Oral medications are sometimes used to control significant inflammation or infection involving the nose and sinuses. They are generally used for a limited period of time and are selected based on the cause and severity of your symptoms.
Oral Corticosteroids
Oral corticosteroids, such as prednisone or prednisolone, are powerful anti-inflammatory medications. They may be prescribed for a short period when nasal or sinus inflammation is significant, particularly in conditions such as chronic sinusitis with nasal polyps.
Potential benefits
- Rapidly reduce inflammation and swelling.
- Improve nasal blockage.
- Reduce nasal polyp size when present.
- Improve the sense of smell in some patients.
- Help topical treatments reach the nose and sinuses more effectively.
A short course can provide significant improvement, although the effect may be temporary if the underlying inflammation remains active.
How should I take them?
Unless your doctor gives you different instructions:
- Take the medication in the morning.
- Take it with food.
- Follow the prescribed dose and duration carefully.
- If a proton-pump inhibitor (PPI) or other stomach-protection medication has been prescribed, take it as directed.
Potential risks
Short courses are usually well tolerated, but possible side effects include:
- Difficulty sleeping.
- Increased appetite.
- Mood changes or irritability.
- Indigestion or stomach irritation.
- Temporary increases in blood sugar.
- Temporary increases in blood pressure.
- Fluid retention.
Repeated or prolonged courses can have more significant effects on bone health, blood sugar, blood pressure, the eyes, and the body's natural steroid production. For this reason, systemic corticosteroid exposure should be limited when possible.
Antibiotics
Antibiotics treat bacterial infection. They do not treat the underlying inflammation responsible for most chronic sinus conditions and are therefore not needed for every episode of sinus symptoms.
They may be prescribed when symptoms and examination findings suggest a bacterial infection or in selected patients with an acute worsening of chronic sinus disease.
Culture-directed antibiotics
In patients with persistent, recurrent, unusual, or difficult-to-treat infections, a sample may sometimes be collected from the nose or sinus during nasal endoscopy.
This can allow treatment to be culture-directed, meaning the antibiotic is selected according to the bacteria identified and which medications are most likely to work.
Possible side effects
- Stomach upset.
- Nausea or diarrhea.
- Rash or allergic reactions.
- Yeast infection.
Unnecessary antibiotic use can also contribute to antibiotic resistance, so antibiotics should be used when there is a reasonable likelihood that they will be helpful.
Oral medication is only one part of treatment
Depending on the condition, oral medication may be used alongside nasal sprays, medicated nasal irrigations, saline rinses, or other treatments. The medication, dose, and duration are individualized to the underlying problem and your medical history.