Never ending s... inus infection?
February 11, 2017 1:19 AM   Subscribe

I have been fighting off a cold since December. After some rest, I thought it had finally gotten better, but this morning I woke up and it's back in full force. What can I do finally kick this motherf..... to the curb?

Apparently there's a terrible virus spreading in mid-Europe, and I've been fighting it since December. Two doctor's visits (both GPs) in January when it just wouldn't get any better, both told me to rest, take some ibuprofen and sit it out. Unfortunately, I couldn't rest until last week due to work and a move etc., but I've been doing nothing for ten days now and finally felt mostly over the stupid thing when my throat started hurting again last night and this morning I woke up with a runny nose, postnasal drip, headache etc. Walking to the bathroom is exhausting, I feel slightly nauseated (which is normal for me with colds) and I had to cancel my plans for today, the first I made in ten days. This blows.

At this point, I'm not sure seeing yet another doctor will be of much help. In September, I saw an ENT for a cold and he told me he could suck out my sinuses once I felt better, but I declined in horror. Maybe I should have taken him up on it because the feel full. When I press next to my nose, it hurts. Same for above my nose/eyebrows. When I bend my head down, it hurts. A friend told me she has her sinuses sucked clean every year because she needs to, but I'm terrified and not sure of the outcome and risks.

I take vitamin C, D, zinc and iron. I eat a relatively healthy diet. I didn't exercise much the last few weeks because going to work exhausted me already, and since I quit (I'm currently waiting for grad school to start in March) I've been resting like the doctor told me to.
I have polyps in my nose and perpetually large-ish tonsils that are not inflamed. I've always been really healthy until about a year or two ago, when I suddenly started getting colds almost every month. It's never been this terrible, though. I was finally diagnosed with endometriosis last April, which I know is a burden on the body, but I'm taking a pill to suppress my periods and feel much better. I'm also on 50mg of thyroid replacement hormones since last June, but it's not yet 100% confirmed that I have Hashimoto's. (The German Hashimoto's support forum is full of people attributing every illness they have to it, sinus problems as well, and while I do believe that your body fighting a part of itself will surely weaken it and the immune system, I'm not sure any doctor would agree.)

What can I do to finally feel better? I only have one more month until I need to be in Japan, and ideally I'd get some research done before then. Help, please?
posted by LoonyLovegood to Health & Fitness (43 answers total) 1 user marked this as a favorite
Forgot to mention my teeth are randomly hurting as well, although mostly in the lower jaw. And I'm allergic to dust mites.
posted by LoonyLovegood at 1:52 AM on February 11, 2017

You have not said what you are taking. Add Sudafed to the mix - pseudoephedrine is the magic ingredient; accept no substitutes. And if you want to recoil in horror, fine but a Neti pot will help.
posted by DarlingBri at 2:04 AM on February 11, 2017 [1 favorite]

Forgot to say I'm in Germany, so I can't get Sudafed here. Right now, I'm taking something called Sinupret which is a super popular herbal remedy for sinusitis here. (Germans love herbal remedies...)
I have also tried something like a neti pot, but the water cannot get through and it just gives me a terrible headache. :(
posted by LoonyLovegood at 2:11 AM on February 11, 2017

Have you gone to your GP and asked for stronger meds? Mine here in France are happy to help with harder-hitting stuff as needed.

Did you have some sort of life change about a year ago? I used to come down with whatever was going around until I moved to a different city. Since moving three years ago, I've only gotten ill once, and nowhere near the severity as before. (I wouldn't just get sick with everything before, I got sick BAD with everything, ugh.)
posted by fraula at 2:17 AM on February 11, 2017

You are my daughter? Nah, she has finally gotten a proper diagnosis after a whole year of this, and will soon have surgery. She is having both her tonsils and the polyps in her nose removed. She has talked with a friend who had it done and is very happy with the result, she has literally not had a cold since.
posted by mumimor at 3:11 AM on February 11, 2017

My bet is you just aquired a different cold virus. It's not very unusual for a cold to last a few weeks. I believe most folks get five colds a year. See doctor for all concerns/complications but this renewal may just be unlucky virus timing. Lots of kids appear to have a cold for the fourish months of winter but it's really a succession of unrelated illnesses.
posted by Kalmya at 3:14 AM on February 11, 2017

