14 best remedies for maxillary sinusitis

Advantages and disadvantages

Fluticasone is one of the mildest and most effective hormonal drugs, it does not cause symptoms of overdose if clinical recommendations are followed. However, there may be interaction effects with other drugs taken at the same time, especially with antifungal agents and drugs for the treatment of HIV infection. Therefore, when first prescribing this medication, if the patient is taking similar drugs, it is mandatory to consult a physician. This medication can be used without clinical monitoring for no more than a week, but if it is prescribed for a longer period, adrenal function should be checked regularly.

Beclomethasone (Nasobec)

Rating: 4.8

The active ingredient of this hormonal spray for treating maxillary sinusitis is the potent corticosteroid beclomethasone. This medicine is a white, odorless suspension and has a pronounced anti-edematous, anti-allergic and anti-inflammatory effect in the nasal cavity and the mouths of the maxillary sinus outlet ducts.

Beclometasone’s mechanism of action is standard for glucocorticosteroid hormones. In addition to acute and chronic maxillary sinusitis, the drug is indicated for the treatment of vasomotor allergic rhinitis, including with seasonal exacerbations due to pollinosis. The drug is used intranasally, in adults – one dose of 50 mcg, but no more than 4 times a day in each nostril, with a subsequent reduction in the dose when you feel normal. Nasobek is produced by Czech pharmaceutical company Teva, and is quite inexpensive: 200 doses in a bottle of spray can be purchased for 151 rubles (about $56 USD). Thus, with a maximum daily dose of 400 micrograms this vial is enough for 25 days, or a month of continuous treatment.

Advantages and disadvantages

Unlike other hormonal drugs and vasoconstrictor drops, the relief from the administration of Nasobek does not appear immediately, but it accumulates and becomes visible after a few days, but after the end of the drug it is also valid for several days. If the dosage is observed, then the side effect is almost non-existent, sometimes there is a slight irritation of a feeling of dryness in the nose. If the drug is taken in a dosage four times higher than the maximum recommended, only then do systemic effects begin to appear, fraught with adrenal insufficiency. This medication can be used in pregnant women if very necessary, although it is not recommended for standard considerations – avoid any prescription for pregnant women other than vital.

Overall, Nasobec is a reliable medication that can reduce the symptoms of exacerbations in chronic maxillary sinusitis, and improve the quality of life in the case of an acute process in the sinuses.

Mometasone (Nasonex, Nosefrine)

Rating: 4.8

The third representative of intranasal glucocorticosteroid hormones for symptomatic and pathogenetic treatment of acute and chronic maxillary sinusitis is represented by Nazonex, with the active substance mometazon (mometasone furoate). The mechanism of action of mometasone, is standard for all corticosteroids. It reduces the release of histamine and arachidonic acid metabolites, decreases migration of neutrophils and macrophages to the inflammation focus, reduces allergic symptoms by blocking the release of histamine and other mediators.

Nazonex is indicated for the treatment of exacerbations of chronic maxillary sinusitis, and it should be used in complex therapy with antibacterial drugs. Also Nazoneks is well able to cope with the symptoms of allergic rhinitis, and especially seasonal, caused by pollinosis. Nazonex can also be used for prevention, for example, at the beginning of flowering of grasses. Nasonex is administered to adults according to the standard scheme: two doses in each nostril, containing 50 mcg, twice a day. As with other intranasal hormonal sprays, the daily dosage should not exceed 400 mcg. Produces Nazonex well-known pharmaceutical company Schering-Plough (UK). A bottle containing 60 doses can be purchased in major Russian cities at retail prices starting at 386 rubles.

