by Carson-DeWitt R

Medications for Sinusitis

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Prescription Medications

Antibiotics
Use of Antibiotics for Sinusitis
Cases of acute sinusitis usually get better on their own, without the use of antibiotics. Your doctor may prescribe an antibiotic if you have certain symptoms. Even if you begin to feel better, take all of the drugs that your doctor has prescribed.
Beta-lactam
Common beta-lactams that may be used to treat bacterial sinusitis include:
  • Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
  • Amoxicillin-Clavulanate (Augmentin)
  • Cefotaxime (Claforan)
  • Ceftriaxone (Rocephin)
Possible side effects include:
  • Allergic reactions, such as rash, itchy skin, difficulty breathing
  • Diarrhea
  • Nausea, vomiting, stomach upset
  • Decreased effectiveness of oral contraceptives—talk with your doctor about another form of contraception while you are taking these medications
Fluoroquinolone
Common fluoroquinolones that may be used to treat bacterial sinusitis include:
  • Levofloxacin (Levaquin)
  • Moxifloxacin (Avelox)
If you are taking certain antacids or sucralfate, this may decrease the levels of antibiotic. Talk to your doctor about ways to avoid this interaction.
Possible side effects include:
  • Increased sensitivity to sunlight
  • Lightheadedness
  • Inflamed, torn tendons
  • Nausea
  • Diarrhea
  • Allergic reactions, such as rash, itchy skin, difficulty breathing
Tetracyclines
Doxycycline is a common tetracycline that can be used to treat acute bacterial sinusitis.
Always take these medications with a full glass of water. The use of tetracyclines during pregnancy, and for children 8 years of age or less, are not recommended.
Possible side effects include:
  • Stomach cramps, burning
  • Diarrhea
  • Nausea, vomiting
  • Tooth discoloration in children, including those whose mothers took tetracycline while pregnant
  • Increased sun sensitivity
  • Lightheadedness
  • Decreased effectiveness of oral contraceptives—talk with your doctor about another form of contraception while you are taking these medications
Other Prescription Medications
Nasal Corticosteroids
Common names include:
  • Beclomethasone (Beconase, Vancenase)
  • Budesonide (Rhinocort)
  • Dexamethasone (Dexacort Turbinaire)
  • Flunisolide (Nasalide, Nasarel)
  • Fluticasone (Flonase)
  • Mometasone (Nasonex)
  • Triamcinolone (Nasacort)
Nasal corticosteroids are inhaled directly into your nose through a special inhaler. These drugs may help relieve congestion by decreasing swelling in the lining of the nose. It will likely take a few days of using nasal corticosteroids before you notice an effect; they must be used daily to sustain this effect. These drugs are often used with antibiotics.
Possible side effects include:
  • Dryness of irritation of your nose, including nosebleeds
  • Stuffy nose
  • Sneezing
  • Changes in the sense of smell or taste
If any of the following occurs while you are taking a nasal corticosteroid, call your doctor:
  • Severe coughing, wheezing, or trouble breathing
  • Painful sores or white or red patches inside your mouth or nose
  • Swelling of the tongue or throat
  • Trouble swallowing
  • Continuous stinging or burning feeling in your nose

Over-the-Counter Medications

Acetaminophen
Common brand names include:
  • Tylenol
Acetaminophen can be helpful in relieving some of the pain and discomfort associated with sinusitis. It’s also safe to give to children. Do not take a larger dose than is recommended by your doctor. Do not drink alcoholic beverages while you are taking acetaminophen.
Ibuprofen
Common brand names include:
  • Motrin
  • Advil
Ibuprofen can also help relieve some of the pain associated with sinusitis. Because some people find ibuprofen to be very hard on the stomach, you should take this medication with food. Drinking alcoholic beverages while you are taking ibuprofen can increase your risk of stomach irritation.
On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately contact your doctor.
Decongestants
Decongestants have been popular choices in the past for acute sinusitis. However, certain professional medical groups such as the Infectious Disease Society of America, no longer recommend these medications. These recommendations are based the lack of evidence that they are helpful.
Talk to your doctor about medications that are safe for you.

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:
  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor first.
  • Do not share them.
  • Ask what the results and side effects may be. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

References

Acute sinusitis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated June 10, 2013. Accessed August 26, 2013.

De Sutter A, Lemiengre M, et al. Predicting prognosis and effect of antibiotic treatment in rhinosinusitis. Ann Fam Med. 2006;4:486-493.

Gosepath J, Mann WJ. Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec. 2005;67:125-136.

Pichichero ME, Brixner DI. A review of recommended antibiotic therapies with impact on outcomes in acute otitis media and acute bacterial sinusitis. Am J Manag Care. 2006;12:S292-302

Sinusitis. American Academy of Allergy Asthma and Immunology website. Available at: http://www.aaaai.org/conditions-and-treatments/allergies/sinusitis.aspx . Accessed August 26, 2013.

Sinusitis. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/Sinusitis.cfm . Accessed August 26, 2013.

Slavin RG, Spector SL, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005;116:S13-47.

Vining EM. Evolution of medical management of chronic rhinosinusitis. Ann Otol Rhinol Largngol Suppl. 2006;196:54-60.

1/10/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Williamson IG, Rumsby K, et al. Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis: a randomized controlled trial. JAMA. 2007;298:2487-2496.

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