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Sinus infection treatment and medications

Cropped SingleCare logo By | Updated on April 29, 2020
Medically reviewed by Karen Berger, Pharm.D.

What is a sinus infection? | Sinus infection diagnosis | Sinus infection treatment options | Sinus infection medications | Best sinus infection medications | Side effects of sinus infection | Sinus infection home remedies | FAQ | Resources

Everyone knows what to expect when cold and allergy season rolls around—you expect a stuffy nose, itchy throat, and frequent sneezing. But if your sinus symptoms worsen, and you experience long-term facial pain, runny nose, headache, and nasal congestion, you there could be a more serious problem.

When cold or allergy symptoms just won’t going away, they could be caused by a sinus infection. Use this guide to what a sinus infection is and how you can treat one with medications and alternative treatments at home.

What is a sinus infection (sinusitis)?

A sinus infection, also known as sinusitis or rhinosinusitis, is a condition where the tissues lining the nasal passages become inflamed. Sinus infections are very common, affecting nearly 30 million people in the U.S. each year, and a large percentage of these infections resolve on their own. Common sinusitis symptoms include nasal congestion, sore throat, headache, and facial pain.

Simply explained, a sinus infection occurs when there is an infection in the sinuses, a connected system of air-filled spaces in the skull. Under normal conditions, mucus drains out so that air can pass through sinus cavities. When fluid builds up in the sinuses, germs grow and an infection can occur.

Sinus infections can cause facial discomfort because of nasal congestion. You may experience a headache, pain behind the eyes, and facial tenderness or swelling. Other sinus infection symptoms are similar to having a bad cold or intense allergies including nasal discharge, postnasal drip, fatigue, sinus pressure, loss of sense of smell, throat irritation, and even a fever.

Typically triggered by allergies or a cold, a sinus infection can take many forms. Acute sinusitis may cause mild symptoms and go away quickly without antibiotics. These cases are often caused by a viral infection like the common cold and do not require anything more than symptomatic treatment for your comfort.

Chronic sinusitis, on the other hand, can stick around for several months and be much more troublesome. Depending on the severity of the infection, you may be able to treat it yourself with home remedies, but it’s likely that you will need antibiotic treatment.

Certain groups of people are more likely to get sinus infections. If you smoke, travel to a different altitude, have a weakened immune system, allergic rhinitis, or cystic fibrosis, you are more at risk for developing sinus infections.

How is sinusitis diagnosed?

If you are experiencing pain and pressure that doesn’t clear up within a week to 10 days, it may be time to schedule a doctor’s appointment. You can visit your primary care physician to be evaluated for a sinus infection.

“A sinus infection is usually diagnosed empirically without need for imaging or cultures,” explains Lindsey Elmore, Pharm.D., BCPS. A simple medical exam and review of your symptoms should be enough for your doctor to identify a sinus infection. Your doctor will likely check your nose with a light to look for inflammation. He or she also may ask you about any pain you’re feeling to see if it traces back to the sinus cavities.

In rare cases, or if you get frequent infections, your doctor may perform other tests to rule out other conditions like a fungal infection. This may include allergy testing, a nasal endoscopy to visually inspect the sinuses, swabbing your nose for a culture of nasal drainage, or lab imagery to scan for abnormalities.

“Symptoms may be acute (short term) or chronic (long term), and you should seek a doctor’s help if you have symptoms that last more than 10 days, or are unresolved with over the counter agents as this may be an indication that you have a bacterial sinus infection,” says Dr. Elmore.

Sinus infection treatment options

There are many treatment options for a sinus infection, but the best treatment option varies by the severity of the case. Some acute sinus infections will clear up on their own without any treatment, and you may just think it was a cold. Others require more serious interventions by a healthcare provider.

The standard treatment healthcare providers prescribe for a presumed bacterial sinus infection is an antibiotic. However, if you have a sinus infection caused by a viral infection such as the common cold, your doctor will not prescribe antibiotics as these medications only treat bacterial infections. Instead, you can treat the sinus infection symptomatically until it resolves, with nasal decongestants and antihistamines.

There are plenty of ways to treat symptoms of a sinus infection at home with over-the-counter (OTC) medications and home remedies. OTC antihistamines block the effects of histamine, helping symptoms like sneezing and runny nose. Simple treatments like drinking water, keeping your sinuses hydrated (with a nasal rinse product), and using warm compresses, can also help treat symptoms of a sinus infection.

