Montelukast/ Xolair effect on turbinates

My respiratory consultant recently started me on Montelukast and it sounded like Xolair soon too.

Obviously these are intended for asthma, but I’ve always had incredibly annoying swollen turbinates in my nose.

The Montelukast does seem to be helping somewhat.

What is people’s experience of Montelukast or Xolair on swollen, tender nasal turbinates?

Thanks

[Tree20862]

Have you used plain Saline spray to keep your sinuses clear/more open?

[Hidden in reply to Tree20862]

Hi Tree!

Yes, I used Sterimar some years ago and have now started again (since my nose problems came back - they were suppressed on the higher dose of Seretide I was on before tapering).

Do you find it effective?

[Tree20862 in reply to Hidden]

I like Saline rinse over drug nose sprays. I use both but use Saline more.

[Hidden in reply to Tree20862]

That’s good to know. I can’t use any with steroids in because I’m currently tapering off my asthma steroid inhaler

[Poobah]

A nasal spray, like Beconase 50mcg, may help if used regularly. But avoid over the counter decongestants like Otrivine or Sudafed as these can exacerbate the inflammation if used for more than 3 days. This video by a NHS ENT consultant is very helpful re the technique for using steroid nasal sprays. youtu.be/LOhmsn4gQMM(Not working as expected?) The same consultant has also made a film about over the counter decongestants which is very informative.

[Hidden in reply to Poobah]

Hi Poobah!

Yes, exactly- I used to find steroid sprays helped somewhat, and certainly more than others. Beconase was what I used when I was younger.

My problem now with that is that I got adrenal insufficiency from my asthma inhaler and am currently tapering off all asthma steroids.

Thanks for the helpful video link too.

[Hidden in reply to Poobah]

Very helpful tips in the video about how to position your head when taking the nasal sprays.

I also found it helpful how he said to spray towards your ear and not sniff inwards afterwards.

Thanks again 😀

[Poobah in reply to Hidden]

I found a low omega 6 diet very helpful, but that's just me. So many processed foods contain soya and palm oil, both of which are high in O6. It's a huge trigger for me in respect of both my asthma and nasal health.

Research is ongoing into the benefits of a healthy nasal microbiome and the potential use of probiotic sprays (testing the theory that allergies are affected by the microbiome). I think these sprays are available in the UK but I have no idea if they're any good.

[Hidden in reply to Poobah]

That’s extremely interesting- they’re learning more about microbiomes now aren’t they.

I’m hoping that if the respiratory team do put me on Xolair that it will help my nose. But I haven’t got my letter yet so don’t know the final plan.

I’ve got millions of allergies and eat accordingly. I can’t really adjust that any more, it’s already a faff. They were diagnosed ages ago at hospital abroad with RAST and skin tests then checked now and then (remained the same). The NHS did some RAST tests in March. That might be in the letter too I imagine.

Thanks for your very helpful replies!!!

[Poobah in reply to Hidden]

Good luck, I do hope you're prescribed Xolair. Biologics for nasal issues lag behind those for asthma. I know Dupixent is licensed in the States for some nasal diseases, as is Mepolizumab. Mepolizumab is licensed in the UK for asthma and I believe that Dupixent may be available in NHS Scotland. All the best. 🤞

[Hidden in reply to Poobah]

Thanks Poobah 🙏

They’d be prescribing it for my asthma.

I’m just hoping for a freebie side effect that helps my totally annoying nasal allergies too!

I’ll let you know what they end up prescribing. I’m in England not sure what influence that’ll have on the consultant’s choice.