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.

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. 

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.

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. 

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.

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

• 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. 

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.