Nasal polyps
Treatment of nasal polyps
Treatment should be started following a failure to respond to a corticosteroid nasal spray and followed by long-term prescribing of a corticosteroid nasal spray.
Betamethasone
Betamethasone 0.1% ear/eye/nose drops
Apply 2-3 drops 2-3 times a day, dose to be applied into each nostril.
Fluticasone
Fluticasone 400microgram/unit dose nasal drops
200micrograms (approx. 6 drops) 1-2 times a day, to be administered into each nostril, alternative treatment should be considered if no improvement after 4-6 weeks.
Prescribing Notes:
- If symptoms due to nasal polyps are severe, consider a course of oral prednisolone (25mg daily for 2 weeks) followed by topical nasal steroid spray. Steroid drops (Betnesol drops, Flixonase Nasule) should be prescribed on specialist advice. Clinicians are directed to further information, such as Lothian RefHelp, and local guidance in Borders and Fife which may support diagnosis, prescribing advice and referral information.
- Fluticasone nasules may be prescribed in conjunction with an extended course of oral clarithromycin 250mg twice daily or doxycycline 100mg for treatment of chronic sinusitis. As this is off-license use, treatment should be prescribed by an ENT consultant. The risks and benefits associated with withholding atorvastatin/simvastatin while treating with clarithromycin (there is a potentially serious interaction between both simvastatin and atorvastatin with clarithromycin) should be considered when prescribing clarithromycin.
History Notes
15/06/2022
East Region Formulary content agreed.