Nasal congestion at night

[Rexlan]

That is an allergy spray and won't do much for decongestant.

Flonase and generic equivalents are steroid sprays. They reduce allergic reaction and swelling which reduces congestion.

What is needed is Flonase Sensimist - different product and no knockoffs yet.

Wrong. The active ingredient in Flonase Sensimist is identical to the active ingredient in Flonase. Sensimist has some inactive ingredients which help to create a finer mist. It's all marketing. They want to convince consumers that Sensimist is a different, more effective product. They have it patented to avoid competition. Some people will be impressed by the finer mist, but it will cost them much more and improve the gross margins of GSK company.

Guess I misread it then - apologies. The Sams, Costco, Walmart knockoffs are much cheaper for sure.
But ....... The similarity in the names of the recently introduced intranasal glucocorticoid fluticasone furoate (FF; Veramyst®, GlaxoSmithKline/Avamys®, GlaxoSmithKline UK, Uxbridge, UK) and the earlier fluticasone propionate (FP; Flonase®/Flixonase®, GlaxoSmithKline) has led many to assume that the two compounds have the same active principle (fluticasone) (e.g. 1, 2). This has been compounded by FP commonly, and incorrectly, being abbreviated to fluticasone. The purpose of this letter is to highlight that FF and FP are completely different drugs with FF showing distinct and superior properties (3), and hence prevent any misprescription of these drugs in the future.

I had the argument yesterday with my ENT and this is what he gave me So I am switching based on that advice. I don't think everyone is out get get me for an easy buck.

Sensimist is:
Ingredients:

Ingredients: Active Ingredients: In Each Spray: Fluticasone Furoate (27.5 mcg) Glucocorticoid).


And the Costco, Sams, Walmart brand is:

Compare to Flonase Allergy Relief Active Ingredient
Fluticasone Propionate(Glucocorticoid) 50 mcg.
Indoor/Outdoor Allergy Relief
Non-Drowsy

[ChicagoGranny]

ngredients: Active Ingredients: In Each Spray: Fluticasone Furoate (27.5 mcg) Glucocorticoid).


And the Costco, Sams, Walmart brand is:

Compare to Flonase Allergy Relief Active Ingredient
Fluticasone Propionate(Glucocorticoid) 50 mcg.

The difference in the recommended daily dosage is explained in this Clinical Respiratory Journal article:

The resulting enhanced affinity of FF for the target receptor is reflected in the lower daily dose of Veramyst (110 µg) compared with Flonase (200 µg).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147057/

The bottom line for me is getting roughly the same treatment for mild to moderate allergies and nasal congestion whether FP or FF is used. So, price per day becomes the deciding factor.

Patients with asthma, should follow their doctor's advice (always with a skeptical eye).

[Muse-Inc]

Might try Xclear nasal spray. It contains Xylitol which starves the bugs that often cause congestion. Also breaks up biofilms that block drugs from penetrating that biofilm. Use it several hours before maskup as it might make your nose runny for awhile.

[ChicagoGranny]

Might try Xclear nasal spray. It contains Xylitol which starves the bugs that often cause congestion. Also breaks up biofilms that block drugs from penetrating that biofilm. Use it several hours before maskup as it might make your nose runny for awhile.

Xlear is just a saline spray with some sweetener added. It's unlikely to "starve any bugs". Generic saline sprays are just as effective and are MUCH cheaper. https://www.walmart.com/ip/Equate-Premi ... Z/10316877

[Dog Slobber]

Xlear is just a saline spray with some sweetener added. It's unlikely to "starve any bugs". Generic saline sprays are just as effective and are MUCH cheaper. https://www.walmart.com/ip/Equate-Premi ... Z/10316877

Not only does it not starve bugs, but the sweetener might attract ANTS!

viewtopic/t175972/ANTS.html

[rcobourn]

Xylitol is toxic to dogs, so maybe it could have some effect on nasal bacteria. I'll give it a try.

[ChicagoGranny]

I'm changing my view on Xylitol in saline nasal sprays.

CONCLUSIONS:
Xylitol Nasal Irrigation results in greater improvement of symptoms of chronic rhinosinusitis and greater enhancement of nasal nitric oxide and inducible nitric oxide synthase messenger RNA in maxillary sinus as compared to saline nasal irrigation.

https://www.ncbi.nlm.nih.gov/pubmed/28390807

Discussion of the mechanism by which Xylitol works: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC17249/

[Dog Slobber]

I'm changing my view on Xylitol in saline nasal sprays.

Since when do we change our view on things, just because there's evidence suggesting an alternative theory?

[zonker]

I'm changing my view on Xylitol in saline nasal sprays.

Since when do we change our view on things, just because there's evidence suggesting an alternative theory?

i know, right? she's SUCH a trouble maker, that one!

[badtux]

Okay, here's the deal on Flonase/Fluticasone Propionate. It is an inhaled corticosteroid. It operates by shutting down the mast cells that release inflammation agents. It takes about two weeks to reach full effectiveness. So: Do take it in order to deal with the rebound congestion from oxymetazoline but understand that it will take a while to operate. Note that you can double the dosage on the label without any problem according to my allergist and pharmacist, the dosage on the label is meant to prevent any possibility of absorbing the active ingredient into your bloodstream but for a two week period you don't need to worry about any tiny amount you might absorb into your bloodstream. For that matter, according to my allergist even the tiny amount involved would not cause any harm long term, but the FDA errs on the side of caution when approving new OTC drugs.

Weaning yourself off the oxymetazoline is critical. By shutting off the blood supply to your nose that stuff will literally burn out your nose if you use it long term and the rebound congestion as your body tries to heal the damage means you will have to increase doses to get any effect, causing the problem to get even worse. Benadryl has a drying effect in addition to its antihistamine effect so can help by reducing symptoms of inflammation though it doesn't address the root cause of the inflammation. Also, ibuprofen will help reduce inflammation. Saline sprays and rinses help also. You also likely want your PCP or ENT to prescribe montelukast (Singulair), this shuts off a different inflammatory pathway than Benadryl does. Singulair is usually prescribed for asthma so it isn't the first thing doctors think of when dealing with nasal inflammation, but luckily my PCP found it when looking for a medicine that wouldn't interfere with upcoming allergy testing. Anyhow, once you're through withdrawal, which can take two weeks, you can discontinue this medicine.

Good luck. As I think you're now aware, you put yourself down a pretty nasty pathway when you started using the oxymetazoline long-term. The good news is that ENT's are quite aware of the issue now, there's been numerous papers etc. on dealing with it. If things are *really* bad your ENT can prescribe a 1 week dose of prednisone to handle the inflammation while your nose heals up from the oxymetazoline. You don't want to do that long term because of numerous side effects but one week is generally considered safe.

In short: If the over-the-counter saline sprays and rinses, benadryl, ibuprofin, and corticosteroid sprays don't do the job, probably need to consult with your PCP or ENT on withdrawal from oxymetazoline. They have some tools like montelukast that you can't get over the counter, and have the Big Gun (prednisone) to pull out if things get really bad.

[rcobourn]

I'm at my local Target where they now carry Xlear. All the registers have crashed nationwide. Guess I won't be trying this today.

[ChicagoGranny]

You're going to get slapped.

[ChicagoGranny]

You edited it out! I was just jokin'.

[rcobourn]

You edited it out! I was just jokin'.

No, you were probably right.

[rcobourn]

They were able to scan one item, any others would clear out, so I escaped with the product and a 10% discount for my patience. I also got three father's day cards for the price of one, because the teller was getting more frustrated than I was .