re: Any sinusitis/rhinitis/upper respiratory docs out there? What can’t I mix?

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Am I missing any component?

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I wrote a long post with mediocre humor, but my browser crashed. I’m upset about it. The brief version:


Flonase is fine, but I generally get poor acute response to it, as do most of my patients.
Nasal oxymetazoline (afrin, and a few others. It’s a nasal decongestant) works great acutely, but read the bottle and follow the directions, or you’ll think I’m a wizard when I fix your 3-month ‘sinus infection’ by stopping it (I do this about 4 times a year)
Behind the counter is nasal ipratropium (Atrovent, an anticholinergic) which is a much better option for basically anytime you want afrin (either short or long term)
Over the counter for a year or two now is Astepro which is a nasal antihistamine. I don’t stop oral antihistamines with it, and I don’t think anyone necessarily recommends to. It works well.


But that’s a bunch of meds. Personally, I take 2 aleve and a cetirizine once or twice a day. I get a fair amount of sinus pressure relief with NSAID + cetirizine, and naproxen is a pretty potent anti-post viral cough medication. But I probably take a grand total of 15 pills a year. I don’t have particularly bad or prolonged cold/allergy symptoms, luckily.