Can you get hold of some Eucalyptus oil? If you can, then add a few teaspoons to a bowl of boiling hot water and make a head tent with a bath towel. Breathe deeply. Expel. Be antisocial for a few days and repeat this procedure as often as necessary. Keep the water boiling hot.
Also works well with Vicks.
posted by esto-again at 3:16 AM on February 11, 2017 [1 favorite]

When this happens to me (frequently. All the time. Right now, in fact) it's usually a secondary bacterial infection that occurs a week or three after the original cold. My doctor prescribes a ZPac antibiotics course, and I recover relatively quickly. I have funky sinuses/a deviated septum, and this probably happens to me 2-3 times/year. I was sick 6-8 months out of the year before an allergist diagnosed the chronic "allergies" as sinus infections.
posted by instamatic at 3:43 AM on February 11, 2017

my throat started hurting again last night and this morning I woke up with a runny nose, postnasal drip, headache etc

Yeah, what I'd put cash on with this kind of sudden recurrence of symptoms, starting in precisely this pattern, is that you've just had the bad luck to get a whole new virus. I get sinus infections sometimes, but I'm going through this same thing right now, just got over one bug a few days ago and last night the new one showed up.

You might very well have a preexisting low-grade sinus infection that is exaggerating it all, but.

Are the steroid nasal sprays available OTC in Germany? If you've been to a doctor about this, I'm very surprised that it hasn't been recommended even if they're prescription. Probably not going to help the cold, but could help get you sufficiently opened up to let it heal properly afterwards. Also, a guaifenesin expectorant, preferably extended release, and make sure that you're drinking a lot of water while you're taking it.
posted by Sequence at 3:44 AM on February 11, 2017

Forgot to say I'm in Germany, so I can't get Sudafed here.

I am not asking you to get Sudafed. I am asking you to get a drug with pseudoephedrine. Apparently Reactine-Duo.
posted by DarlingBri at 3:57 AM on February 11, 2017 [1 favorite]

The pain in your face plus the goopy stuff really sounds like a sinus infection. Do doctors in Germany not prescribe antibiotics for those? It's not caused by a virus, it's bacterial, so...
posted by cooker girl at 4:34 AM on February 11, 2017 [1 favorite]

None of the doctors I saw even checked my sinuses, and antibiotics are really hard to get here. I've taken them once in my 27 years.

I'll try to get some Reactine-Duo on Monday if I don't feel better, thanks! Am already doing camomille baths etc.

I just wish I knew why this keeps happening. A new virus seems strange since I only stayed at home, and I've never been so sick before, but around 25/26 I started catching everything. Switzerland isn't so far from Germany, it would have made much more sense to suddenly get sick when I lived in Japan...
posted by LoonyLovegood at 4:38 AM on February 11, 2017

Sorry you aren't feeling well! Being sick with cold/sinus symptoms just sucks.

I can see why you might be confused about finding pseudoephedrine in Germany, especially since you were told to "add Sudafed to the mix." You should look for Rhinopront (make sure it has pseudoephedrine, NOT phenylephrine). Reactine-Duo contains an anti-histamine and pseudoephedrine - it's equivalent to Zyrtec-D in the US. It will be much more expensive than Rhinopront and since you don't have allergies, paying the extra money isn't worth it.

cookergirl: It is 100% patently false that all sinus infections are bacterial in nature. Some are, some aren't. If symptoms persist for more than a week with no signs of improvement (maybe you are already there - it's not clear to me if this is a recurrence of your earlier illness or something new), then it would be appropriate to consider antibiotics. Throwing antibiotics at possibly-viral infections is not good at all. Please don't encourage antibiotic overuse.

Neti pots are very soothing and relieve sinus pressure well.

Finally, I've found a cool-mist humidifier to be super helpful for sinus congestion. I add a few drops of eucalyptus oil to the water for some extra effect.
posted by schroedingersgirl at 4:47 AM on February 11, 2017 [4 favorites]

Once I had something like that and it turned out it was a bacterial infection. The doctor took a sample of the mucus to test after I was sick for two months and it wasn't going away. I took antibiotics for one whole month to get rid of it, but felt well after a week of antibiotics.
posted by TheGoodBlood at 4:47 AM on February 11, 2017

Honestly, judging from the pain you reported in your face, it sounds like you have an incredibly nasty sinus infection. Is the discharge/mucus production dark green or still clear? If you have the darker variety coming up and out in large quantities, you need to get back over to your GP as soon as you can to get some antibiotics. Also, you might want to consider visiting an allergist and talk about testing. You may have an allergy to mold that is just kicking your ass repeatedly, your body has a reaction to it (producing tons of mucus) and you end up getting sick repeatedly.

