14 best remedies for maxillary sinusitis

*Review of the best according to the editors. About the selection criteria. This material is subjective, it is not an advertisement and does not serve as a guide to purchase. Consultation with a specialist is necessary before buying.

There are several cavities inside the bones of the human facial skull, which are called sinuses. They lighten the bone mass, resonate, making the sounds louder. They warm and humidify the air inside them, and have thermo-insulating properties. The largest are the paired maxillary sinuses, or maxillary sinuses, which are named after the English physician and anatomist Nathaniel Guymore, who discovered them.

They have wide exit openings that communicate with the nasal cavity. Almost one third of all diseases that are treated by ENT doctors, in one way or another, are associated with sinus sinus pathology, and, above all, with the maxillary sinuses. The acute or chronic process of inflammation of the mucosal and submucosal tissue lining the inside of the maxillary sinus, and is called acute or chronic sinusitis, or maxillary sinusitis, respectively. But since most often there is a combined pathology, and the nasal cavity and sinuses, you can hear the name of the disease “rhinosinusitis”.

Indeed, the maxillary sinus, or maxillary sinus, is most commonly affected by inflammation. Slightly less frequent occurrences:

  1. Ethmoiditis, or inflammation of the bony air-bearing cells of the labyrinth of the lattice bone;
  2. Even less commonly, there is inflammation of the frontal sinus, or frontitis;
  3. Very rarely do ENT doctors deal with a deep-lying sphenoid sinus of the main bone, or sphenoiditis. But just the proximity of the sphenoid sinus to the brain, the liquor ducts, and the structures of the central nervous system, and makes us treat sphenoiditis with the greatest concern, due to the high risk of intracranial complications, such as purulent meningitis.

If several sinuses are inflamed at once, the ENT doctor diagnoses polysinusitis, and if all sinuses are inflamed on one side, which happens after a massive and sharp hypothermia (for example, when driving in a car with an open windshield), then the diagnosis is made hemisinusitis.

Symptoms and causes of maxillary sinusitis

One of the most important symptoms of acute maxillary sinusitis, or exacerbation of a chronic process, is heaviness in the area of the sinuses, that is, in the face. There are pains in the upper jaw, and headaches, profuse or scanty nasopharyngeal discharge. The patient may have difficulty nasal breathing, and he may stop smelling.

If the outlets from the sinuses are clogged, and the inflammatory discharge does not drain into the nasal cavity and does not descend into the oropharynx, then there is a rasping headache associated with high fluid pressure inside the sinus. In this situation, quite often it is necessary to open the sinus and drain it.

It is very important to distinguish between a unilateral and bilateral process. If both right and left maxillary sinuses are inflamed, the patient may have a diffuse headache and nasal breathing is impaired on both sides. Accordingly, with unilateral inflammation, all symptoms are localized on the corresponding half of the head. The intensification of symptoms and headache is especially pronounced with downward tilting of the trunk and increased intra-abdominal pressure.

If severe, there may be asymmetry and swelling of the face, and general symptoms such as subfebrile fever, malaise, decreased performance, and typical inflammatory changes in blood tests. These are increased leukocytosis, increased sedimentation, and other signs.

More often the cause of maxillary sinusitis is inflammation of the nasal cavity – rhinitis, both acute and chronic, viral diseases – measles and flu, scarlet fever. Quite often the cause of maxillary sinusitis is odontogenic, or the presence of unsanitized upper jaw teeth.

Also occurs, but much less frequently, so-called nosocomial maxillary sinusitis, as well as fungal process associated with a massive suppression of immunity, for example, during prolonged treatment with corticosteroid hormones, Or against the background of the course of HIV infection. Nosocomial maxillary sinusitis is a nosocomial infection. Nosocomial sinusitis is usually diagnosed in intensive care patients with respiratory distress, and especially if there was a foreign body in the nasal cavity for a long time, for several days. This may be a nasogastric tube, tampons, or intubation tube.

In general, the problem of sinusitis is increasing every year, and inflammatory diseases of the maxillary sinuses are the most common reason for which patients must be hospitalized in the ENT department, it is 20% of all emergencies. Currently, there are a large number of different conservative and surgical treatments, but the number of cases of chronic acute maxillary sinusitis is constantly increasing, with the possibility of the development of intra-orbital and intracranial complications. (Sinusitis: a lecture for general practitioners, Moscow Scientific and Practical Center of Otorhinolaryngology)

Among the bacterial pathogens of acute sinusitis, Streptococcus pneumoniae, Haemophilus influenzae, and various types of β-haemolytic streptococci not belonging to group A are currently the most significant.

