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Taking medicine for asthma and sinus. Facing toothache and headache. Alternate medicine?

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ENT Specialist
Practicing since : 1991
Answered : 2544 Questions
I have sinus/asthma problem and my ENT surgeon has advised on Glemont F, Medrol 4mg and becozinc along with fluticasone nasal sprays for period of 2 weeks before I go for blood test and CT scan.
I am facing severe toothache, leading to headache as well. I heard that I cannot take ibuprofen with Medrol. Could you please suggest any alternate medicine for toothache/headache along with the medicines listed above that would be safe to take and can reduce the tooth/head pain.
Posted Thu, 21 Mar 2013 in Medicines and Side Effects
Answered by Dr. Sumit Bhatti 23 minutes later

Thank you for your query.

1. Ibuprofen and Methylprednisolone (Medrol) both cause gastrointestinal side effects.

2. However, 4 mg (even 3 to 4 times a day) is a small dose and since you are taking it for only two weeks (is it a tapering dose?) you can safely take both medicines.

3. The only precaution that you may take is to take the medicines at different times. For example, Medrol before and Ibuprofen after a meal or alternatively separated by a few hours.

4. You may request the doctor to prescribe an antibiotic for your severe tooth ache. This is because steroids may flare up an infection if taken without an antibiotic cover.

5. The above treatment is fine and the suggestion to take two weeks of medication before going in for a CT scan is excellent. You may share the CT scan images (not the report) here for an accurate assessment.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

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Follow-up: Taking medicine for asthma and sinus. Facing toothache and headache. Alternate medicine? 22 minutes later
Thanks Dr. XXXXXXX for answering the query in detail.
The medicines are started just 4 days back during my first consultation with ENT, and I was informed that there are chances of nasal polyps being developed.
The toothache is specially at tooth area where I had gone for root canal treatment two years back, so like you said, I understand now it may be because of some infection being flared up. This toothache along with headache happens specially during afternoon and continues till night until I take a pain killer (combiflam). My current medicine dosages are :
Morning : Medrol + Glemont F + fluticasone nasal spray (after food)
Night : Medrol + Becozing +fluticasone nasal spray (after food)

As I could consult my doctor only after a week when he is back, could you please suggest any anti-biotic for a week that could be taken with combiflam. Also, should I replace combiflam with paracetamol if you think it could be safer.

Thanks !
Answered by Dr. Sumit Bhatti 5 hours later

Thank you for writing back.

1. The combination of nasal polyps, asthma and aspirin hypersensitivity is known as Samter's Triad. The CT PNS (Para Nasal Sinuses) Scan will settle the issue.

2. You must always take medication under the supervision of a local physician. Augmentin (amoxicillin + clavulanic acid) or Pecef Duo (Cefpodoxime + clavulanic acid) are good options.

3. You may try plain Paracetamol and if it is adequate, continue with Paracetamol. Another reason for avoiding Combiflam is that Ibuprofen worsens asthma.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

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