What Causes Postnasal Drip Plus 6 Ways to Stop It

Postnasal drip is one of the most common causes of chronic cough. While there are many causes of chronic cough, if you also have nasal congestion, dripping mucus in your throat, or the need to frequently  clear your throat, you may have upper airway cough syndrome (UACS)  from postnasal drip. 

Here, we’ll cover what postnasal drip is, symptoms you might have, and some of the most common medications to treat it.

What is postnasal drip?

Postnasal drip refers to mucus from the nose or sinuses draining into the throat. It can be related to allergies, an infection of the sinuses (sinusitis), or even certain foods. If you have postnasal drip, you may have inflammation in the nose or throat, or mucus collecting there. Your symptoms and physical exam can help your primary care professional diagnose you with postnasal drip.

Mucus is produced by the lining of the nose, sinuses, and throat to keep these airways moist and clean. Postnasal drip is what happens when the nose and sinuses make more mucus than normal, and it runs down the back of your throat. This can happen for many reasons, including: 

• Upper respiratory infection, like a cold or a flu
• Hay fever (allergic rhinitis) 
• Infected sinuses (sinusitis) 
• Taking certain medications, such as for erectile dysfunction
• Being in cold or dry air 
• Eating certain foods or drinks, such as spicy foods or alcohol
• Fumes from smoke, chemicals, and other irritants 
• Pregnancy

If you have postnasal drip, you may often complain of congestion in your nose and a sensation of mucus dripping into your throat. You might also have a cough, although you don’t feel sick. In fact, postnasal drip is one of the most common causes of cough, and it can linger for weeks to months. Other common symptoms of postnasal drip include:

• Feeling of needing to clear the throat often
• Sore or irritated throat
• Runny nose
• Hoarse voice

Some people with postnasal drip feel like their symptoms are worse at night. This is because mucus is more likely to drip into the throat when you’re lying down. 

A combination of preventive measures and medications can help stop your postnasal drip. Your healthcare professional may sometimes recommend:

• Staying hydrated, which can also help to thin mucus
• Using a humidifier or vaporizer to keep the air moist
• Propping yourself up with extra pillows when you sleep to keep mucus from collecting in the back of your throat
• Using guaifenesin (Mucinex) to thin mucus

It’s important to keep in mind that treatment for postnasal drip usually depends on what might be causing it. For instance, if your symptoms are caused by allergies, the first step might be trying to pinpoint what you’re allergic to and avoiding those triggers. This may help to stop your postnasal drip immediately.

As a next step, there are several other over-the-counter (OTC) and prescription medications that can provide additional relief. They can help stop postnasal drip by treating inflammation and thinning or drying up the mucus. 

Here are six common medications to stop postnasal drip and help get rid of mucus in your throat.  

1. Steroid nasal sprays

Intranasal steroids, or steroid nasal sprays, are a good first choice to treat nasal congestion or postnasal drip. They can decrease inflammation and drainage in the nasal passages and sinuses. They start working in a few hours, but it may still take a few days to get rid of your postnasal drip and cough. Steroid nasal sprays work best if you take them on a regular basis, rather than as needed. Here’s a breakdown of some popular intranasal steroids.

OTC steroid nasal sprays include:

• Budesonide (Rhinocort Allergy) 
• Fluticasone propionate (Flonase )  
• Triamcinolone (Nasacort Allergy) 

Prescription steroid nasal sprays include:

• Beclomethasone (Beconase) 
• Ciclesonide (Omnaris, Zetonna) 
• Mometasone (Nasonex)

Side effects of these medications usually affect the nose, including:

• Burning
• Stinging
• Dryness

Keep in mind that older steroid nasal sprays, such as beclomethasone and triamcinolone, can be absorbed more readily into the bloodstream. So you may want to go for a newer steroid nasal spray like fluticasone if you already take a steroid medication like a pill or an inhaler. Before starting a new medication, always talk about it with your primary care professional.

2. Oral antihistamines

Antihistamines block the chemicals that cause allergy symptoms. They can reduce swelling and congestion in the nasal passages and improve postnasal drip and cough. There are two main types of oral antihistamines: 

• Older, first-generation antihistamines: Diphenhydramine (Benadryl) and chlorpheniramine are available over the counter. Cyproheptadine is available through prescription.
• Newer, second-generation antihistamines: Medications like loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec) are available over the counter. Desloratadine (Clarinex) is available by prescription.

Second-generation antihistamines are often preferred because first-generation antihistamines can have more side effects. Common side effects of antihistamines include fatigue and dry mouth. If you have any medical conditions, you’ll want to check with your primary care professional before starting an antihistamine to make sure it’s safe for you.

3. Nonsteroidal nasal sprays

Nonsteroidal nasal sprays are another good option for postnasal drip. Here’s a breakdown of a few common ones and how they work:

• Azelastine: Azelastine (Astelin, Astepro) is an antihistamine nasal spray that can reduce congestion and runny nose. When taken with intranasal steroids, it works very well for postnasal drip. Azelastine can cause sleepiness and headache.
• Ipratropium: Ipratropium (Atrovent) works by stopping the production of mucus. It can cause headaches and nasal irritation with use. It isn’t recommended for people who have an enlarged prostate or glaucoma.
• Oxymetazoline: Oxymetazoline (Afrin) is a decongestant spray that shrinks the blood vessels in the nose to help relieve congestion. This medication should only be used for a day or two. Longer use may lead to more intense symptoms and side effects. 

4. Saline nasal sprays and irrigations

Other safe ways to help relieve sinus and nasal congestion and postnasal drip include saline nasal sprays and irrigation. Saline solution is water that contains sodium chloride (salt). There are many OTC saline nasal sprays that you can use to keep the nose moist and reduce symptoms.

Nasal irrigation, on the other hand, involves flushing your sinuses with a large volume of saline solution. You can make your own irrigation solution with sodium chloride packets mixed with boiled or distilled water. Or you can also buy a pre-prepared saline wash kit, like a neti pot at the pharmacy. 

It’s very important not to use tap or shower water to make your saline wash, unless it has been boiled and has cooled first. Although rare, flushing your sinuses with unboiled tap water can lead to a serious infection that can potentially affect the brain.

You can also use a bulb syringe, bottle sprayer, or neti pot for nasal irrigation. For best results, it’s recommended that you wash out each side of your nose with at least 200 mL of saline solution. Check with your primary care professional to see how often you should flush your sinuses.

5. Pseudoephedrine

Pseudoephedrine, the active ingredient in Sudafed, is an oral decongestant. This medication shrinks the blood vessels in the nasal passages and helps relieve congestion. You can either get pseudoephedrine on its own or mixed in a medication that also contains an antihistamine, such as loratadine/pseudoephedrine (Claritin-D) or fexofenadine/pseudoephedrine (Allegra-D). 

Although effective in treating postnasal drip, pseudoephedrine can cause the following side effects:

• Jitteriness
• Insomnia
• Headache
• Nausea
• Fast heart rate

It can also elevate blood pressure. If you have hypertension (high blood pressure), talk with your primary care professional before using this medication.

6. Oral leukotriene inhibitors

Montelukast (Singulair) and zafirlukast (Accolate) are common leukotriene inhibitors. They have anti-inflammatory effects and can help expand the airways. However, these are not first-choice options for getting rid of postnasal drip. These medications are only recommended for postnasal drip if other measures aren’t effective. 

When to get further treatment for postnasal drip?

If your symptoms don’t improve within 1 to 2 weeks, you should contact a healthcare professional. They can help you determine what might be causing your postnasal drip. And they can also recommend any next steps you need to take for treatment.