(Etiopathogenetic therapy of acute sinusitis, Ministry of Health of the Russian Federation FGBU “St. Petersburg Research Institute of Ear, Throat, Nose and Speech” of the Ministry of Health of Russia, guidelines, approved by the Ministry of Health of the Russian Federation 2014).

Modern treatment protocols of acute and chronic maxillary sinusitis stipulate prescription of various pharmaceutical preparations to patients as conservative therapy, and surgical interventions related to sinus decompression (decrease of fluid pressure and pain reduction), and its drainage (constant withdrawal of inflammatory exudate) as well as introduction of various medications into its cavity. Let’s look at the main medications in different forms used for maxillary sinusitis that are available over-the-counter at retail.

All the remedies listed below are in formal order, the list is not a rating of efficacy or popularity, and this article is offered for guidance only. The material below is not a pretext for buying. Any medications should be prescribed by an ENT doctor, taking into account the indications and contraindications.

The only sources of information for this material are approved national and international clinical guidelines and protocols for the treatment of acute and chronic sinusitis, articles in medical periodicals, and publications in international peer-reviewed databases, such as Pubmed. The source of information about the medicines was the official instructions, located in the public domain on the website

Those who are interested in the most current state of the problem and the novelties in the treatment of maxillary sinusitis and other sinusitis can be advised the mostThe latest revision of the European consensus document EPOS.

Best medications to treat maxillary sinusitis

Intranasal adrenomimetics – anticongestants1Nafazolin (Naphthisin, Sanorin)11 €
2Xylometazolin (Galazolin, Vednos, Xylenol, Xymelin, Rhinorus, Rhinostop)42 €
3Oxymetazoline (Nasivin, Nasivin-sensitive, Oxyfrine, Rhinostop, Sialor)148 €
4Vibrocil (Bebifrin)198 €
Topical anti-inflammatory therapy: intranasal GCS1Fluticasone (Flixonase, Avamis),432 €
2Beklometasone (Nasobek)198 €
3Mometasone (Nasonex, Nosefrine)303 €
Antibacterials1Framicetin (Isofra)311 €
2Polidexa255 €
3Miramistine189 €
Mucolytics1Sinuforte2 014 €
2Libexin Muco (carbocysteine)467 €
3Ambroxol (Ambrobene, Ambrohexal, Ambrosal, Bronchovern, Lazolvan, Medox)27 €
4Tuaminogeptan + acetylcysteine (Rhinofluimucil)158 €

Intranasal adrenomimetics – Anticongestants

Various vasoconstrictor drops that lead to reduced edema, in the initial stages of maxillary sinusitis, improve communication of the sinus outlet duct with the nasal cavity. It is important for the patient to realise that this symptomatic treatment improves drainage only in the initial stages of acute sinusitis, or in the acute exacerbation of chronic sinusitis.

The fact is that liquid medications applied inside the nasal cavity to the mucous membrane work only “on one side”, and often do not get inside the sinus, because the inner opening of the duct leading into it may be covered from the inside by swollen mucosa. Since the drug does not penetrate inside the sinuses, these drops should be used only in the joint treatment of maxillary sinusitis together with antibiotics, and you should not rely only on their effect.

Nafazolin (Naphthisin, Sanorin)

Rating: 4.8

Nafazolin (Naphthisin, Sanorin)

Naphthisin, (chemically, naphazolin) is a vasoconstrictor drug that exhibits alpha-adrenomimetic effects in maxillary sinusitis. The mechanism of action of naphazolin lies in the activation of alpha-2 adrenoreceptors. The result is a vasospasm of the nasal submucosa, a decrease in mucus secretion and redness and a decrease in the exudative component. As a result, nasal breathing becomes easier.

Indications for Naftizin drops are all acute processes in the nasopharynx, and chronic lesions, allergic and vasomotor components, accompanied by edema. Naphtisin is sprayed into each nostril one drop at a time, but not more often than 3 times a day. Naphtisin is probably the cheapest remedy for treating maxillary sinusitis in the ranking. A bottle of 15 ml would cost only 9 rubles., Spray of the same volume – from 23 rubles. Naftisin is produced by domestic pharmaceutical companies, such as Slavyanskaya Apteka LLC, Lekko CJSC.

