Postnasal Drip Treatments and Medications

Postnasal drip refers to the sensation of mucus traveling from the back of the nose to the throat, which can lead to symptoms like an irritated or sore throat, coughing, and a hoarse voice. For many people, allergies and respiratory infections like the common cold are common cause of postnasal drip. While most cases of postnasal drip improve on their own within a couple of weeks, certain medications may help improve symptoms. For example, a steroid nasal spray, in addition to a saline rinse, can help reduce inflammation from allergies in the nasal passages. In any case, it’s best to see a healthcare provider if symptoms worsen or continue for more than 10 days.

RELATED: What does the color of your snot say about your health? 

How is postnasal drip diagnosed? 

Postnasal drip is typically a symptom of an underlying condition. A healthcare provider can directly examine the nose and throat and review a person’s medical history to determine the best treatment option. An evaluation may include:

• Questions about what’s causing the symptoms, any medications being taken, and whether the cough worsens at night

• Allergy testing to see whether specific allergens, like dust mites or pollen, are causing symptoms

• Nasal endoscopy, which involves using a thin camera to see into the nasal passages

• Imaging tests, such as a CT scan, especially if a sinus problem or deviated septum is potentially causing symptoms

After determining the cause of postnasal drip, a healthcare provider can recommend treatment. In some cases, postnasal drip is a sign of a more serious condition that may require medical care, especially if accompanied by a high fever or trouble breathing. 

Postnasal drip treatment options

Treating postnasal drip means treating whatever is causing the mucus. Options for managing postnasal drip usually start with home remedies and medications to reduce inflammation and clear mucus. If a bacterial infection is causing symptoms, then an antibiotic may be prescribed. In severe cases like a deviated septum, surgery may be recommended.

Postnasal drip medications 

Various medications can help manage postnasal drip. Most medications for postnasal drip are available over the counter, including steroid nasal sprays, antihistamines, decongestants, and expectorants.

Steroid Sprays

Steroid nasal sprays can help reduce inflammation that may be causing excess mucus. They’re often a first-line treatment for allergic rhinitis, which can cause symptoms such as nasal congestion and postnasal drip. Options include Flonase (fluticasone), Nasacort Allergy 24HR (triamcinolone), and Nasonex (mometasone), which are all available without a prescription. It could take a few days to see relief and several weeks to experience their maximum effects.

Oral antihistamines 

Antihistamines are the most common treatment options for allergies. Second-generation antihistamines like Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine), and Xyzal (levocetirizine) can help if symptoms are caused by exposure to dust mites, pollen, or other allergens. In some cases, a first-generation antihistamine like Benadryl (diphenhydramine) or Chlor-Trimeton (chlorpheniramine) may be recommended, as they have drying effects that can help reduce postnasal drip. However, first-generation antihistamines often cause more drowsiness than newer second-generation ones and should be avoided in older adults.

Antihistamine nasal sprays

Antihistamines are also available as nasal sprays that can work directly in the nasal passages. Astepro (azelastine) is an option for adults and children 6 and older. It may be used alongside a steroid spray, especially if symptoms are not improving with just one medicine. 

Decongestants

Decongestants work by shrinking the blood vessels in the nasal passages, which may help reduce mucus drainage. Sudafed (pseudoephedrine) is the most common decongestant used to treat postnasal drip and stuffiness from an upper respiratory tract infection. Afrin (oxymetazoline) is a decongestant nasal spray that can work quickly, but it should not be used for more than a few days in a row due to the risk of rebound congestion. 

Expectorants

Expectorants may also help manage postnasal drip. They work by thinning the mucus to make it easier to clear. Mucinex, which contains guaifenesin, is a common expectorant, although study results are mixed regarding the meaningfulness of its benefits. 

Prescription medications

A prescription nasal spray, such as ipratropium bromide, can help treat a runny nose that may be causing postnasal drip. Singulair (montelukast) is another prescription option available as an oral tablet and approved for allergic rhinitis. These medications are not first-line options and may be prescribed for more serious cases after a visit to a healthcare provider.

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