Also, talk to someone about your teeth situation. I had a friend with Hashimotos and for some reason (not sure what the clinical reason was) her front teeth started to shift to the point where they became crooked.

I hope you feel better soon and enjoy your trip to Japan! Perhaps the change of scenery will bring about a dose of new found health!
posted by bkeene12 at 6:08 AM on February 11, 2017 [1 favorite]

Yeah, get a swab taken to check whether you need antibiotics. If I may suggest, get your pee tested as well, water infections make one very systematically peculiar with general malaise.
posted by glasseyes at 6:19 AM on February 11, 2017

Now that you mention it, I do feel slightly weird in the blatter region, like a mild UTI.
posted by LoonyLovegood at 6:22 AM on February 11, 2017

I had a similar - 2 month - sinus infection about 10 years ago (never before nor since, thankfully). It just had to run its course (but was tremendously satisfying when it finally drained out over the course of 2 hours one afternoon - though seeing thick orange stuff flowing out of your skull is disconcerting).

FWIW I was advised by my doctor that antibiotics are largely ineffective for bacterial sinus infections.
posted by bifter at 6:26 AM on February 11, 2017

Sorry you're going through this exhausting coldlike nonsense.

Is it possible the dust mites are making everything worse? Is your body trying to fight this virus AND dust mites simultaneously? Can you wash linens and get a HEPA air filter?

What works for me is: time, pseudoephidrine allergy combo of decongestant and antihistimine (it may be overkill but it works for me), trying to pound at least a gallon of water daily, endless cups of ginger tea and honey to combat the post nasal drip queasiness in my stomach, forcing myself to eat toast or bananas, eucalyptus showers, Vapo-Rub or eucalyptus oil under my nose, and using a double-pack Neti-Pot squeeze bottle. It pushes the saline solution through your sinuses and it's marvelously revolting to see what comes out. After the Neti-Pot, I'll use an OTC steroid spray like Flonase, then an OTC decongestant spray for no more than 3 days and rest A LOT.
posted by yes I said yes I will Yes at 6:39 AM on February 11, 2017

I was sick for six weeks exactly like you describe and am finally recovering. Stress played a huge role. Huge. Try to just take care of yourself and reduce stress however possible.
posted by sockermom at 7:08 AM on February 11, 2017 [1 favorite]

I have an issue that results in regular sinus infections, 2-5 a year since about 2002. Here's what I do:

1. Get antibiotics. Now. That's how you kill this.

That's it. Here's my advice for maintenance:

1. Get a neti pot and use it daily.
2. Get a humidifier and use it at night.
3. Stay hydrated and dress warmly in winter.

Other people's allergy advice is good, but pseudoephedrine isn't going to kill a sinus infection. It may mask the symptoms, but it's not going to kill it.
posted by bile and syntax at 7:09 AM on February 11, 2017

If you stand in the shower and let really hot water hit the bridge of your nose, it melts the goo and it drains out. It can be uncomfortable, but can make a sinus headache ease off. It isn't a cure but it feels good to get the sinuses drained.

I like the Nasaline better than a netipot.
posted by chocolatetiara at 7:18 AM on February 11, 2017

Humidifier was really the game changer for me in keeping sinus issues down to a manageable level. Everyone's sinuses are a little different, but there are certain things that should at least be on the "to try" list. For me this is

- keeping the humidifier running non-stop in the wintertime, but keeping an eye on mold growth which would, of course, make things worse
- paying attention to allergens and trying to keep them from getting out of hand. I take Loratadine (don't know your local name) and it seems to help
- keeping mucus flowing. I take Guaifenesin for this. There's some debate whether it's useful (I've had some ear nose and throat people say no and others say yes, it feels like it's helping me)
- Pseudoephedrine can keep the congestion down which can also help things drain
- My sinus issues also come with a lot of ear pressure, stuffiness, so I pay attention to glue ear treatments (specifically the "auto-inflation" thing they note there, just do it without the special balloon) and it helps.
- Neti pot or equivalent only if you can get liquid through your nose. If not, don't do it. I get better results with warmer water

But yeah, antibiotics in some cases. Here is Harvard Medical School talking about what the criteria might be for treating a sinus infection with antibiotics. If you red that you can see that there's a thing called "double worsening" which is often oneo f the indicators that antibiotics might be necessary.
posted by jessamyn at 7:27 AM on February 11, 2017 [2 favorites]

I promise I'm not threadsitting, but the fact that I cannot get water through my nose with a netipot seems to have been buried a little.
I've also read that humidifiers can cause better living environments for dust mites as well, which I'm trying to avoid.
posted by LoonyLovegood at 7:31 AM on February 11, 2017

With the netipot, is it the congestion that's the problem? When I'm really plugged up I find that using the netipot right after a steaming hot shower helps.