Advantages and disadvantages

The advantages of Nazonex include extremely low absorption into the blood, and the complete absence of systemic effects. Therefore, there is not even a description of the pharmacokinetics, that is, the path of the active substance in the blood, in the official instructions. Even in the event that some amount of this drug is swallowed orally, very little mometasone will be absorbed into the bloodstream from the gastrointestinal tract. That is why you should not be afraid to swallow an excess of the drug that accidentally gets into your throat after being injected into your nose. Despite its high safety, it is still not recommended for use in pregnant and lactating women due to general contraindications. Mometasone may have side effects, but only local. It is a burning sensation in the nose, occasional irritation, and occasionally a mild form of nasal bleeding may occur. They always stop on their own, and occurred in 1 in 20 patients.

Antibacterials

Perhaps the fastest way to recovery and reduction of all symptoms of acute maxillary sinusitis and exacerbation of chronic process is the direct injection of antibiotic solutions into the cavity of the maxillary sinus during puncture and lavage. But it is not always possible for the patient to get to a doctor right away, and it is not always possible to perform this minimally invasive surgical intervention.

Clinical practice shows that almost all patients start taking antibacterial drugs on their own, and just to avoid surgical intervention. In this section we will not consider modern and powerful antibiotics that are administered intramuscularly or intravenously, that is, parenterally. Consider their main representatives, which are used to treat ENT diseases. Currently, there are a number of antibacterial agents with high effect, which are applied topically, and applied to the mucous membrane of the nasal cavity.

Framicetin (Isofra)

Rating: 4.9

Isofra is the commercial name of a highly effective antibiotic – an aminoglycoside (Framicetin). Framicetin acts as a highly soluble sulfate, and is commercially available as an intranasal spray. In addition to bactericidal action, the drug also has a bacteriostatic effect, that is, it not only prevents the reproduction of various pathogens, but also contributes to their destruction. When a sufficient concentration of the drug accumulates on the surface of the nasopharynx, bacteriostatic activity is first manifested, and then the destruction of pathogens. It affects the most common pathogens of ENT – infections and upper respiratory tract.

Isofra is given by one dose daily, one injection per day, into the right and left nasal passages, 4-6 times a day, reduced to 3 injections per day in children. Maximum use of Isofra without specialist’s advice – not more than one week. This drug is produced by “Laboratorio Bouchard Ricordati”, France. The cost of one spray bottle (15 ml) is 255 rubles.

Advantages and disadvantages

The advantages of Isofra include a wide range of antibacterial activity, relatively infrequent intra-day use, and rare side effects in the form of mild skin allergic reactions. The only unpleasant fact that accompanies long-term use of the drug is the destruction of the natural biocenosis and the appearance of upper respiratory tract dysbacteriosis. Also, a long reception can contribute to the emergence of drug resistance in microorganisms, so the ideal duration of the course of treatment is from 5 to 7 days.

Polidexa

Rating: 4.8

Polydexa is a highly effective antibacterial medication for alternative therapeutic regimens when, for example, bacteriological cultures of the maxillary sinus void and nasal cavity wipes show resistant strains to framycetin. In this case, the drug Polidexa, which contains as many as two antibiotics – polymyxin B and neomycin – is indicated. This combination greatly extends the range of antibacterial action to microorganisms that cause inflammation of the maxillary sinuses and structures of the external and middle ear. Polidexa also contains dexamethasone, which suppresses the accompanying inflammation and reduces the symptoms of pain and swelling.

In order to avoid confusion, it should be mentioned that there are two forms of the drug: the drug, which is buried in the ears in otitis media, and nasal drops Polidex with phenylephrine, which, in addition to antibacterial and anti-inflammatory effect, cause symptomatic relief of breathing due to vasoconstriction and alpha-adrenomimetic action.

Polidex should be injected into the nose of adults from 3 to 5 times, injected into each nasal passage. For children under the age of 15 the number of injections daily should not exceed three doses. The average course of treatment with the drug lasts from 7 to 10 days. A bottle of Polydex with phenylephrine in a volume of 15 ml can be purchased for 270 rubles., This preparation is also produced by the French company “Laboratoire Bouchard Ricordati”.

