What are the treatment options for postnasal drip (PND)?

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Last updated: March 17, 2025View editorial policy

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From the Guidelines

Postnasal drip can be effectively managed with nasal corticosteroids, as they have been shown to reduce total symptom score in adults suffering from acute post-viral rhinosinusitis, although the effect is small 1.

Treatment Options

The treatment of postnasal drip (PND) depends on its underlying cause. Based on the most recent and highest quality study, the following options can be considered:

  • Nasal corticosteroids: Nasal corticosteroids are effective in reducing total symptom score in adults suffering from acute post-viral rhinosinusitis 1.
  • Nasal irrigation with saline: Although the evidence is limited, nasal saline irrigation can be expected to be beneficial rather than harmful 1.
  • Herbal medicine: Some herbal medicines like BNO1016 tablets and Pelargonium sidoides drops and Myrtol (and other essential oil) capsules have significant impact on symptoms of acute postviral rhinosinusitis without significant adverse events 1.

Lifestyle Changes

In addition to these treatment options, lifestyle changes can also play an important role in managing PND:

  • Staying hydrated with 6-8 glasses of water daily
  • Using a humidifier in dry environments
  • Avoiding known allergens
  • Elevating the head while sleeping

When to Consult a Healthcare Provider

If symptoms persist beyond 10 days or are accompanied by fever or facial pain, it is essential to consult a healthcare provider as you may need prescription medications or further evaluation 1.

Note: The use of antibiotics, systemic corticosteroids, and homeopathy is not recommended for the treatment of postnasal drip due to the lack of evidence or potential harm 1.

From the FDA Drug Label

Uses • temporarily relieves sinus congestion and pressure • temporarily relieves nasal congestion due to the common cold, hay fever or other upper respiratory allergies

The treatment options for postnasal drip (PND) may include:

  • Nasal sprays, such as fluticasone propionate, to control symptoms every day, all day and all night 2
  • Oral decongestants, such as pseudoephedrine, to temporarily relieve sinus congestion and pressure, and nasal congestion due to the common cold, hay fever or other upper respiratory allergies 3

From the Research

Treatment Options for Postnasal Drip (PND)

  • Medical treatment is generally the first line of approach for managing PND, as stated in 4.
  • Empiric treatment for PND symptoms should be guided by associated symptoms that suggest either a sinonasal cause or gastroesophageal reflux, according to 5.
  • Treatment can include flushing the nasal cavity by herbal liquid, using glucocorticoid locally, taking medicine of improving the sticky film cilium function, immunotherapeutic or operation, as mentioned in 6.
  • Azelastine nasal spray has been shown to be effective in improving nasal symptoms associated with rhinitis, including post-nasal drip, as reported in 7.
  • In some cases, surgical treatment may be required, as noted in 4.
  • The choice of treatment depends on the underlying cause of PND, which can be complicated and include chronic rhinitis, chronic sinusitis or nasal polyp, allergic rhinitis, adenoid vegetation, or chronic nasopharyngitis, as identified in 6.
  • A total cure rate of 82% was achieved after 6 months of follow-up when patients were treated accordingly for their specific causes of PND, as stated in 6.
  • New therapies and hypotheses regarding the pathophysiology of PND are being discussed, including the possibility of airway sensory hypersensitivity rather than actual irritation from inflamed nasal secretions, as mentioned in 8.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The management of postnasal drip.

Australian family physician, 1999

Research

The patient with "postnasal drip".

The Medical clinics of North America, 2010

Research

[Analysis the causes and treatment of postnasal drip syndrome].

Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery, 2008

Research

Postnasal drip and postnasal drip-related cough.

Current opinion in otolaryngology & head and neck surgery, 2016

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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