Mucolytics are medications designed to make the nasal secretions more watery. That is to make that thick, tenacious, or viscous mucous thinner and more serous so it drains easier. Everyone makes a liter of “snot” or nasal secretions per day, so drainage is the norm; however, it seems to be more noticeable and problematic when those secretions are thicker. Those secretions are necessary to warm, filter, and humidify the air you breathe, so we do not want to disrupt the normal functions of the nose.

Typically we place patients on the maximally tolerated dose of Guifenesin. This is the active ingredient in Mucinex and Humabid. There are some extended release formulations available; however, we generally strive to give patients 2400 mg per day of guifenesin. We prescribe this as Humabid LA or Mucinex 1200 mg PO BID or Mucinex 600 mg PO QID.

Adequate hydration cannot be overstressed. Avoiding dehydrating fluids such as soft drinks or coffee and trying to drink as much water as the person can stand can be incredibly helpful for the sinus patient. The primary limiting symptom for high dose mucolytics seems to be nausea.

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