Advantages and disadvantages

Naphtisin entered the rating of the most popular remedies for maxillary sinusitis, thanks to its cheapness, widespread distribution in pharmacies, and, alas, due to the low medical literacy of the population. Naphtisin is addictive when used for a long time, and with the constant use of Naphtisin, atrophy of the mucous membrane of the nasal cavity occurs and the so-called atrophic rhinitis develops.

As a result, a constant dependence on Naphtizin is formed, and the patient is forced to use it almost constantly, because without this drug the nose immediately gets stuffy. In addition, Naphtisin has a short duration of action, and relieves the condition only for 3 – 4 hours or less. Naphtisin is capable of causing systemic effects due to its general adrenomimetic action. This is a rise in blood pressure, the development of heart palpitations – tachycardia. In the XXI century there have long been more effective and not such “rough” nasal drops for maxillary sinusitis.

Xylometazoline (Galazolin, Vednos, Xylenos, Xymelin, Rinorus, Rinostop)

Rating: 4.8

Xylometazolin (Galazolin, Podnos, Xylenol, Xymelin, Rhinorus, Rhinostop)

The next generation of anticongestants in drops for maxillary sinusitis is represented by a group of popular drugs that contain Xylometazoline. They are also available as a spray, there is a dosage for children – in a concentration of 0.05%, and for adults – 0.1%.

Xylometazoline is also an adrenomimetic, but it doesn’t irritate the nasal passages, doesn’t promote habituation or atrophic rhinitis, and has almost no systemic action. It lasts much longer, lasting 6 to 10 hours. It is indicated to use Galazolin and other products on average about 2 times a day, in the morning and evening, sometimes an instillation in the middle of the day is required.

Produces xylomethazoline a lot of different companies, but one of the most high-quality and effective drugs is a drug Otrivin, which is produced by Novartis, Switzerland. So, a bottle of 10 ml, intended for adults, you can buy for 135 rubles. Domestic xylometazoline in the same dosage and volume produced by Grotex OOO can be purchased for just 19 rubles (depending on the price).

Advantages and disadvantages

First of all, xylometazoline is considered a safer drug, it has no systemic effects like naphazoline, its effect is longer. In addition, there is a special, children’s dosage. Still, an adrenomimetic, even a safer one, can cause adverse effects. Often, if the dosage is exceeded, cephalgia and nasal burning develop, sometimes there is dryness in the nose. You should also consider possible diagnoses when the use of adrenomimetics is generally contraindicated. These are glaucoma and thyroid pathology, hypertension and heart palpitations, pregnancy and age under 2 years, even for children’s dosage, as well as individual intolerance. In general, xylometazoline and its analogues are recognized as working well, basic drugs for acute maxillary sinusitis.

Oxymetazoline (Nasivin, Nasivin-sensitive, Oxyfrin, Rhinostop, Sialor)

Rating: 4.8

Oxymetazoline (Nasivin, Nasivin-sensitive,Oxyfrin, Rhinostop, Sialor)

The latest drugs to reduce swelling of the inner surface of the nasal cavity, – Oxyfrin and others, contain oxymetazoline. This compound has a dual action. Low concentrations stimulate alpha-2 adrenoreceptors, while high drug concentrations have an effect on alpha-1 receptors. When used without an overdose, oxymetazoline does not cause local irritation, and with a long period of treatment do not provoke redness of the mucosa.

Nazivin is indicated, in addition to maxillary sinusitis, also in allergic diseases of ENT – organs, otitis media, diagnostic manipulations in order to reduce the risk of bleeding.

Nasivin is used 1-2 drops in the right and left nasal passages 3 times a day (0.05%). In newborns, the drug is used with a concentration of 0.01%. Nasivin is also available in spray form, and is indicated by short courses, not more than 5 days. Nasivin is manufactured by the company Megsk, Germany. The minimum cost of children’s nasal drops of 10 ml will be 116 rubles. and higher, and a nasal spray for adults in a concentration of 0.05% will have the same cost.

Advantages and disadvantages

The main advantages of Nazivin and its analogues are a more favorable safety spectrum, as well as long-lasting and persistent effect. After a single injection, the effect of nasal breathing relief and reduction of mucosal edema can last up to 12 hours. However, if the drug was used in much higher doses than recommended, systemic effects such as nausea, narrowed pupils, rapid heartbeat, increased body temperature may also occur. It is also not recommended to continue a course of treatment with agents containing oxymetazoline for more than 7 days. Despite their much higher safety, an addiction to them may develop, with a significant reduction in effectiveness.

