your doctor, who may consider other medicines.
From the Research
Treatment Options for Nasal Polyps
- Medical treatment is the first line of therapy for nasal polyps, with topical corticosteroids being the most effective treatment option 3, 4, 5, 6, 7
- Topical corticosteroids, such as fluticasone propionate, can reduce polyp size, improve nasal symptoms, and increase nasal inspiratory flow 3, 5, 7
- Intranasal corticosteroids are recommended for maintenance therapy, while short courses of oral corticosteroids can be used for exacerbations 4, 6
- Functional endoscopic sinus surgery can be considered for patients with symptomatic nasal polyposis who are nonresponsive to medical therapies 6
Administration and Dosage
- Fluticasone propionate nasal drops can be administered at a dose of 400 microg once or twice daily, with both doses being effective and well-tolerated 3
- Fluticasone propionate aqueous nasal spray can be administered at a dose of 200 microg twice daily, with some evidence suggesting a faster onset of action compared to beclomethasone dipropionate aqueous nasal spray 5
Special Considerations
- Care should be taken when using intranasal corticosteroids in selected populations, such as children, pregnant women, and elderly patients, especially those with comorbid conditions like asthma 4
- The use of topical corticosteroids can be safely prolonged due to their low propensity to cause systemic side-effects, making them a viable treatment option for many inflammatory diseases of the upper respiratory tract 7