Allergy & Sinus Formulas

The Allergy & Sinus Formula is a customized prescription blend that may include ingredients such as; intranasal antibiotics, antifungals, antihistamines, anticholinergics, antioxidants, and/or corticosteroids that target the main symptoms of allergy and sinus infections. A single dose is typically delivered into the nasal cavity twice daily.

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Topical vs. Oral

Topical applications are known to have a lower-side effect profile when compared with systemic administration. Because the drugs are being applied directly to the nasal passages, there is no first-pass metabolism by the liver. As a result, lower doses of the drugs may be used to get the intended response compared to the oral route. Research has shown topical application may reduce the risk of serious gastrointestinal, renal and cardiovascular adverse events compared with oral treatment options. However, you should always discuss the benefit to risk ratio with your healthcare prescriber.

Common Ingredients

Acetylcysteine

Acetylcysteine is in a class of medications called mucolytic agents. It works by thinning the mucus in the air passages to make it easier to clear the airways.

Azelastine

Azelastine is an antihistamine. It works by preventing the effects of a substance called histamine, which is produced by the body. Histamine can cause itching, sneezing, runny nose, and watery eyes.

Betamethasone

Betamethasone is used to treat certain growths in the nose (nasal polyps). It belongs to a class of drugs known as corticosteroids. Betamethasone works by reducing swelling (inflammation) in the nasal passages. This can help decrease symptoms such as an itchy or runny nose, sneezing, or other symptoms caused by hay fever.

Budesonide

Budesonide is used to treat certain growths in the nose (nasal polyps). It belongs to a class of drugs known as corticosteroids. Budesonide works by reducing swelling (inflammation) in the nasal passages. This can help decrease symptoms such as an itchy or runny nose, sneezing, or other symptoms caused by hay fever.

Fluconazole

Fluconazole is in a class of medications called Triazole antifungals. It kills fungus by causing holes to appear in its cell membrane and the contents leak out. This kills the fungus and treats the infection.

Gentamicin

Gentamicin belongs to a class of medications called Aminoglycoside antibiotics. Gentamicin is commonly used to treat or prevent infections in the nose due to certain strains of pseudomonas aeruginosa aureus bacteria as well as a host of other bacteria. This medicine works by killing bacteria or preventing their growth.

Ipratropium

Ipratropium is used to treat a runny nose caused by the common cold or seasonal allergies. It works by reducing the amount of fluid/mucus released from inside your nose.

Levofloxacin

Levofloxacin belongs to a class of medications called Fluoroquinolone antibiotics. It is considered a broad-spectrum antibiotic that covers pathogens that are involved in sinusitis, and an added advantage is that it is effective in attacking organisms that are becoming resistant.

Mometasone

Mometasone is in a class of medications called high-potency corticosteroids. Mometasone works by reducing swelling (inflammation) in the nasal passages. This can help decrease symptoms such as an itchy or runny nose, sneezing, or other symptoms caused by hay fever.

Mupirocin

Mupirocin belongs to a class of medications called Carboxylic acid antibiotics. Mupirocin is used to treat or prevent infections in the nose due to certain strains of resistant Staphylococcus aureus bacteria as well as a host of other bacteria. This medicine works by killing bacteria or preventing their growth.

Frequently asked questions

What is a compounded medication?

One size doesn’t fit all and every patient is unique. Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient by a pharmacist as the result of a practitioner’s prescription drug order. While compounded medications are not FDA-approved, they serve an important patient need—especially when FDA-approved medication is not available for treatment. Our formulations are made to order in small batches to ensure freshness. The specific ingredients in your compounded formula will depend on your specific concerns and goals. It should be understood that your personal healthcare practitioner will make the final decision.

Are compounded medications FSA & HSA eligible?

Yes! All of our compounded formulations, regardless of ingredients, are eligible for Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA).

What is allergic rhinitis?

Allergic rhinitis is an inflammatory disorder of the nasal mucosa induced by allergen exposure. Clinically, it is characterized by four major symptoms–runny nose, sneezing, nasal itching, postnasal drip, and nasal congestion. Allergic rhinitis symptoms result in sleep disturbance, fatigue, depressed mood and cognitive function compromise that impairs quality of life and productivity. Triggers of Allergic rhinitis are domestic allergens as mites, domestic animals, insects or of plant origin; common outdoor allergens include pollens and moulds; occupational triggers as latex; tobacco smoke, and automobile exhaust.

