Most sinus infections (sinusitis) are caused by a virus and clear up on their own within about 2–3 weeks, so treatment is usually self-care to relieve symptoms — pain relievers, saline rinses, and decongestants — rather than antibiotics. Antibiotics are reserved for the smaller number of infections that are bacterial, and those require a doctor.
Available without a prescription — follow each label.
Tylenol Analgesic / antipyretic | Eases facial pain, headache, and fever from a sinus infection. A first-line option per NHS/MedlinePlus, and a good choice if you can't take ibuprofen. |
Advil, Motrin NSAID (pain reliever / anti-inflammatory) | Relieves sinus pain, pressure, and fever. Naproxen (Aleve) is a similar OTC option. Take with food; not for everyone (e.g. stomach ulcers, kidney issues) — check with a pharmacist. |
saline nasal spray or rinse NeilMed, Ayr, Simply Saline Saline nasal irrigation | Drug-free rinse that flushes mucus and thins secretions to help the sinuses drain. Recommended by NHS, CDC, and MedlinePlus; use distilled, sterile, or previously boiled-and-cooled water — never untreated tap water. |
oxymetazoline Afrin Topical (nasal) decongestant | A nasal spray that quickly shrinks swollen nasal passages to relieve congestion. Do NOT use for more than 3 days — longer use can cause rebound congestion (worse stuffiness) and dependence. Phenylephrine nasal spray (Neo-Synephrine) works the same way. |
pseudoephedrine Sudafed Oral decongestant |
A doctor may prescribe these — not for self-treatment.
amoxicillin-clavulanate Augmentin Antibiotic (penicillin + beta-lactamase inhibitor) | A doctor may prescribe this if a bacterial sinus infection is suspected — for example, symptoms lasting more than 10 days without improvement, a high fever, or symptoms that improve then worsen again. Infectious Diseases Society of America (IDSA) guidance favors it over plain amoxicillin for bacterial sinusitis. Antibiotics do not help viral sinusitis and are not used for it. |
fluticasone (prescription strength) / other steroid nasal sprays or drops Intranasal corticosteroid | A doctor may prescribe a steroid nasal spray or drops to reduce sinus swelling, sometimes for several months, especially for persistent or chronic sinusitis or when nasal polyps are present. |
antihistamines Antihistamine | A doctor may prescribe or recommend an antihistamine if an allergy is found to be triggering the sinus symptoms. Antihistamines treat the allergy, not a sinus infection itself. |
Match the remedy to your symptoms. For pain, pressure, or fever, start with acetaminophen or an NSAID like ibuprofen. For congestion, a saline rinse is the gentlest first step; an oral decongestant (pseudoephedrine) or a short course (no more than 3 days) of a decongestant nasal spray like oxymetazoline can give faster relief. If allergies seem to be the trigger, an OTC steroid nasal spray such as fluticasone may help over a few days. Because most sinus infections are viral, the goal is comfort while your body clears it — antibiotics aren't a default and only help genuine bacterial infections, which a clinician must diagnose. Never start a prescription antibiotic or prescription nasal steroid on your own.
See a doctor or pharmacist if symptoms last more than about 10 days without improving, get better and then suddenly worsen again (a "double-worsening" pattern), or keep coming back. Seek prompt care for a fever of 102°F (39°C) or higher, especially lasting 3–4 days; a severe headache or facial pain that OTC pain relievers don't relieve; or symptoms that aren't settling after a week of pharmacy treatment or 3 weeks of self-care. Get urgent help right away for red-flag signs: swelling, redness, or pain around the eyes, changes in vision (blurred or double vision), confusion, a stiff neck, or severe forehead swelling — these can signal a serious complication spreading beyond the sinuses. Also contact a doctor sooner if you are very unwell or have a weakened immune system (for example, from chemotherapy).
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
| A pill that relieves nasal and sinus congestion. Sold from behind the pharmacy counter (ID required) but without a prescription. Avoid if you have high blood pressure, heart disease, or certain other conditions — ask the pharmacist. |
fluticasone Flonase Allergy Relief Intranasal corticosteroid | OTC steroid nasal spray that reduces nasal swelling — most useful when allergies are driving the congestion. Works gradually over days, not instantly. Call a doctor if symptoms don't improve after about a week of daily use. |