Nasal Irrigations – Instructions
Saline nasal irrigations
Homemade: Mix 1 teaspoon of iodide-free (Kosher) salt and 1 teaspoon of baking soda in 1 cup (8oz or 240mL) of distilled or boiled water. Saline can be drawn up in a syringe or infant nasal bulb. Lean over a sink and using steady gentle pressure irrigate nose with a squeeze bottle. Blow nose gently. Some of saline should come out of the other side of the nose. A sinus pot can also be used. Do this on both sides at least once a day.
Commercial: Several commercial preparations are available at most any pharmacy which contain both an irrigation bottle and pre-made salt packets. The most frequently available is the NeilMed Sinus Rinse ($10-$15).
Your doctor may prescribe this as an off-label use for chronic sinus disease. Originally designed for nebulizers in asthma, budesonide is a topical steroid that is very effective for sinus disease. Since it is an off-label use, most insurance carriers to not cover the medication. The cost is around $1 per treatment through a compounding pharmacy.
After making 240mL of saline irrigation, empty take 1 capsule (1mg) of budesonide and empty HALF OF ONE CAPSULE into saline irrigation bottle and shake. Irrigate once on both sides. This can be done about every other day to start and adjusted more or less frequently depending on the severity of your sinusitis.
Alternatively a nasal nebulizer can be used to aerosolize the medication to distribute thoroughly to the nose and sinuses only. This can be done in about 2 minutes but requires purchase of a machine (cost $200) . See nasoneb.com for details.