Keeping your nasal passages clean can help you prevent future sinus infections. If you anticipate having sinus issues during allergy or cold season, flushing out your nasal passages with a saltwater solution can help you avoid the pains of a sinus infection.

Recurrent and chronic sinus infections could be a sign of a more serious problem with the physical structure of the sinuses, such as a deviated septum or nasal polyps. These issues may require specialized treatment from an allergist, otolaryngologist, or another doctor to avoid continuous sinus infections in the future.

Sinus infection medications

When medications are necessary for sinus infection treatment, there are many different options. The primary types of medications used for treating sinus infections include decongestants, antibiotics, steroids, antihistamines, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Decongestants

Decongestant medications help reduce swelling, pressure, and congestion of mucus in the nasal passages. Decongestants for sinus infections typically come in the form of nasal sprays such as Vicks Sinus Nasal Spray or Afrin Nasal Spray (both contain oxymetazoline), and oral pills like Sudafed.

These medications can quickly help to relieve sinus pressure, but should not be taken for a long time. Overusing decongestant nasal sprays can actually make congestion worse, so you should take each of these medications as directed by your doctor. Decongestant nasal sprays should only be used for a maximum of 3 days. Common side effects of these nasal sprays include irritation, dryness, burning, stinging, and sneezing.

If the decongestant nasal spray dries you out, you can add a saline nasal spray or drops to moisturize the nasal passages—saline products can be used as needed with no limitations on duration. Nasal decongestant oral tablets can raise your blood pressure, so if you have high blood pressure, ask your healthcare provider before using it.

Antibiotics

In many cases, antibiotics are not necessary for sinus infections, but physicians may prescribe one if they suspect a bacterial infection is the cause of sinusitis. Generic antibiotics like amoxicillin or cefdinir can be used to stop the growth of or kill bacteria to resolve a sinus infection.

Other popular antibiotics prescribed for sinus infections include Zithromax (azithromycin) or Augmentin. Common side effects of antibiotics include nausea, vomiting, and diarrhea.

Steroids

Corticosteroids can improve sinus drainage by reducing inflammation of the sinuses. Doctors typically only prescribe steroids for severe sinus infections. The most common steroids used for sinus infection treatment are prednisone and Medrol (methylprednisolone).

Fluticasone nasal spray is a steroid drug that can be purchased over-the-counter (or by prescription) for relieving symptoms of sinusitis. Flonase is a popular nasal spray that you can spray in each nostril daily for relief of sneezing, runny nose, and congestion. Prolonged use of steroids can cause disruptions in the body’s hormone levels, so they should only be taken as advised.

Antihistamines

Many sinus infections are caused by allergies, so antihistamines can help clear up a case of sinusitis by reducing or stopping an allergic reaction. Benadryl is a commonly used OTC antihistamine that can relieve sneezing, runny nose, and other symptoms of a sinus infection. The main side effects of antihistamines include dizziness, dry mouth, and drowsiness.

Newer antihistamines such as Claritin, Allegra, Zyrtec, and Xyzal, treat the same symptoms but cause less drowsiness. Some antihistamines also contain a decongestant. Ask your pharmacist for assistance in picking an appropriate product that will help your symptoms and is safe and appropriate to take, considering your medical condition(s) and the medications you take.

Tylenol and NSAIDs

OTC pain relievers can help reduce symptoms associated with a sinus infection. Tylenol (acetaminophen) is an analgesic that helps relieve pain and fever, while Advil (ibuprofen), Aleve (naproxen), and aspirin are nonsteroidal anti-inflammatory drugs (NSAIDs).

NSAIDs help with symptoms of pain and fever, as well as swelling/inflammation. NSAIDs can interact with other drugs, so ask your healthcare provider if you can take an NSAID with the other drugs you take. Also, NSAIDs should not be taken for a prolonged period of time, so consult with your doctor if this treatment method does not resolve your sinusitis within 7-10 days.

What is the best medication for a sinus infection?

The best medication for sinus infection treatment is determined by your doctor and varies by case. Below, you can see a comparison of the most common sinus infection medications to learn what to expect.

