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Suggest Treatment For Post Nasal Drainage And Runny Nose

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Posted on Thu, 2 Jul 2015
Question: I have drainage in the back of my throat which causes a lump in my throat and I am dizzy. I cough it up but I can feel it draining. Is it better to take an antihistamine or decongestant or a combo of the two?
One thing I neglected to mention is my nose runs as well as it drains down my throat.
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Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Antihistamine for allergy, Decongestant for infection, Flonase for either.

Detailed Answer:
I am sorry you are having post nasal drainage and runny nose.

You asked if it is better to take an antihistamine or decongestant:

If you suspect that your are having an allergy (such as to seasonal pollens), an antihistamine would be helpful. Symptoms of allergies vs an infection (such as a cold) are that allergies tend to cause some itchy feelings of the nose or throat and are worse after exposures to the things you may be allergic to. A good antihistamine you can get over the counter is Zyrtec (generic is cetirizine) and it lasts 24 hours. Best to take it at bedtime if you find it sedating. Zyrtec is generally less sedating than Benadryl.

If you think you might have an upper respiratory infection (i.e. a cold), a decongestant may be helpful. Pseudoephedrine is probably the most effective of over the counter decongestants but can be stimulating and interfere with sleep in some people. Phenylephrine is another decongestant and it is not as stimulating but maybe not as powerful. By the way, if you want to try pseudoephedrine, you need to ask the pharmacist for it as they keep it behind the counter.

For either problem (allergy or cold), nasal corticosteroid sprays can be very effective. You can get Flonase over the counter. It may take a few days until you get maximum benefit from it. This would be my number one choice particularly if your symptoms are ongoing (more than just a few days).

Saline irrigation with a nettipot can help too, although it may not stop the problem. It will help wash germs, mucus, and pollen from your nose and sinuses. You can get a nettipot and pre made buffered salt packets at most drugstores and pharmacies. It will come with directions.

If you used a nettipot and Flonase, avoid using them within an hour of each other as the nettipot will just make the nasal spray drip down to your stomach where you don't want it!

I am assuming the drainage is mostly clear, or discolored just after you wake up, that you don't have a fever or pressure in your sinus areas. These can indicate a sinus infection. Sinus infections can still be treated at home with the things listed above, but if it is going on more than 2-3 weeks, I usually prescribe an antibiotic.

I hope this information helps. Please let me know if I can provide further information or clarification.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Suggest Treatment For Post Nasal Drainage And Runny Nose

Brief Answer: Antihistamine for allergy, Decongestant for infection, Flonase for either. Detailed Answer: I am sorry you are having post nasal drainage and runny nose. You asked if it is better to take an antihistamine or decongestant: If you suspect that your are having an allergy (such as to seasonal pollens), an antihistamine would be helpful. Symptoms of allergies vs an infection (such as a cold) are that allergies tend to cause some itchy feelings of the nose or throat and are worse after exposures to the things you may be allergic to. A good antihistamine you can get over the counter is Zyrtec (generic is cetirizine) and it lasts 24 hours. Best to take it at bedtime if you find it sedating. Zyrtec is generally less sedating than Benadryl. If you think you might have an upper respiratory infection (i.e. a cold), a decongestant may be helpful. Pseudoephedrine is probably the most effective of over the counter decongestants but can be stimulating and interfere with sleep in some people. Phenylephrine is another decongestant and it is not as stimulating but maybe not as powerful. By the way, if you want to try pseudoephedrine, you need to ask the pharmacist for it as they keep it behind the counter. For either problem (allergy or cold), nasal corticosteroid sprays can be very effective. You can get Flonase over the counter. It may take a few days until you get maximum benefit from it. This would be my number one choice particularly if your symptoms are ongoing (more than just a few days). Saline irrigation with a nettipot can help too, although it may not stop the problem. It will help wash germs, mucus, and pollen from your nose and sinuses. You can get a nettipot and pre made buffered salt packets at most drugstores and pharmacies. It will come with directions. If you used a nettipot and Flonase, avoid using them within an hour of each other as the nettipot will just make the nasal spray drip down to your stomach where you don't want it! I am assuming the drainage is mostly clear, or discolored just after you wake up, that you don't have a fever or pressure in your sinus areas. These can indicate a sinus infection. Sinus infections can still be treated at home with the things listed above, but if it is going on more than 2-3 weeks, I usually prescribe an antibiotic. I hope this information helps. Please let me know if I can provide further information or clarification.