4.5 Review

Contemporary Role and Regulation of Over-the-Counter Sinonasal Medications

Journal

OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Volume 165, Issue 1, Pages 7-13

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/0194599820969177

Keywords

pharmaceutical; over-the-counter; antihistamine; corticosteroid; decongestant; sinonasal; nasal spray

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Numerous OTC sinonasal remedies have limitations in effectiveness and safety, compared to alternative drugs. Clinicians should encourage patients to use alternatives like intranasal corticosteroids and newer-generation antihistamines, while discouraging unsupervised use of decongestants. Dialogue between healthcare providers and patients about OTC sinonasal remedies can optimize individual health and healthcare delivery.
Objective Numerous pharmaceutical options are available over-the-counter (OTC) for the relief of sinonasal symptoms. Patients typically utilize these drugs in an unsupervised manner, without appreciation of their relative efficacy or potential for adverse effects. This review covers the scope and regulation of the OTC drug market, the pros and cons of OTC availability, and specific concerns that surround the most common classes of OTC sinonasal drugs. Suggestions are provided for the improvement of patient care and public health. Data Sources MEDLINE publications and market reports. Review Methods Literature review. Conclusions Some of the most commonly used OTC sinonasal remedies, including decongestants and first-generation antihistamines, are less effective than alternative drugs and pose potential safety concerns. Implications for Practice Clinicians should advocate to their patients for the appropriate use of alternative agents, such as intranasal corticosteroids and newer-generation antihistamines, and discourage the unsupervised use of oral and topical decongestants. Furthermore, health care practitioners should encourage dialogue with their patients about the use of OTC sinonasal remedies, with the goals of optimizing individual health and health care delivery.

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