What is sinusitis?

Important factors in differentiating viral from bacterial sinusitis are the overall symptom duration and the symptom trajectory. Symptoms of viral infection tend to peak early and gradually resolve. Thus symptoms present for less than 10 days indicate a viral infection, whereas symptoms present for more than 10 days, without an improvement, suggest a bacterial infection. Symptoms that worsen after an initial improvement (so-called "double sickening") suggest secondary bacterial infection following viral sinusitis.


Specific symptoms may help distinguish between viral and bacterial sinusitis. Purulent nasal discharge, nasal obstruction, dental pain, or facial pain/pressure/headache are more common with acute bacterial sinusitis. Fever, sore throat, myalgia, or a clear nasal discharge usually indicate viral sinusitis. However, the color of the mucus, as a sole indicator, does not distinguish bacterial from viral etiology.

Cough is a common symptom in acute viral and bacterial sinusitis.

What is nasal saline irrigation?

Nasal saline irrigation is recommended by the American and European guidelines as an initial treatment for both acute and chronic sinusitis. Irrigating debris, as well as inflammatory molecules, have been shown to improve secretory stasis and help improve nasal congestion and obstruction. Easily performed and usually well-tolerated, irrigations have been shown to be very beneficial.

When should I see improvement in my symptoms?

Based on research and patient testimonials, you may see improvement as early as 1 to 2 days after intranasal delivery, but it often takes a few days of continuous use to see the full benefits. Each patient is unique and time frames may differ.

How should I use the Allergy & Sinus Formula?

  • The Allergy & Sinus Formula is for topical use only. If this medicine gets in your eyes or mouth, rinse with water.

  • Follow all directions on your prescription label and read all medication guides or instruction sheets.

  • Nasal Rinse

    1. Please wash your hands.

    2. Open 1 dose and empty all powder into the nasal irrigation bottle.

    3. Open 1 saline packet and empty all powder into the nasal irrigation bottle.

    4. Fill the clean bottle with the designated volume of distilled, microfiltered, reverse osmosis filtered, commercially bottled, or previously boiled and cooled down water.

*You may warm the water in a microwave in increments of 5 to 10 seconds to avoid overheating the water, damaging the device or scalding your nasal passage.

    1. Tighten the cap and tube on the bottle securely. Place one finger over the tip of the cap and shake the bottle gently to dissolve the mixture.

    2. Tilt your head forward over your sink and irrigate one nostril with half the amount of solution and irrigate the remaining solution through the opposite nostril. The solution should go in one nostril and out the other. You may also open your mouth and place the tip of your tongue to the roof of your mouth

    3. Clean and dry your irrigation bottle with warm, soapy water and store in a clean and dry place until the next use.

  • Nasal Nebulizer

    1. Please wash your hands.

    2. Fill the cup with the dose for one nostril as directed on your prescription, or the dose on the product instructions.

    3. Place the insert into the cup using the alignment tabs to ensure it is positioned correctly.

    4. Lean forward slightly. Insert the nasal tip of the nebulizer cup into one nostril, ensuring it is completely inside your nose.

    5. Place the cup tip into one nostril, aim it straight in or slightly away from the septum.

    6. Turn the compressor on. Turn off the compressor when empty before removing the tip from the nostril.

    7. After treatment, disconnect the tubing from the cup and separate the cup and insert.

    8. Clean the cup and insert with warm soapy water, set aside to dry.

    9. Wipe off the outside of the tubing with a damp cloth (keep the inside of the tubing dry and do not wash the inside of the tubing).

  • Nasal Spray

    1. Shake the bottle gently before each use.

    2. The very first time the spray is used; prime the pump into the air by pressing downward on the pump actuator. You will see a fine mist appear. The pump is now ready for use.

    3. Gently blow your nose to clear your nostrils.

    4. Tilt your head down to look at your feet.

    5. Insert tip of the nozzle into the opening of the right nostril while holding the bottle in the LEFT hand. While pulling your right nostril open with your right hand, aim the nozzle toward the back corner of your right eye.

    6. For each spray, press firmly downward on the pump actuator while slowly exhaling out

    7. Wait two seconds; gently inhale the solution to allow penetration into the nasal passages.

    8. Next, exhale out slowly through your mouth.

    9. Repeat the recommended number of sprays in the opposite nostril.

  • Protect the treated area(s) from natural and artificial sunlight.

