My preference is to prescribe a short course of oral steroid which is tapered (reduced gradually) every two days for a total of ten days. A nasal steroid spray is prescribed for long-term use. The nasal steroid sprays are not addictive and may help to maintain good airflow through the nasal passages as the oral steroid is eliminated. The patient is instructed to stop the TND within two days, allowing time for the oral steroid to take effect. If there is no history of blood pressure elevation, heart, thyroid or eye problems, an oral decongestant (. Sudafed) may also be recommended. I also recommend nasal saline rinses.
Mortuaire, G., de Gabory, L., François, M., Massé, G., Bloch, F., Brion, N., ... Serrano, E. Rebound congestion and rhinitis medicamentosa: Nasal decongestants in clinical practice. (2013, June 1). Critical review of the literature by a medical panel. European Annals of Otorhinolaryngology, Head and Neck Diseases , 130(3), 137-144. Retrieved from https:///#!/content/playContent/1--S1879729612001378?returnurl=http:%2F%%2Fretrieve%2Fpii%2FS1879729612001378%3Fshowall%3Dtrue&referrer=https:%2F%2F .
Though they each try to get your symptoms under control, they do it by different mechanisms which when taken altogether, can work even better than by itself.
So, using the table below, a patient can generally take one medication from each column at the same time (but not more than one medication contained within a column unless directed by your doctor). For example (highlighted in BOLD ), a patient can choose to take allegra, nasonex, singulair, patanase, nasalcrom, and saline flushes all at the same time.
Steroid Nasal Spray
Anti-Histamine Nasal Spray
Cromolyn Nasal Spray