From the Guidelines
For post-nasal drip, the most effective nasal spray is typically a corticosteroid spray like fluticasone (Flonase), as it reduces inflammation in the nasal passages and decreases mucus production, with a recommended dosage of 1-2 sprays per nostril once or twice daily, as directed 1.
Key Considerations
- Corticosteroid sprays are the most effective for post-nasal drip due to their ability to reduce inflammation and mucus production.
- Fluticasone (Flonase) is a commonly recommended option, available by prescription, with a dosage of 50 µg per spray, and can be used in adults and children over 4 years old.
- Other corticosteroid sprays like mometasone (Nasonex) and budesonide (Rhinocort) are also effective, but may have different age restrictions and dosages.
Additional Options
- Saline nasal sprays can be beneficial in moisturizing the nasal passages and thinning mucus, making it easier to clear.
- Antihistamine sprays like azelastine (Astelin) can provide immediate relief, especially if allergies are causing the post-nasal drip.
- Decongestant sprays containing oxymetazoline (Afrin) offer quick relief but should not be used for more than 3 days to avoid rebound congestion.
- Ipratropium bromide (Atrovent) can help reduce excessive nasal secretions, as shown in studies 1.
Proper Use
- Consistency is key when using corticosteroid sprays, as they may take several days to reach full effectiveness.
- Proper technique is also important: tilt your head slightly forward, aim the spray toward the outer wall of the nostril, and avoid sniffing hard after spraying to prevent the medication from going down your throat.
- It is essential to follow the recommended dosage and usage guidelines for each nasal spray to ensure safety and effectiveness, as outlined in the clinical practice guideline 1 and supported by studies such as those in the European position paper on rhinosinusitis and nasal polyps 2020 1.
From the FDA Drug Label
Astelin® Nasal Spray significantly improved a symptom complex comprised of rhinorrhea, post nasal drip, nasal congestion, and sneezing. Astelin® Nasal Spray is indicated for the treatment of the symptoms of vasomotor rhinitis, such as rhinorrhea, nasal congestion and postnasal drip in adults and children 12 years and older.
The best nasal spray for post nasal drip is Azelastine (IN), as it has been shown to significantly improve symptoms of post nasal drip in patients with vasomotor rhinitis 2 2.
- Key benefits:
- Improves symptoms of post nasal drip
- Also improves other symptoms of vasomotor rhinitis, such as rhinorrhea and nasal congestion
- Available for use in adults and children 12 years and older
- Important consideration: The efficacy of azelastine for post nasal drip has been demonstrated in clinical trials, but it is essential to consult a healthcare professional to determine the best treatment option for individual patients 2.
From the Research
Nasal Sprays for Post-Nasal Drip
- Azelastine nasal spray is a fast-acting, efficacious, and well-tolerated H1-receptor antagonist for the treatment of rhinitis, including post-nasal drip 3, 4.
- Azelastine nasal spray has a rapid onset of action and improves nasal symptoms associated with rhinitis, such as nasal congestion and post-nasal drip 3, 4.
- Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray has been shown to be effective in treating patients with seasonal allergic rhinitis, including those with post-nasal drip 5.
- MP-AzeFlu, a single formulation nasal spray of azelastine hydrochloride and fluticasone propionate, has been shown to provide significantly greater symptom relief than either azelastine or fluticasone propionate alone, with an onset starting at 30 minutes after the dose 6.
Key Benefits of Azelastine Nasal Spray
- Fast-acting and efficacious in treating post-nasal drip 3, 4.
- Well-tolerated, with a low incidence of side effects 3, 4.
- Can be used on an as-needed basis without compromising clinical efficacy 3.
- Effective in alleviating nasal congestion, a particularly bothersome symptom for rhinitis sufferers 3.
Comparison with Other Treatments
- Azelastine nasal spray has a faster onset of action and a better safety profile compared to intranasal corticosteroids 3.
- Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray is more effective than either agent alone in treating patients with seasonal allergic rhinitis 5.
- MP-AzeFlu provides greater clinical benefit than an intranasal corticosteroid in treating allergic rhinitis 6.