Best medications for sinus infections
Drug name Drug class Administration route Standard adult dosage Common side effects
Flonase (fluticasone) Corticosteroid Nasal spray 2 sprays in each nostril per day Headache, nasal burning or irritation, nosebleed, dizziness
Sudafed (pseudoephedrine) Decongestant Oral 2 tablets every 4-6 hours; no more than 8 tablets per 24-hour period Headache, dizziness, insomnia, nervousness
Benadryl (diphenhydramine) Antihistamine Oral 1-2 capsule(s) or tablet(s) every 4-6 hours; do not take more than 6 times in 24 hours Dizziness, dry mouth, drowsiness
Mucinex (guaifenesin) Expectorant (for chest congestion/productive cough) Oral One 1200 mg tablet every 12 hours; no more than 2 tablets in 24 hours; do not chew or crush. Take with a full glass of water. Headache, nausea, dizziness, drowsiness

Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

What are common side effects of sinus infection medications?

The most common side effects of sinus infection medications differ by the type of medication you use. Decongestants tend to cause nervousness, insomnia, and a loss of appetite. Side effects of antibiotics include nausea, vomiting, and diarrhea. Antihistamines and steroids can cause dizziness and sleep disturbances.

This is not an exhaustive list of sinus infection medication side effects. If you experience any adverse reactions from a medication or treatment, it’s always best to consult with your healthcare provider.

What are the best home remedies for sinus infections?

There are a few simple home remedies that can be effective for relieving your pain and helping you clear your sinuses. “To avoid using medications, try a warm compress on the nose and face, and flush nasal passages with a warm saline irrigation,” says Dr. Elmore.

A homemade solution for nasal irrigation is one of the best home treatments for a sinus infection. You can use a syringe or a neti pot to stream a solution of non-iodized salt, baking soda, and lukewarm distilled (or previously boiled) water through the nostrils to help keep your nasal passages clean. Or, you can choose a product at your pharmacy that is already prepared and ready to mix packets.

Other home remedies for sinus infections include staying hydrated by drinking a lot of water, using decongestant nasal sprays, and inhaling steam over the stove or in the shower. Certain lifestyle adjustments may also promote nasal drainage such as sleeping with your head elevated at night or keeping a humidifier running in your home to avoid an arid environment.

To relieve pain at home, you can use a warm compress or take over-the-counter pain medications to reduce headaches and facial pain from congestion.

Frequently asked questions about sinus infections

How do you get rid of a sinus infection fast?

You can treat a sinus infection at home or with OTC medications for symptom relief, and/or a prescription antibiotic medication, in the case of a bacterial infection. Stay hydrated, use a humidifier, and sleep at an incline to help resolve your sinus infection quickly. Consult your healthcare provider to see if you need an antibiotic.

What is the best treatment for a sinus infection?

Nasal irrigation and nasal sprays are common treatments for a sinus infection. If the cause of the infection is a bacteria, you may need antibiotics to clear the infection. Your pharmacist can be a great resource to help you choose an OTC nasal spray that will help your specific symptoms.

Can you get rid of a sinus infection without antibiotics?

Many sinus infections are caused by a virus like the common cold and do not require antibiotics for treatment. If you have mild symptoms, OTC medications may help relieve your symptoms until you feel better. However, consult your healthcare provider if symptoms worsen or do not improve after seven days, or if at any time you have intense/severe pain or pressure, or a high fever.

What happens if you let a sinus infection go untreated?

Some sinus infections can clear up on their own. Others may be chronic and longer-lasting. It’s best to visit a doctor if your symptoms last more than 7-10 days, or if you have severe symptoms.

What are some effective home treatments of sinus infections?

Using a warm compress, drinking water, and using a solution for nasal irrigation are effective home remedies for sinus infections. These treatments can help relieve symptoms, but if the cause of the infection is bacterial, your healthcare provider will prescribe an antibiotic as well. 

What will a doctor prescribe for sinusitis?

If the cause of the infection is a bacteria, a doctor will prescribe an antibiotic. If the cause is viral, your physician may recommend OTC decongestants, NSAIDs, antihistamines, or prescription steroids.

Should you take antibiotics for a sinus infection?

Antibiotics are only effective for sinus infections caused by bacteria. A doctor will help you determine the best treatment method.

How can I treat sinusitis at home?

You can take over-the-counter decongestants, antihistamines, or NSAIDs to help reduce symptoms of inflammation of the sinuses and promote nasal drainage at home. These OTC remedies will provide symptom relief, but will not treat a bacterial infection.

Related resources for sinus infections