Nasal polyps are noncancerous soft tissue growths that form in your nasal passages and sinuses. They’re often a result of inflammation from sinusitis, allergens, or other issues. Experts don’t know why some people are prone to them, but once you have nasal polyps, they often continue to happen even after surgery to remove them.
Medications can help. The goal of most nasal polyp medications is to shrink the polyps so they’re less likely to block your nasal passageways and cause symptoms like trouble breathing, snoring, and reduced sense of smell and taste. Other medications can help treat underlying issues that lead to sinus inflammation.
Medications to Shrink Nasal Polyps
Often the worst symptoms of nasal polyps happen when they grow large or you have multiple nasal polyps. Infection is more common when this happens. Certain medications work specifically to shrink polyps so they take up less space in your sinuses.
These include:
Nasal steroids. Steroids reduce inflammation. You take these steroids as sprays directly into your nasal passage. Nasal steroids work best right after surgery and on small polyps. They may not make much of a difference on larger nasal polyps.
Some you can buy over the counter, and others require a prescription. Nasal steroids include:
- Beclomethasone (Beconase AQ)
- Budesonide (Rhinocort)
- Ciclesonide (Omnaris, Zetonna)
- Fluticasone (Flonase Allergy Relief, Xhance)
- Mometasone (Nasonex 24hr Allergy)
- Triamcinolone (Nasacort Allergy 24HR)
Oral steroids. Sometimes nasal polyps grow in a way that a spray into your nostril can’t reach where it needs to. In these cases, your doctor may prescribe a steroid (typically prednisone) you take by mouth. Because you swallow oral steroids and they go through your whole body, they cause more side effects. Doctors usually only prescribe these for short periods of time. In the case of severe nasal polyps, your doctor may give you steroids as a shot.
Steroid injections. In the case of severe nasal polyps, your doctor may give you steroids as a shot. They’ll inject the steroids directly into the polyp they’re trying to shrink. This reduces the amount of side effects you get when compared to oral steroids.
Steroid implants. Sometimes after surgery, your surgeon will put a dissolvable device in your nose that delivers steroids right to the lining of your sinuses. These implants (also sometimes called stents) can help keep sinuses clearer during recovery and keep new nasal polyps at bay for longer.
Biologics. Biologics are a newer class of medications used to treat nasal polyps. Doctors sometimes turn to these in cases where nasal steroids and other treatments haven’t worked well enough. These biologics are a type of drug called monoclonal antibodies. They target specific inflammatory pathways that are a part of forming nasal polyps. The FDA has approved three biologics for treating nasal polyps:
- Dupilumab (Dupixent)
- Mepolizumab (Nucala)
- Omalizumab (Xolair)
You typically take biologics as a shot every two to four weeks.
Leukotriene inhibitors. These medications aren’t FDA-approved for treating nasal polyps, but doctors sometimes prescribe them off-label. Montelukast is one type of leukotriene inhibitor doctors use to treat asthma. Studies have shown they can help treat nasal polyps in some people.
Medications to Treat Underlying Conditions
In addition to taking medications that shrink your nasal polyps, you may also need to treat the condition that caused the inflammation in the first place. This might mean taking:
Antihistamines. These medications don’t treat nasal polyps themselves, but they help reduce inflammation that can lead to polyps. Histamines are chemicals your body releases when you come into contact with something you’re allergic to (an allergen). Histamines cause inflammation to happen. Antihistamines help block these chemicals so your body doesn’t have the same response when you’re around an allergen, and inflammation is lower.
Examples of antihistamines include:
- Cetirizine (Zyrtec)
- Fexofenadine (Allegra)
- Loratadine (Claritin)
These options are known as second-generation H1 antihistamines. Unlike first-generation H1 antihistamines, they’re non-drowsy and have fewer side effects.
Allergy shots. This treatment is also called immunotherapy. A doctor injects small amounts of the substance you’re allergic to into your skin over a period of time. This changes your immune system and makes it less reactive to the allergen over time.
Decongestants. These medications help soothe a stuffy nose by narrowing and reducing the swelling in the blood vessels and tissues in your nose. You take them as pills, liquid, sprays, or drops. Often they’re combined with other medications such as pain relievers or antihistamines.
Common choices include:
- Oxymetazoline (Afrin Nasal Spray, Dristan Nasal Spray, Zicam Nasal Spray, and others)
- Pseudoephedrine (Sudafed)
Aspirin. If your nasal polyps are a result of the inflammation you get from a condition called aspirin sensitivity, also known as aspirin-exacerbated respiratory disease (AERD), your doctor can guide you through a treatment called aspirin desensitization therapy. Much like allergy shots, you get small amounts of aspirin while a doctor monitors you, and you build up your body’s tolerance to it.
Antibiotics. Often nasal polyps cause infections in your sinuses. When this happens, you may need an antibiotic to help treat the infection.
When Medications Don’t Work
Medications work best when you follow your doctor's instructions and also include preventative care in your routine. These include practices like rinsing with saline daily and avoiding allergens.
But sometimes if you’ve tried medications and your nasal polyps aren’t getting better, or if they’re especially large or severe, your doctor may first try to combine medications or move to biologics if they haven’t yet. Or they may decide surgery is the best choice for you.
You might have a:
- Polypectomy, which is a simple outpatient procedure where a doctor puts a small suction device or tiny rotating blade into your nostrils to remove the polyps.
- Endoscopic sinus surgery, which is more advanced, where a doctor uses a thin, flexible tube with a camera called an endoscope through your nose to remove large, deep polyps and clear blocked sinus passages.
Surgery isn’t a permanent cure for nasal polyps. Often the polyps grow back, but you can help stave them off and lower your risk with corticosteroid sprays and preventative care.