Advantages and disadvantages

Polydexa is a multicomponent drug that acts immediately and powerfully on inflammation, on various strains of microorganisms that cause maxillary sinusitis, including those resistant to monocomponent antibacterial drugs, as well as vasoconstrictor – phenylephrine. This allows the drug to quickly cope with uncomplicated maxillary sinusitis in the first days of the appearance of unpleasant symptoms.

Contraindications include age under 2.5 years, severe heart and kidney disease, hypertension. Also, the drug can cause allergic reactions, which will be expressed by burning and unpleasant sensations on the nasal mucosa. The drug should be used for several days, but no more than 10 days without the approval of the attending physician.

Miramistin

Rating: 4.8

A certain pride is caused by the fact that such a highly effective antiseptic drug was developed in the Russian Federation. We will not name the chemical name of the drug here, it is very complicated. Suffice it to say that the active antiseptic substance refers to ammonium compounds.

Miramistin is successfully used for all forms of inflammatory lesions of the nasopharynx and oropharynx, including chronic and acute maxillary sinusitis. In addition to nasal irrigation and nasopharyngeal and oral cavity lavage as a disinfectant, Miramistin is also indicated as a first-line agent for drainage and irrigation of maxillary sinuses. This medicine is highly effective against various types of pathogenic microorganisms, both Gram-positive and Gram-negative. Miramistin destroys protozoa, viruses and fungal infections.

It is necessary to use Miramistin to irrigate the nasal passages and to gargle the throat in case of maxillary sinusitis three times a day. Buy Miramistin can be in bottles in the form of a spray, on sale there are bottles from 50 to 500 ml in volume. The average cost of a 150 ml spray bottle is 270 rubles. Produces Miramistin domestic scientific enterprise Infomed K.

Advantages and disadvantages

Miramistine does not irritate the mucosa in the mouth and nasal passages. It is a slightly foaming liquid that has neither taste nor smell. Miramistin is not able to cause allergies in most cases, except for rare individual intolerance. Miramistin has no systemic action, it is not absorbed through the skin and mucous membranes, and acts only where it is applied. There are virtually no contraindications to the prescription of Miramistin, and it is used to treat acute and chronic maxillary sinusitis almost without restrictions. In terms of the ratio of antimicrobial effect and safety profile – this remedy is one of the most advantageous to purchase and for treatment in this ranking. At the same time, the cost of Miramistin is more than democratic.

Mucolytics

Consider another very important group of drugs that must be taken into account, especially in chronic maxillary sinusitis, when the secret inside the maxillary sinus becomes thick, viscous, and ceases to excrete itself into the nasal cavity. In order to improve the rheological properties of this secretion, to increase its fluidity, and to break down too long mucin molecules into shorter fragments, mucolytic drugs are used. Usually they are prescribed for various forms of bronchitis and pulmonary pathology, but they are also used for the therapy of maxillary sinusitis, when you need to restore the drainage function and improve the removal of mucus. Let’s consider the most popular and effective drugs that are widely used in domestic and world practice.

Sinuforte

Rating: 4.9

Perhaps Sinuforte is the most amazing drug that is presented among the remedies for the treatment of maxillary sinusitis. Its high efficacy is based on the ability of the famous and beautiful cyclamen flower, or rather its tubers, to cause abundant mucus secretion into the nasal cavity from all sinuses of the facial skull. This excessive secretion of mucus is called hypersecretion, and in this case the mucus becomes very liquefied. Its viscosity becomes very low, and the mucus begins to move on its own through the exit channels from the cavity of the sinuses into the nasopharynx. It does not have any selective action only on the maxillary sinuses. Active outflow from all sinuses begins and drainage function normalizes. By the way the preparation increases capillary blood supply of the mucous membrane of the sinuses, i.e. microcirculation. The remedy acts quickly, in a few minutes it begins to show its effect, which lasts for up to two hours. This drug is indicated for all types of sinusitis, both acute and chronic. In addition to maxillary sinusitis, it is used to treat ethmoiditis, frontitis and other similar diseases.