I don't think the netipot will necessarily be the cure, btw, it just might help things be more comfortable.

Also, sometimes I have to start with one side first. I have no idea why that works, but it does.
posted by ghost phoneme at 7:48 AM on February 11, 2017

I find the Neilmed squeeze bottle to be way more effective than a neti pot. When I was experiencing recurrent sinus blockage (but not infection), my ENT recommended doing it twice per day. It really helped. (I still ended up getting a balloon sinuplasty after about 6 months because my insurance covered it and it was a more long term solution.)
posted by melissasaurus at 7:52 AM on February 11, 2017 [2 favorites]

I cannot get water through my nose with a netipot

Have you been checked for a staph infection? I put up with what I thought was a sinus infection for way too long.
posted by Mr. Yuck at 8:48 AM on February 11, 2017

How are you handling your dust mite allergy? My doctor recommended high quality allergy covers for mattress and pillows, the ones that feel like finely woven cloth and not plastic. I also take a prescription antihistamine nasal spray (azelastine) and an over the counter steroid spray (Nasacort) as well as an allergy pill (Allegra). When I don't keep up with things I get stuffy and prone to stuffed up sinuses. Right now I would recommend pseudoephedrine, breathing in steam, and try the Neti pot method when it loosens up a little--agreed that the squeeze bottle mentioned helps immensely, use warm water and double salt to help draw the fluid out of the nasal tissues. Pseudoephedrine will help you get to the point where you're clear enough to use it. It will not only help rinse the mucous out and reduce inflammation, it will also rinse out any dust mite particles that might be making things worse. Good luck.
posted by impishoptimist at 8:57 AM on February 11, 2017

I have also find the Neilmed squeeze bottle to be better than a neti pot, although I sometimes have the experience that it sounds like you're having of not even being able to get water through my nasal passages.

I will definitely strongly second Guaifenesin (the brand name is Mucinex in the US, not sure about availability in Germany). I don't take decongestants like pseudoephedrine because I've had bad reactions to them in the past. The Guaifenesin is helpful because it loosens up the mucus. Make sure you drink a lot of water with it.

I would take the Gauifnesin, drink a bunch of water, give it a couple hours to work, then take a hot shower, and then try a sinus rinse, preferably with the squeeze bottle. That combo sometimes does the trick for me.

However, I also realized that it wasn't always mucus that was the issue. Sometimes my nasal/sinus passages just seemed to get so swollen inflamed that this was the primary barrier to being able to do the sinus rinse. I use an over the counter nasal spray (Flonase in the US), and that has been a huge help, but in my case, all these issues seem to be primarily caused by allergies to various things (mold especially but also dust and pollen). IANAD/IANYD, so I have no idea if this would be useful for a sinus infection.

Anyway, I hope you feel better soon!
posted by litera scripta manet at 10:42 AM on February 11, 2017

When my awful sinus infections were first diagnosed, the doctor prescribed:

- Afrin (to clear the nose out enough for Neilmed/Neti pot sinus rinse to work)
- wait 2-5 minutes after Afrin, then sinus rinse (this also helps with the "rebound" effect where Afrin can make congestion worse if you use it frequently)
- wait a few minutes, then Flonase (steroid nasal spray), aiming at the sides of the nose instead of "into" the nose.
- repeat with Astelyn (antihistamine nasal spray)

Later, once I got the perpetual sinus infection under control, I didn't need the Afrin anymore. These days, using sudafed (or similar, even the fake kind works for me) helps keep the sinus infection from getting traction, and guefasin helps if it's already dug in.

But yeah, if sinus rinse doesn't work, my doc said Afrin.
posted by instamatic at 11:49 AM on February 11, 2017 [1 favorite]

Chiming in again to recommend fluticasone nasal spray. It's Flonase in the US and it looks like it's Avamys in Germany.

