Wednesday, April 23, 2014

Saturday, August 22, 2009 Anita, Community Member, asks

Q: Pulmicort Respules for sinus problem

The ENT doctor prescribed Pulmicort Respules for my chronic sinus problems.  I tried this with part water in an atomizer bottle and squirted up my nose.  This burned up my nose and had pain in my gums.  Is this normal to have pain?

Answer This
Answers (7)
Kathi MacNaughton, Health Pro
8/29/09 8:07pm

Hi Anita,

 

Your question intrigued me because I had never heard of Pulmicort Respules being used in any way other than in a nebulizer for childhood asthma. But some Internet research revealed that there was a recent study published that showed it could be used safely in a nasal wash for sinusitis. I couldn't find any information, however, on how to administer it for this purpose.

 

So, I'm wondering if you were on  your own or if you have specific instructions on how much water to mix it with and how to use it? It sounds as though the concentration you used may have been too strong, but I really don't know. Does your pharmacist have any more info on this off-label use?

 

To your health,

Kathi

Reply
Patti, Community Member
9/ 1/09 10:26am

My sinus surgeon prescibed this treatment yesterday.  The respule is to be mixed in 240 ml of distilled water in which one saline packet has been disolved.  Have used twice now and no burning sensation at all.

 

Having had 5 prior sinus surgeries, I've probably tried just about everthing.  Hopefully, this will provide long term relief.

 

 

Reply
SarBear06, Community Member
12/ 3/10 11:39am

How has this been going for you?  I have also had 5 sinus surgeries and am due for a 6th.  Two doctors have recommended this treatment to me. Should I try this now or directly after surgery?  What this treatment successful?

Reply
Jean, Community Member
9/ 3/11 10:20am

Just happened to come across your site and I was prescribed this by my EMT two days ago:  2ml of Pulmicort Respules packets mixed with sinus irrigation mix.  I had sinus surgery four years ago for removal of polyps but they have returned ad I suffer off and on from swelling in these areas.  I also take Nasonex in the a.m. daily. Jean from Florida

Reply
jim, Community Member
4/28/12 2:17pm

if you mix the pulmicort with in a mild salt ssolution - 1/8 of a tsp to 8 oxx of water - there is not stinging.

Reply
Susan Smiley, Community Member
3/ 1/10 6:33pm

This is not FDA approved yet for sinus treatment.  That being said, both my ENT doc @ Massachusetts Eye & Ear as well as the allergist/immunologist @ Massachusetts General Hospital have prescribed this treatment for me as well.  I have had 1 previous sinus surgery & possibly another looming.  I have tried every spray known to mankind but this seems to be actually making a difference.  My MEEI doc had me put 1 capsule of Pulmocort into my sinus rinse (no difference really noted) but my Mass. General doc has had me put the Pulmocort into a syringe & directly insert into my sinus area & then hand my head over bed as if I am looking under my bed so that it can penetrate way up into my sinus cavatiy.  This really does make a difference!

Reply
namaste, Community Member
6/18/10 10:57pm

I had sinus surgery in March after never ending chronic sinusitis and exacerbation of asthma. Steroids and antibiotics this whole year. My nasal passages continually get inflamed about a week after tapering the medrol Pack. When I saw him, my sinuses were completely blocked and now resolving on meds. yesterday he wrote the prescription for the Pulmacort for nasal rinse, but said to mix in water and do like a nasal rinse. He wrote the exact amount for the Pulmacort, but the way to do this installation was not explained. If you use a syringe, which makes sense to me, what do you mix the Pulmacort in and how much do you mix it in.

 

Thank you.....I feel hopeful about treated this locally...it makes sense and I could be inflamed due to rebound coming off the steroids all of the time, that my mucous membranes just don't ever get back to normal.

 

I also stated Xolair for allergic asthma. Injections every other week.

 

I look forward to hearing from you.

Reply
Susan Smiley, Community Member
3/ 1/10 6:34pm

This is not FDA approved yet for sinus treatment.  That being said, both my ENT doc @ Massachusetts Eye & Ear as well as the allergist/immunologist @ Massachusetts General Hospital have prescribed this treatment for me as well.  I have had 1 previous sinus surgery & possibly another looming.  I have tried every spray known to mankind but this seems to be actually making a difference.  My MEEI doc had me put 1 capsule of Pulmocort into my sinus rinse (no difference really noted) but my Mass. General doc has had me put the Pulmocort into a syringe & directly insert into my sinus area & then hand my head over bed as if I am looking under my bed so that it can penetrate way up into my sinus cavatiy.  This really does make a difference!