Sinuforte is used by inserting the sprayer – dispenser into each nasal passage and spraying 2-3 drops of the product. Medication for maxillary sinusitis should be used once a day, daily or every other day. With daily use, the average duration of treatment should not exceed 1 week, and if Sinuforte is injected every other day, the duration of the course can be doubled to two weeks. Produced by the Spanish pharmaceutical company Pharma Mediterranea and Invar. Sinuforte is a rather expensive drug. The bottle costs 1820 rubles. and higher. The dried, lyophilized concentrate is diluted into 5 ml of liquid. Each milliliter contains 10 drops, respectively, with the daily use of two drops, one package is enough for 25 days of treatment, or two full courses.

Advantages and disadvantages

A great advantage of Sinuforte is its unique effect on the ability of the sinuses to synthesize a large amount of mucus, which is a cleansing procedure, and may well in uncomplicated cases replace the puncture of the maxillary sinus. But the drug Sinuforte has contraindications.

For example, in the presence of cysts or polyps in the maxillary sinuses, if there is a blockage or obstruction of the outlet ducts by tissue, then the excess secretion will not be able to find its way out. This may lead to a serious deterioration: the appearance of persistent headaches, a feeling of tumescence in the face, increased blood pressure, and other unpleasant symptoms.

The first aid will be an urgent bilateral puncture of the maxillary sinuses to remove the secretion. Therefore, before independently and for the first time to apply this expensive and highly effective remedy, you need to be sure that the path for the formed secretion into the nasal cavity has no obstacles. And this can only be identified by an ENT doctor. Therefore, the conclusion is this: before spending almost 2,000 rubles. on Sinuforte, a full consultation with a doctor is necessary.

Libexin Muco (Carbocysteine)

Rating: 4.8

Carbocysteine is a modified molecule of acetylcysteine. Its task is to liquefy and break down the glycoproteins of the mucus inside the maxillary sinuses. Of course, it is mainly used for bronchitis, but when taken internally, carbocysteine is able to affect all secreted mucus that is produced in the body. Carbocysteine activates the enzyme sialic acid transferase. This causes normalization of the acid-base composition of mucus, which leads to its liquefaction. It is very important that carbocysteine promotes the entry into the cavity of the maxillary sinuses of secretory immunoglobulins A, which have a protective function.

It is necessary to take this drug in persistent chronic sinusitis, when the drainage of mucus and discharge into the nasal cavity is impaired. Libexin Muko is available in syrup form, and an adult patient needs to take it three tablespoons three times a day. Libexin Muco is produced by French pharmaceutical company Sanofi, and a bottle of 125 ml costs from 400 rubles. and above.

Advantages and disadvantages

The main advantage of carbocysteine is the high degree of liquefaction of the secretion not only in maxillary sinusitis, but also in other sinusitis cases: ethmoiditis, frontitis, when the labyrinthine labyrinth is affected. This drug has contraindications for use, for example, in patients with an exacerbation of gastric and duodenal ulcer disease, in the presence of acute cystitis, and lesions of the glomerular kidney apparatus – in glomerulonephritis. It is not used in pregnant and lactating women, as well as in babies under two years of age.

Ambroxol (Ambrobene, Ambrohexal, Ambrosal, Bronchovern, Lasolvan, Medox)

Rating: 4.8

This drug is very popular in pulmonology and the treatment of ENT – diseases, as evidenced by the large number of various commercial analogues. Ambrobene is one of the highest quality and highly effective drugs that contain Ambroxol. It is produced by the German company Merkle. The chemical name is benzylamine. If there is a thickening of the secretion in the sinus in chronic maxillary sinusitis, after Ambrobene administration an intensive liquefaction process of this secretion begins within 30 minutes.