  • Do not use it in combination with other medications in the same class of drugs.

Who should not use the Allergy & Sinus Formula?

Do not start using the Allergy & Sinus Formula if you have a history of hypersensitivity to any of the prescribed ingredients. These ingredients may include, but are not limited to; Corticosteroids (budesonide, fluticasone, mometasone or others), Antihistamines (azelastine, cetirizine, levocetirizine, loratadine or others), and/or Quinolones (levofloxacin, ciprofloxacin, moxifloxacin or others), Aminoglycosides (gentamicin, tobramycin or others), Antifungals (fluconazole, clotrimazole, itraconazole or others). Please tell your doctor if you are pregnant or thinking about becoming pregnant. Caution is advised in those patients with cataracts or glaucoma.

What happens if I miss a dose?

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose.

How should I store this medication?

Store at room temperature away from moisture and heat between 68°F to 77°F (20°C to 25°C).

Safety Information

Research has shown, topically applied medications are less likely to cause the same systemic side effects or drug-to-drug interactions as oral medications; however, there is never an absolute zero chance that side effects or drug interactions will not occur. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

What should I avoid while using the Allergy & Sinus Formula?

  • Avoid driving or hazardous activity until you know how this medicine will affect you

  • Do not drink alcohol or take other medicines that may cause you to feel sleepy until you know how this medicine will affect you.

  • Avoid using other products that may contain budesonide, azelastine, ipratropium, levofloxacin, gentamicin, mupirocin, clindamycin, doxycycline, and/or fluconazole.


What are the common side effects of the Allergy & Sinus Formula?

Although the risk of serious side effects is low when the Allergy & Sinus Formula is applied to the skin, this medicine can be absorbed through the skin.


Common side effects may include application site reactions of:

  • Local nasal effects

  • Headache

  • Nosebleeds

  • Altered sense of taste


Stop using and seek emergency medical attention if you have signs of severe drowsiness; severe or ongoing nosebleeds; noisy breathing, runny nose, or crusting around your nostrils; redness, sores, or white patches in your mouth or throat; fever, chills, tiredness, body aches; blurred vision, tunnel vision, eye pain, or seeing halos around lights; any wound that will not heal; or signs of low adrenal gland hormones--worsening tiredness or weakness, feeling light-headed, nausea, vomiting.


Get emergency medical help if you have signs of an allergic reaction: hives, severe itching; difficult breathing; swelling of your face, lips, tongue, or throat. These are not all of the possible side effects of the Allergy & Sinus Formula. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effects that bother you or do not go away.


What happens if I overdose?

An overdose is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

References

  • Varshney J, Varshney H. Allergic Rhinitis: an Overview. Indian J Otolaryngol Head Neck Surg. 2015 Jun;67(2):143-9. doi: 10.1007/s12070-015-0828-5. Epub 2015 Jan 31. PMID: 26075169; PMCID: PMC4460099.

  • Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-39.

  • Gwaltney JM Jr, Hendley JO, Simon G, et al. Rhinovirus infections in an industrial population. II. Characteristics of illness and antibody response. JAMA. 1967 Nov 6;202(6):494-500.

  • Peters AT, Spector S, Hsu J, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014 Oct;113(4):347-85.

Disclaimer

All prescription medications require a valid and complete online consultation prior to approval and final pricing is determined. All compounded medications in the U.S. are considered off-label use. Licensed healthcare practitioners have the ability to prescribe compounds for off-label treatment, if they believe that it is an appropriate course of treatment.


The drug and medical information provided on this website is not meant to cover all adverse effects, drug interactions, warnings, medical uses, directions and precautions. The information provided is a medical resource and the judgment of your physician and/or healthcare practitioner should not be substituted. Premier Pharmacy has made every effort to ensure the information on the website is accurate and current based on present medical literature.


Premier Pharmacy does not make any guarantees regarding the drug and medical information, and does not assume responsibility regarding the content. The drug safety and drug information contained on the website may be time sensitive and should not be utilized as a medical reference beyond the date hereof. The deficiency of a warning for prescription medications and vitamins provided on this website in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.


If you have questions or concerns about your medications, please do not hesitate to contact us and/or your medical practitioner, including your pharmacist. Compound prescription products have not been tested or approved by the FDA for their intended use. No claims are made as to the safety, efficacy or use of this compound.

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