Reply
Susan Smiley, Community Member
3/ 1/10 6:34pm

This is not FDA approved yet for sinus treatment.  That being said, both my ENT doc @ Massachusetts Eye & Ear as well as the allergist/immunologist @ Massachusetts General Hospital have prescribed this treatment for me as well.  I have had 1 previous sinus surgery & possibly another looming.  I have tried every spray known to mankind but this seems to be actually making a difference.  My MEEI doc had me put 1 capsule of Pulmocort into my sinus rinse (no difference really noted) but my Mass. General doc has had me put the Pulmocort into a syringe & directly insert into my sinus area & then hand my head over bed as if I am looking under my bed so that it can penetrate way up into my sinus cavatiy.  This really does make a difference!

Reply
Erindlz, Community Member
8/ 4/11 6:30pm
You HAVE to add something to plain water in order for it to be comfortable in your sinuses. You need to buy a NetiPot or a NeilMed Sinus Rinse squeeze bottle... These can be found at WalMart, Target, Walgreens, CVS, etc. (it will be by Afrin nose spray and/or cold & allergy meds). You will get the NetiPot or squeeze bottle along with 50+ packets of a PH balanced powder that once mixed with water makes a solution that is the same saltiness as your sinuses. You then add the Pulmicort to the solution you've made and squirt it up your nose. I use it intermittently when I get sinus infections (long history of them and surgery to correct blockages). I once forgot to add the powder to my Sinus Rinse squeeze bottle and with full force squeezed the plain water deep into my sinuses.... IT WAS EXCRUCIATING. It burned terribly, my eyes watered and burned, my gums hurt and it stayed that way for at least 1-2 minutes. Your doctor should have told you that you can't put regular water in your nose... I can't believe he/she left that part out! One more thing, make sure the water is not too cold or too hot, but somewhere in-between: lukewarm or just slightly warmer than lukewarm. Cold water and water that's too hot BURNS like plain water going up there! Good luck & happy rinsing! It's a lot to remember but it is 150% worth it. Reply
donstaff, Community Member
1/16/13 3:36pm

Almost correct.  NEVER USE PLAIN WATER.  ALWAYS USE DISTILLED WATER.

Reply
donstaff, Community Member
1/16/13 3:50pm

Your reference to plain water may be missleading.  The NelMed directions speciffically say to never use tap water, but to always uce distilled water.

Reply
Tom, Community Member
12/15/12 12:53pm

I had 2 sinus surgeries about 10 years ago & have been struggling with infections ever since. I also lost my sense of smell over that same period. The polyps have returned & I was destined for another surgery. Thankfully, my surgeon wanted me to go on prednisone & antibiotics for 2 weeks & the pulmicort/salt water nasal first. I have not needed any antihistimines since then & my sense of smell has returned! Quite a milestone for me. He also told me to hold my head down for 5 minutes while some of the rinse is still in my sinuses to 'bathe' the polyps. I assume that this has caused the polyps to shrink. I go for a follow up visit in 1 week.Smile

Reply
Pattyjo, Community Member
1/29/13 7:48pm

How are you doing now?  Does the rinse still help you?  Are you using it twice a day?  I also wonder how much water you put in the Neil Med bottle?  I have used this method for about 8 weeks and also had a Kenalog injection on my polyps which reduced them significantly and I have my sense of smell back.  Since this is an off label use, i would like to know how safe t his is to use it this way.  Could it cause bone loss later since the use of steroids could contribute to that.  It has definitely helped me though.  My doc said my polyps don't need surgery since the Kenalog injection on them helps so much and they are not that big, but when they are normal size, i have no sense of smell.  But I really don't know how safe that is, and don't want to have them every 3 months for the rest of my life.  Thanks for  any info i can get on this.  Patty

Reply
Tom, Community Member
1/30/13 11:38am

I reduced the frequency of the pulmicort/saline rinse to once every other day & doing saline rinses twice daily. I have noticed that my sense of smell is fading again so I will go back to doing the pulmicort rinse twice daily & see if that helps. I use 4 oz. of water in the nedi med bottle & hold the last portion of the rinse in my nose for 5 minutes with my head down while kneeling on the bed. I'm 70 now so I am not all that concerned about potential side effects of the pulmicort if positive results continue. Tom

 

Reply
Kathi MacNaughton, Health Pro
2/11/13 9:02pm

Patty, I don't think you need to worry too much about bone loss from using Pulmicort Respules intranasally. Steroid contributions to bone density losses are usually from large doses of oral steroids (or perhaps injected) that are distributed throughout the body because of the way they are taken. The small amount of steroid placed into the nasal tissues is not going to get circulated throughout the body in the same way.

