Is Mucinex-D making me sicker?
August 27, 2010 7:26 PM   Subscribe

Is it possible for Mucinex D to make sinus problems worse?

(I'm asking on behalf of my husband.)

He says: I'm taking Mucinex D (1200mg of guaifenesin and 120mg of pseudoephedrine HCI) twice a day for a horrible sinus infection.

I've been noticing that about 30 minutes to an hour after taking it that I'm much more congested in my nose and have *considerably* more mucous (which is also thicker) than before I take it.

After a few hours, the congestion eases up and there seems to be less and thinner mucous.

Could either of the two drugs in Mucinex D be making things worse or is it doing what it's supposed to do?

A bit of background on his current illness: He's been sick for several weeks now. Went to the family doctor two weeks ago, who prescribed one round of antibiotics (Bactrim) and steroids (Prednisone) and advised him to take the 1200mg Mucinex-D. When he wasn't getting better, he went to an ENT and was given a steroid injection and another round of Bactrim.

He is using the Neti Pot several times a day, and has tried a few homeopathic remedies like oregano oil (I think inhaled or in the Neti Pot. All I know is our kitchen smells like an Italian restaurant quite often.) and grapefruit seed oil as well as xylitol spray and 4 Way nasal spray. In spite of this, the sinus infection is not getting significantly better.
posted by pyjammy to Health & Fitness (12 answers total) 1 user marked this as a favorite
Is he well-hydrated? If you don't drink enough water with Mucinex you will feel worse.
posted by Medieval Maven at 7:29 PM on August 27, 2010

Yes, definitely make sure he's drinking enough water. You're supposed to drink an entire glass when you take it, then keep pushing fluids.
posted by jenny76 at 7:31 PM on August 27, 2010

Response by poster: He says yes, he's drinking "buckets of water" daily.
posted by pyjammy at 7:49 PM on August 27, 2010

If this is just a sinus irritation/infection with no chest congestion or cough, I don't see any reason to use guafenesin. Guafenesin makes you produce more mucus, but makes it thinner, allowing your coughs to be more effective in clearing your throat (at least this is the idea). I wouldn't think it would make your condition any worse, but it could. Try using just pseudoephedrine instead to see if it makes a difference.

Obviously, I am not a doctor.
posted by Michael M. Tripp at 8:23 PM on August 27, 2010

Best answer: I'm no doctor either, but I've gone through sinus hell this summer. One doctor did say that you really don't want to take decongestants or antihistimines because they thicken mucus. Maybe plain mucinex would work better? I didn't notice much of a difference, myself.

I did experience relief with slightly stronger and warmer than suggested saline for the neti pot.

Good luck to him. Sinuses are the pits.
posted by littleflowers at 8:36 PM on August 27, 2010

I have chronic sinus issues, and have a hell of a time with mucinex and the neti pot. My ENT told me that some folks, like me, who have sooooo very much snot in the head have issues with things that loosen mucus up and shouldn't use them in conjunction.

For me, I don't use the neti pot when I'm taking any sort of thing with decongestants. It turns me into the most disgusting snot faucet.
posted by teleri025 at 8:52 PM on August 27, 2010

Best answer: Last time I had a sinus infection my doctor told me just to take plain Mucinex - no D - because the decongestant can dry up the mucus and make it harder to clear out.
posted by katopotato at 8:52 PM on August 27, 2010

I take Mucinex to clear chest congestion, not for sinus. I have to be diligent about drinking water.

I had been taking Four Way for years but ended up with a specialist who said it was extremely addictive, with all the bad effects that suggests (building tolerance, increased dosage, terrible rebound congestion, etc) and not to use it at all. He prescribed Flonase (Fluticasone Propionate) nasal spray to be used once a day. When moisturizing is needed, plain saline nasal spray. This has been reasonably effective for a couple of years now. At least I'm not desperately reaching for the Four Way just to be able to breathe. I seldom have sinus pain and headaches now.

Funny how that works; the only thing that I felt helped me immediately was exacerbating the problem.
posted by Anitanola at 9:15 PM on August 27, 2010

In spite of this, the sinus infection is not getting significantly better.

Xylitol and rinsing are not a cure-all. Topical decongestants make the underlying problem worse.

Sudafed should help a little (but watch your blood pressure), and Mucinex can be hit or miss. It's probably not making anything worse, though.

It's time to see a doctor and follow his or her advice. This could be further testing (to ensure that it's a sinus infection and not allergies), a course of antibiotics, and nasal spray to get over the congestion without rebound congestion.

Speaking from experience, I thought I had a sinus infection on and off for about a year. I finally decided that not seeing a doctor was not helping me. My doctor took some blood, and noticed there was no sign of infection. It was allergies, not a sinus infection.

I went on some new allergy meds which helped the problem (Singulair), and went to an allergist to start allergy shots. A few months later, I don't really have allergies anymore!

Funny how that works; the only thing that I felt helped me immediately was exacerbating the problem.

To be fair, it does say this on the label: "Do not use for more than three days."
posted by jrockway at 9:26 PM on August 27, 2010

Probably time for a second trip to the ENT, where your husband should lay out everything he's been doing in detail, note that the two rounds of Bactrim haven't helped, and see what the next step is. They may want to get some images of the sinuses, prescribe a steroid or antihistamine nasal spray, or otherwise investigate further.

I do wonder if there's just too many things going on in there-- the Bactrim, the guaifenesin, the pseudoephedrine, the steroids, the grapefruit oil, the xylitol, the oregano oil, multiple irrigations per day, and whichever version of Four Way spray he has (I've googled and found one that's oxymetazoline-- addictive and capable of causing rebound congestion-- and one that's phenylephrine, what they put in new OTC decongestants so that you can't cook meth with them)-- for the sinuses to get sorted out.

Any time I start thinking that Afrin might go well with Flonase and Sudafed, and then maybe some Mucinex and a couple Tylenol... well, that's when I know I have to go to the doctor, confess my sins, and see what the real problem is.
posted by fairytale of los angeles at 9:36 PM on August 27, 2010 [2 favorites]

Last time I had a sinus infection my doctor told me just to take plain Mucinex - no D - because the decongestant can dry up the mucus and make it harder to clear out.

That has been my experience as well.

Considerably more mucus: that's what Mucinex does.

Thicker: That's probably the 'D' talking. 120mg of pseudoephedrine twice a day is a LOT, to me. I can't prove it, but my sense is that guaifenesin and pseudo actually work against each other, and the pseudo is included in many pills like this simply because it makes us feel slightly less miserable.

I would cut the D and take an NSAID instead. The idea being that you want to let the body heal the infection, and the way to do that is to get all the mucus out. The nsaid will open up the passages like the D purports to, but without the drying out factor.

The other thing I have done when I have a cold is to cycle what I'm taking. Sometimes, you have to turn the draining and sniffling off because you need to go to work. So, decongestants for that. Then, in the evening, an expectorant to sort of "unload" and keep everything moving.
posted by gjc at 3:12 AM on August 28, 2010

Response by poster: Thanks, everyone...he stopped taking the Mucinex-D on Saturday (I think he'd taken a 12 hour pill a few hours before I posted this question, but that was the last one he's taken in a few days.) He says he has been staying uncongested for longer after using the Neti pot than he was when he was taking the Mucinex-D, so I'll bet that was a big part of the problem.

And regarding the 4-Way spray - he's well aware that it causes rebound issues. He's dealt with that several times in the past, but it's hard to stop using something that gives such immediate relief, you know? (I know - I've had issues with it myself before. We never learn.)
posted by pyjammy at 8:12 AM on August 30, 2010

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