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It is a good idea to have a prescribed decongestant and expectorant in your arsenal of medications. OTC decongestants are fairly expensive these days and aren't as strong as their prescribed counterparts.
Dr. Grogg suggests Guiamax-D.
Guiamax-D is an expectorant (1200 mg Guaifenesin) and decongestant (120 mg Pseudoephedrine) generically available as Guaifenex GP for $15 x 10 days.
Consider using prescription-strength Guiamax-D BID x 10 days in relieving congestion associated with viral URI and conjunctivitis. It can also be used for "ocular pain" associated with sinusitis. A typical clinical presentation would be a patient presenting with a complaint of periorbital pain or pain behind the eye. After you have ruled out the obvious differentials (preseptal cellulitis, hordeoli, corneal disease, uveitis, increased intraocular pressure, optic neuritis), you may consider periorbital pain referred from sinusitis. Palpation of the sinuses may help, but it is really impossible to palpate the ethmoid sinus. Patients will often describe ethmoid sinusitis by saying the pain is deep and nasal to the orbit. Dr. Grogg will put such a patient on Guiamax-D and Zpak regimen to see whether she can rule out periorbital pain associated with sinusitis.
Contraindications are severe hypertension, coronary artery disease, and within 14 days of MAOIs. Precautions include hypertension (meds will be antagonized), diabetes mellitus, cardiovascular disease, narrow angle glaucoma, elderly, prostatic hypertrophy, and hyperthyroid. Nervousness, insomnia, headache, GI upset, and urinary retention are listed as adverse reactions. Be sure to insist that patients take the medication at breakfast and dinner time. Stress to them that if they take it at bedtime, they WILL have insomnia.
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