Reply
rb5505, Community Member
3/10/14 3:48pm

i've been using the pulmicort 1mg mixed into a syringe of 10 ml of sinus rinse water (1 neilmed packet per 16 oz distilled water) for about a year or so.  it's been the only thing close to almost giving me my taste/smell back.  can breathe through my nose & more energy too.  due to eminent loss of insurance, i might have to go to .5 ml size.  even generic w/o insurance is pricey for this stuff.  anyone find it more reasonalbly priced elsewhere?  canadian pharmacy's have it for much less.  anyone else use them? 

Reply
Breathe Easy, Community Member
12/25/13 5:31pm

hi

I hope my answer can help. I have Asthma, Salicylate Allergy and Nasal Polyps.

Over 20 years, 5 or 6 Polyp operations, nasal sprays and Prednisone injections it gets a bit much especially with no sense of smell or apetite.

 

I am allergic to salicylates in many foods and just about any airborne allergen. The last surgery lasted much longer as I was using a netipot bottle to flush a saline solution through the sinus's nearly every day for the last 5 years, however this year the spring time caught up with me and back to the blocked nose which is unbearable when trying to sleep.

 

Had been searching the internet for some natural rememdies when I came across some sites discussing using Pulmicort solution and going by some responses I felt this was worth trying out.

 

Asked my doctor who is helpful even though had not heard of using pulmicort for polyps prescribed it for me as I am an Asthmatic. I had intended on getting a referral to visit a surgeon and that was going to take 2 months at this time of year, I just could not go through another night bad sleep and waking up like the dog had pooed in my mouth.

 

Here is what I did, for the first two weeks I put in half a litre of boiled filtered tap water, two sachets of saline solution from the chemist and one 1mg in 2mL Respule of Pulmicort. Let the water cool to warm before putting in the pulmicort, mixed in the saline and pulmicort and ensured the temperature was just warm, about the same temperature you might put in babies bottle. That way it does not sting at all, I think the saline sachets also correct the PH of the water so it does not sting as well.

 

Flushed that through with difficulty as one side of the nasal passages were completely blocked, persisted and gently managed to get some through from one side to the other a few times, kept this up for several days and after 3 - 5 days I noticed a little easier to get the solution to flush through.   After 1 -2 weeks I was clear and was able to easily flush through and even felt a bit high from the very clear feeling in my sinus's.

 

Keeping this up just once a day for two weeks I reduced the dosage of Pulmicort to half a Respule by counting the drops, there is an everage of 32 drops in each Pulmicort Respule and I use half a Respule each day ( 16 drops ), I kept up with the 2 Saline sachets and the 500Mls of boiled water.

 

After 3 weeks I was able to smell some scents around the home, after a month my sense of smell was the best it has been in 20 years and now I am about 5 weeks into this treatment course and my apetite has for the first time in years also increased which is fantastic.

 

I can sleep so well now and feel a 100% better, I am considering reducing the drops of Pulmicort down to 10 drops a day instead of the 16, this will mean 1 Respule will last 3 days give or take a drop.

 

The goal with any medication IMHO is to reduce it to a level that it is effective enough to have quality of life and reduce any possible long or short term side effects.

 

The method of use is the flush through from each side once and then using the last of the solution I fill up my sinus's and hold it there for a few minutes tilting my head side to side and shaking my head to ensure the solution is getting into all cavities in the sinus area, holding your breath while doing this is helpful as it puts pressure on the back of your throat to prevent leakage of the solution down your throat. I realise that 500 mls of boiled water my not be the correct amount but having such a large volume to use to rinse with helps clear a lot of the rubbish from the upper sinus area.

 

The drug company recommends you do not drink or swallow Pulmicort and therefore I am very careful not to do so and ensure I gargle very well afterwards and drink plenty of water.

 

I would have to say this is totally the best treatment for my sinus polyps I have ever had, no surgery, good sleep and the medication is being administered directly to the condition. Unlike taking prednisone tables which go through your entire system and digestive system this is much better, also I tried nasal sprays for years and the problem with those is they have little chance of reaching the upper area's of the sinus's where many of the polpys start to grow, they just do not work to the level this does.

 

I will see if I can update in a few months or a year on the effectiveness of this long term, I see on the internet that there is now a UK study into the cost effectiveness of this treatment compared to Sinus surgery.

 

Good luck to everybody as I totally know how bad it is to have sinus polyps.

Reply
Answer This

Important:
We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of Remedy Health Media. Remedy Health Media does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.

By Anita, Community Member— Last Modified: 03/31/14, First Published: 08/22/09