My doctor advises against Afrin nasal spray because of the risk of rebound congestion, but I know it works well for some people!
posted by schroedingersgirl at 12:06 PM on February 11, 2017

A similar drug to Afrin in Germany is xylometazoline. Do not use any nasal spray decongestant like Afrin for more than three days. They are very effective if you use them very short term, but after that they cause more trouble than they relieve. Try to get by with using it in only one nostril so the other one remains unaddicted.
posted by artistic verisimilitude at 12:10 PM on February 11, 2017

I had bad, recurrent sinus infections every winter until I got my dust mite allergies under control. This doesn't help you currently, but to attack the problem long term, here's what helped me.

- Prescription antihistamine.
- Singulair (generic name: montelukast).
- Nasal steroids.
- Allergy shots. (Not 100% sure they are helping, and the certainly haven't fixed the problem to the extent that I can get off the other drugs, but I haven't had a sinus infection since starting them 2 summers ago).
- Neti morning and night (start when you don't have a sinus infection, obvs.)
- Encasements on pillows, mattress and comforter.
- Washing my bedding in hot water once a week.
- Changing pillow cases twice a week.

Also, whenever I get a cold, I take Sudafed aggressively so things never get a chance to get plugged up.
posted by BrashTech at 1:02 PM on February 11, 2017

This sounds like a sinus infection to me... I know you saw an ENT but it sounds like you need to see another one? If I'm right this is an easy fix, two weeks of antibiotics. It won't prevent you from getting another cold, though.

There are cases where sinus infections continue to recur because of the way the interior of the nasal cavity is shaped (basically it is too narrow and holds onto too much crud, plus scar tissue builds up when infections happen again and again) and there is a simple operation to fix that. But IANAD, just someone who had the operation (it did help.)
posted by fingersandtoes at 2:14 PM on February 11, 2017

I have both allergies and a history of more serious sinus problems going back to an infection 20 years ago that took a CAT scan to diagnose and then debilitating headaches at least yearly for over a decade, and my go-to remedy is steam, especially when I'm too clogged for a neti or squeeze-bottle saline rinse.

I wholeheartedly recommend the (ridiculously named) MyPurMist personal vaporizer.

My dad got one a couple of years back and whenever my sinuses get too bad I borrow it (I'd get my own but they're expensive!). When he's using it or I'm not in the neighborhood, I fall back to either a small-mouth thermos of steaming water held directly below my nose and then breating in my nose and out my mouth, or a big pot of steaming water and the towel tent trick mentioned above. Eucalyptus or other oils are nice, too (but can't be used in the MyPurMist - distilled water only!).
posted by MoTLD at 3:19 PM on February 11, 2017

I had an incredibly bad sinus infection that lasted for about three months. I tried everything, multiple courses of antibiotics, eucalyptus oil, honey/garlic/lemon mixes, Neti pots, you name it, I did it. Nothing worked. (And like you, my teeth ached but I had the added bonus of green mucus.) Finally, at my wits' end, I saw a tradition Chinese medicine doctor. He mixed me up some herbs and it was gone in three days. Amazing.
posted by Jubey at 11:45 PM on February 11, 2017

I used to have sinus infections at least once a year, lasting weeks and weeks, and which did not end without a round of antibiotics prescribed after a visit to an ENT, which is where my knowledge of them comes from. My pithy answer above perhaps should have included "Have a doctor look at your sinuses." Never did I intend to suggest that OP demand antibiotics. Just a more thourough exam.
posted by cooker girl at 6:55 AM on February 12, 2017

Oh, also, if you do want to try a nasal spray along with the sinus rinse (neti pot or squeeze bottle), one thing I've found is that with the sinus rinse, although the rinse itself helps clear out my sinuses somewhat while I'm actively doing the rinse, the effect continues for some time after I've finished the rinse, so I tend to notice an increased rate of mucus flow and needing to blow my nose after I finish using it. (I guess because it helps loosen everything up?)

Anyway, the reason I mention this is that if you use a nasal spray like fluticasone (Flonase in the US), it's best to try to avoid blowing your nose for a while after you use it so that the spray actually has a chance to "sink in" so when I do a sinus rinse, I wait at least an hour before using Flonase. Of course, you also don't want to use the sinus rinse right after you've used the nasal spray.

So basically, my regimen would be something like this:

- Take Guanifesin and drink lots of water
- A couple hours later shower and/or do sinus rinse
- An hour or more, use nasal spray

Another thing that I don't think has been mentioned: At night, I use one of those foam wedge pillows to raise my upper body while I'm sleeping (link goes to Amazon US site, but I'm sure you can find something like that in Germany). I originally started using the wedge pillow because of acid reflux, but I think it can be helpful for sinus issues to, because it encourages drainage of your sinuses over night. Swallowing a bunch of mucus probably isn't ideal, but it's better than spending all night being congested.