Vibrocil (Bebifrin)

Rating: 4.8

Vibrocil (Bebifrin)

This medication is mixed, and the effect is not only alpha-adrenomimetic, which narrows arterioles, reduces swelling and redness in the nasal cavity. Vibrocil facilitates drainage from the maxillary sinus, and it also acts as a histamine receptor antagonist, which has an anti-allergic effect. Therefore, Vibrocil can be prescribed more widely, and in addition to maxillary sinusitis, it is prescribed to different patients with different manifestations of allergies in the ENT clinic.

It is necessary to drop Vibrocil 2-3 drops three times a day both into each nostril of children older than 6 years and adults. For children under 1 year of age, one drop in the left and right nasal passages with the same frequency of administration is sufficient. Vibrocil is also available – a spray that ejects a specially measured dose. Vibrocil is produced by Novartis (Switzerland), a well-known pharmaceutical company, and a 15 ml. bottle (dropper) can be obtained for the price from 240 rubles.

Advantages and disadvantages

Vibrocil combines the high vasoconstriction effect caused by phenylephrine and the allergic effect of dimethindene. All this together allows you to reduce the number of drugs to be prescribed, and instead of two means to use one, eliminating polypragmasy. The cost of this drug is certainly not small, but if we consider that Vibrocil is a drug “two in one”, it is not too high.

The peculiarities of use should also include the need for a short course, no longer than 7 days without a doctor’s prescription. Longer use in the form of self-treatment, as in the case of other drops for maxillary sinusitis, may cause a deterioration due to the ricochet effect, in which the swelling of the nasal cavity mucosa already causes the drug itself. This drug also has no pronounced symptoms of overdose and no serious side effects. In some cases, when Vibrotsil is heavily abused, patients have experienced discomfort in the stomach area and palpitations.

Local anti-inflammatory therapy: intranasal GCS

It is known that the strongest anti-inflammatory and anti-allergic effects have corticosteroid hormones such as prednisolone, dexamethasone, and their active derivatives, which are used in clinical practice. Of course, in acute and chronic maxillary sinusitis hormones are not always and not all patients, but only in the stormy nature of inflammation, with excessive intensive exudation, which is accompanied by the accumulation of a large amount of secretion in the cavity of the maxillary sinuses, and causes pronounced clinical symptomatology. These patients experience fever, a debilitating headache, facial aches, and other symptoms. This is when intranasal forms of the glucocorticosteroids come in handy.

Fluticasone (Flixonase, Avamis)

Rating: 4.9

Fluticasone (Flixonase, Avamis)

The hormonal drug Flixonase contains only fluticasone, that is, it is a monocomponent, with only the glucocorticosteroid in its composition. This drug interacts with specific hormone receptors on the nasopharyngeal mucosa, and inhibits all cellular links of immunity. Decreases macrophage and neutrophil activity, mast cells stop releasing inflammatory mediators such as histamine, cytokines. This suppresses the allergic reaction and reduces the symptoms of hyperemia and swelling of the upper airway mucosa.

Flixonase effectively combats symptoms such as nasal congestion and sneezing, nasal itching and lacrimation, eye pressure, and a feeling of distention in the upper jaw associated with overflow of maxillary sinus secretion

Flixonase is fast-acting; the patient already feels relief of symptoms after an hour or an hour and a half; the effect lasts for 24 hours after a single dose of fluticasone is injected into the nose. Fliksonase should be administered to adults by injecting two doses into each nostril in the morning. This brings the total daily dose to 200 mcg. Once symptoms are relieved, the dosage can be halved. The maximum dosage is 400 mcg per day, which means no more than 4 instillations in each nostril during the day.

Manufactured by the British company GlaxoSmith K

  • It costs 400 rubles for 1 vial with 60 doses of the hormonal spray., One nebulized dose contains 50 mg of active substance.

    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

    Beclomethasone (Nasobec)

    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

    Mometasone (Nasonex, Nosefrin)

    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.


    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

    Framicetin (Isofra)

    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.


    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.


    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.


    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.


    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

    Libexin Muco (carbocysteine)

    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

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

    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

    Tuaminogeptan + acetylcysteine (Rhinofluimucil)

    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.

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