Treating Sinusitis Symptoms With Medications

3 Different Types of Medications To Treat Sinusitis

Man using nasal spray
Man using nasal spray. ballyscanlon/Getty Images

What is Sinusitis and How Do You Treat It?

Sinusitis occurs when there is a blockage in the sinus cavities, usually because of inflammation and excess mucous. There are two types of sinusitis; acute sinusitis lasts 4 weeks or less, while chronic sinusitis lasts at least 12 weeks. Chronic sinusitis can be difficult to treat and may require surgery to cure.

Acute sinusitis usually starts out as a common cold virus, which causes excess swelling and inflammation in the sinus and nasal cavities that can create a blockage.

When mucous is unable to drain out of the sinuses and they're cut off from air, an environment perfect for bacterial growth is created. Acute sinusitis can usually be cured with a round of antibiotics, while chronic sinusitis may be a bit more complicated, as diseased or abnormal tissue may be blocking the sinus cavities. If you have acute sinusitis that is not going away with antibiotics, you may also be suffering from a specific type of fungal allergy. Additionally, chronic sinusitis may occur because fungus, rather than bacteria, has grown inside of the sinuses. If this is the case, anti-fungal medications should cure the infection.

With the exception of antibiotics and anti-fungal medications, any medications given for sinusitis are for symptom management and not to cure. The main symptoms that you are most likely wanting treated are related to:

Even though many of the medications listed below are available over-the-counter, you should always check with your doctor or pharmacist before taking a new medication or combining medications.

Sinus Pain Relief

Sinusitis can cause headaches, toothaches, and pain and pressure in the face. Over-the-counter pain relievers can be helpful in managing the pain of a sinus infection and include:

  • acetaminophen
  • ibuprofen
  • naproxen
  • aspirin

Some of these medications can be combined; for example, most healthy adults can take both acetaminophen and ibuprofen simultaneously, as long as they follow the dosing instructions included in the package.

It's typically recommended that ibuprofen and naproxen not be combined, as the action of these two drugs is very similar. Aspirin is a potent blood thinner and should not be taken by anyone who is already taking blood thinners, or by people with certain high risk conditions. Aspirin should not be given to children due to the risk of Reye syndrome.

If your symptoms become worse after taking aspirin, you may be one of the unlucky few that have aspirin intolerance that actually aggravates the symptoms of sinusitis. If you do have aspirin intolerance, you may have feelings of tightness in the chest, wheezing, cough, and sudden nasal congestion within a few hours of taking aspirin, naproxen or ibuprofen. If you suspect you might have this condition, you should avoid taking these medications and use acetaminophen instead.

If over-the-counter pain relievers are not effective in controlling pain, consult your doctor.

Nasal Sprays to Treat Congestion

Nasal congestion, runny nose and post nasal drip can all be symptoms of sinusitis. Fortunately, there's a variety of over-the-counter and prescription decongestant medications available to control these symptoms.

  • pseudoephedrine
  • phenylephrine

Saline nasal spray and guaifenesin work to thin your mucous and help it drain easier, which may help to relieve congestion. The other medications on this list should only be used for 3-5 days to avoid a condition called rebound congestion.

There are also over-the-counter nasal sprays which can be helpful in treating congestion including:

  • Nasacort (triamcinolone acetonide)
  • Flonase (fluticasone)

If the over-the-counter nasal sprays do not work for you, you may respond better to prescription medications, including:

All of the nasal sprays listed above are steroid nasal sprays which work to open up the nasal passageways by relieving inflammation.

They are superior to steroid medications taken in pill form because they don't have as many side effects. If nasal sprays however are not effective in treating your congestion, your physician may prescribe an oral steroid (prednisone).

Another group of medications called leukotriene modifiers may be beneficial for some people suffering from chronic sinusitis. These prescription medications include:

  • Singulair (montelukast)
  • Accolate (zafirlukast)


Antihistamine medications may work to "dry up" mucous, but they're most effective in people who developed sinusitis as a result of allergies. Some antihistamines cause drowsiness, which may also be beneficial if you're unable to sleep at night because of bothersome symptoms. Many antihistamines are available over-the-counter. If you are looking for an antihistimine to help you sleep, the following are known for causing drowsiness:

  • Benadryl (diphenhydramine)
  • Unisom (doxylamine)

While everyone responds differently, the following antihistamines are considered non-drowsy:

While medications can be helpful in treating sinusitis, you may also need to add other therapies like nasal irrigation or lifestyle changes to decrease your symptoms of sinusitis.


UpToDate. Acute sinusitis and rhinosinusitis in adults: Treatment. Accessed: February 27, 2013 from (Subscription Required).

UpToDate. Chronic rhinosinusitis overview. Accessed: February 27, 2013 from (Subscription Required).