Ambrobene is mainly indicated in chronic maxillary sinusitis, since in the acute form of the disease there is usually no obstacle to the liquefaction of the inflammatory secretion, and it escapes on its own. But thickening of the secretion often occurs when the process becomes chronic. Ambrobene is available in a variety of forms: in capsules, in syrup, in tablets, and even in a solution for intravenous injection, in emergency situations in pulmonology.

Ambrobene for maxillary sinusitis is most often used in syrup, or in tablets. Dosage – depending on the severity of the condition and the goals of therapy.

You can buy the syrup in a bottle of 100 ml for 100 rubles. Ambroxol does not exist in nature, it is synthesized artificially, and to it, although rarely, but nevertheless sometimes develop side effects. Most often it is dryness in the mouth and nasal cavity, in overdose nausea and perversion of taste are possible. It is not recommended to take drugs containing Ambroxol in the first trimester of pregnancy, and patients with severe renal or hepatic dysfunction. But despite the side effects, a big plus remains the rapid liquefaction of the sinus secretion, which allowed to include Ambroxol in the rating of means for the treatment of maxillary sinusitis.

Tuaminogeptan + acetylcysteine (Rhinoflumucil)

Rating: 4.8

Presenting the classic combination drug Rinofluimucil. It is both an anticongestant and mucolytic drug. The component acetylcysteine liquefies mucous secretions, purulent secretions also become fluid, white blood cell activity decreases, and symptoms of inflammation as well as exudation and facial skull pain decrease.

Tuaminogeptan narrows the vessels of the nasal cavity and the mucous membrane of the maxillary sinuses. It helps eliminate hyperemia and mucosal edema. Rhinofluimucil is indicated for various types of sinus inflammation. Including – in the presence of thick secretion, which is difficult to separate.

Rhinofluimucil is available as an aerosol, it must be injected into the nasal passages, and a dosage of 2 doses is indicated for adults, that is, two pressings on the discharge valve, with a frequency of 3 to 4 times a day. The duration of the course should not be longer than 14 days. Rhinofluimucil is a product of the Italian company Zambon, and one bottle of 10 ml will cost, on average, from 280 to 330 rubles.

Good quality studies on the efficacy and safety of Rinofluimucil are presented in the latest issue of Vestnik Otorinolaryngology, 2020, T. 85, №5, s. 40-43

Advantages and disadvantages.

This drug is prescribed only with local manifestations of maxillary sinusitis, if there is no general inflammatory reaction, fever and malaise. Do not use it if you are intolerant to adrenomimetics. It was necessary to be very careful when prescribing Rinofluimucil to children under three years of age. Medication is prohibited in glaucoma, thyrotoxicosis. The drug does not have antimicrobial activity, so if necessary it should be combined with antibiotics and antiseptics.

What not to do for maxillary sinusitis, or in lieu of a conclusion

This rating considered the main groups of drugs that are used to treat various acute and chronic sinusitis, and primarily, maxillary sinusitis, which leads in frequency of occurrence among all sinusitis.

In conclusion, it is necessary to say what can harm the health condition in a patient with maxillary sinusitis, especially in the first days, when the visit to the ENT doctor has not yet been made, and various attempts are made to self-medicate. In acute maxillary sinusitis, heat procedures and warming in the first days are categorically contraindicated. In the acute phase, it causes swelling and pain, and if you try to warm the area, the swelling and pain will only increase, and if the outflow of the secretion from the sinus is compromised, it will lead to the need for surgical intervention.

The second mistake can be called the beginning of treatment, in which strong antibiotics in pills are immediately used, or, even worse, by intramuscular injections. Such self-prescription of potent drugs, and even with the introduction of them into the systemic bloodstream, can only cause intestinal dysbiosis, and is unlikely to help cope with maxillary sinusitis. At best, the symptoms will somewhat subside, the inflammation will become chronic, and the microorganisms that led to the emergence of maxillary sinusitis can acquire drug resistance to such a single injection of antibiotics. Therefore, first of all, you need to visit a doctor, and only follow his instructions.