I've definitely noticed the wedge pillow helping; or rather, when I don't use it, I regularly wake up feeling like I can't breathe. So maybe this is something you might want to try too.

The exhaustion you're feeling may well be just because you're body is fighting off an infection, but I know that on days when my allergies are really bad, I'll wake up feeling utterly exhausted, and I suspect that this is in part due to the effect it has on my sleep. (I could literally predict changes in the weather because for some reason, within 24 hours of a rain storm, I'd wake up feeling unbearably tired and crappy). Daily use of Flonase has really improved this.

One more thing about the Flonase: It's supposed to work for 24 hours, but I have not personally found that to be true, so I usually divide the dose up between morning and afternoon/evening.

With all that being said, if you can get in to see another ENT, I'd recommend that too, and also possibly an allergist, but if that's not possible or until you can get in to see someone, hopefully some of these things will help out.
posted by litera scripta manet at 8:17 AM on February 12, 2017

Just wanted to add two more things upon re-reading your question:

I've always been really healthy until about a year or two ago, when I suddenly started getting colds almost every month.

I'm in my late twenties, and although I had some mild allergies as a kid, for whatever reason, in the last few years, it seems like my allergies got significantly worse. I don't know how much, if any, of what you're experiencing is due to allergies, but just thought I'd mention this. I've read about other people experiencing this as well, so apparently this is a thing. (I'd previously heard about people growing out of allergies/asthma, but not so much about it developing later.)

Forgot to mention my teeth are randomly hurting as well, although mostly in the lower jaw.

Another piece of anecdata, but when my sinuses get really congested, I sometimes get pain in my teeth, which I've always assumed is due to sinus pressure or something like that.
posted by litera scripta manet at 8:23 AM on February 12, 2017

Also coming in to mention fluticasone propionate nasal spray. It's what my GP prescribed* me a few years ago when I finally made an appointment after suffering for a month with painful sinuses, aching jaw, nagging earache and feeling as if I was underwater all the time. I was very sceptical - I felt so ill, I was sure there had to be something more going on - but it really worked; I felt much better in well under a week.

[*]I got it on prescription the first time, but it turns out to be available without a prescription in the UK, which has proved useful. I've needed it a couple more times since.
posted by ManyLeggedCreature at 2:04 PM on February 12, 2017

Short update: I bought Reactine-Duo, put dust mite covers on my bed and could actually breathe through my nose last night. Since the Reactine-Duo pack has only six pills in it, I assume it is not intended for long term use? (If so, that would be very expensive...) I'm feeling a lot better and will see how much my sinuses clear up and if I need a doctor (probably not for antibiotics, it seems) or if I try Chinese medicine in Japan.

Thank you so much, everyone!!
posted by LoonyLovegood at 7:11 AM on February 14, 2017

Glad you're feeling better!

I just looked up Reactine-duo, and it looks like the active ingredients are cetirizine and pseudoephedrine (assuming that web site is correct). The fact that it has pseudoephedrine in it is probably why you wouldn't want to take it long term, but cetirizine is a pretty common antihistimine (brand name Zyrtec in the US). I've been taking cetirizine daily for a couple years (one of these days I really will see an allergist), so if your sinuses take a turn for the worse, you can see if you can get your hands on cetirizine without the pseudoephedrine.
posted by litera scripta manet at 4:40 PM on February 15, 2017

I bought Reactine-Duo, put dust mite covers on my bed and could actually breathe through my nose last night. Since the Reactine-Duo pack has only six pills in it, I assume it is not intended for long term use?

No, that's not accurate. I took Sudafed daily for almost a decade under my doctor's instructions. I still take it frequently. SCUBA divers live on it; flying and often diving can be a no-go without it. There is no safety issue taking it long term, except that a very small percentage of long-term users get rebound nasal congestion. The small dosage in Germany is most likely due to the fact that it can be used in an ingredient to cook meth and so it is more tightly controlled now. This has become a problem in the last years. In the US you have to register to buy it!

In Ireland and the UK there are now only 12 tablets per pack. Each tablet contains 60mg of pseudoephedrine hydrochloride. I can't tell how many mgs in the German ones, but basically you should be able to go down to your chemists and ask what else they sell that has pseudoephedrine hydrochloride in it and they may be able to sell you an alternative for less.
posted by DarlingBri at 6:24 PM on February 18, 2017

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