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Respiratory Nasal Polyps Medication
Medication
Treating CRSwNP

Medication

Corticosteroids are a common type of medication used for treating CRSwNP.

They are also used for a wide range of other conditions and work by reducing inflammation, which helps to control your symptoms.1,2

The following types of corticosteroids are used to treat CRSwNP:3

Three boxes with text and icons detailing types of corticosteroids. The first box is “Corticosteroid nasal spray” with a nasal spray bottle icon. There is an arrow from this box to the second. The second box is “Corticosteroid nasal drops” with the icon of a dropper bottle. There is an arrow from this box to the third. The third box is “Corticosteroid tablets” with icons of pills.

Your doctor will decide which option will work best for you. Usually, you will be prescribed a corticosteroid nasal spray first, before progressing to other types if your symptoms are not well-managed by it. 

Corticosteroid nasal sprays and nasal drops

They should be used with your head leaning forward and looking down. They can cause burning, stinging or bleeding in the nose.4

Corticosteroid tablets 

They are a type of systemic medication, which means the medication travels all over your body, including your nasal passages and sinuses. Because of this, corticosteroid tablets have more side effects, including increased appetite, heartburn and changes in mood.

If you have been prescribed corticosteroid tablets, you should not stop taking them unless advised by your doctor. This is because there is a chance you will develop a condition called adrenal insufficiency caused by your adrenal gland in your body stopping working properly.5 

If you are worried about any of the side effects from your medication, or it your symptoms are not improving, you should contact your doctor.

Surgery

If you were not able to take medication or it has not helped to improve your symptoms, you may be referred to have surgery. 

If you have not seen an improvement after about 12 weeks of taking medication, your doctor may suggest surgery to remove your polyps. Surgery may also make your sinus opening larger so that medications work better.6

Two medical professionals in full surgical PPE performing endoscopic sinus surgery on a patient.

Surgery is usually done using a minimally invasive technique called endoscopic sinus surgery. This type of surgery involves a small tube with a lens or camera called an “endoscope”. This is inserted through the nostrils and into the sinuses.7 One of the following procedures may then be performed:

  • Polypectomy - small tools are used to remove the polyps.
  • Balloon sinuplasty – a small balloon is placed into your sinuses and slowly inflated3
  • Functional endoscopic sinus surgery (FESS) – small tools are used to clear your nasal passages. This involves the removal of polyps and damaged bone or tissue8

After surgery 

After surgery, your nasal passage and sinuses may be sore and painful. Using a saltwater rinse can help to promote healing.8 

Most people who have surgery will see an improvement in their symptoms, however, the polyps usually tend to grow back within a few years.6  You may therefore be recommended to take a corticosteroid nasal spray to keep them from growing back. 

Biologics and biosimilars

Sometimes medication and/or surgery are not effective in controlling CRSwNP. For a small number of people, biologics may be an alternative. 

What are biologics or biosimilars? 

Biologic medicines refer to medicines made from a living source, such as cells or tissues. “Biosimilars” is another term that may be used when talking about biologics. Biosimilars are biological medicines which are highly similar to the original biologic reference medicine in terms of quality, safety and efficacy. This means there is no clinically meaningful difference between the biosimilar and the original biologic medicine. 

Biologics, block part of the body’s immune system involved in inflammation. This means that, in contrast to the other types of medication or surgery, which control the symptoms, biologics target one of the underlying causes of CRSwNP.9 Biologics are very specific, meaning that they will only work against the exact part of the immune system they have been designed to target. 

How are they taken?

Biologics are given by injection, which is usually done by your doctor or nurse. 

Who can have biologics? 

Generally, biologics are recommended for those who have already undergone surgery which has failed, for people who are not able to have surgery or for people who have had early/multiple episodes of their nasal polyps returning. In Europe, you must meet the criteria below to be considered for biologics.

Textbox with a list: The title is “Criteria for biologics (three required) (reference 10)”. List: 1. Evidence of type 2 inflammation (this is sometimes referred to as an “overactive immune system”). 2. Need for systemic corticosteroids or not able to take systemic corticosteroids. 3. Significantly impaired quality of life. 4. Significant loss of smell. 5. Asthma diagnosis.

Your doctor will be able to let you know if biologics are a potentially suitable option to help treat your CRSwNP. 

References

  1. American College of Allergy, Asthma & Immunology. Chronic Rhinosinusitis With Nasal Polyps. Available at: https://acaai.org/allergies/allergic-conditions/chronic-rhinosinusitis-with-nasal-polyps/. Last accessed April 2025.
  2. NHS Inform. Corticosteroids (steroids). Available at: https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/corticosteroids-steroids/. Last accessed April 2025.
  3. Mayo Clinic. Chronic sinusitis – Diagnosis and treatment. Available at: https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/diagnosis-treatment/drc-20351667. Last accessed June 2025.
  4. American College of Allergy, Asthma & Immunology. Chronic Rhinosinusitis With Nasal Polyps. Available at: https://acaai.org/allergies/allergic-conditions/chronic-rhinosinusitis-with-nasal-polyps/. Last accessed April 2025
  5. Trust UHPN. Display Patient Information Leaflets. Available at: https://www.plymouthhospitals.nhs.uk/display-pil/pil-prednisolone-and-adrenal-insufficiency-5729/. Last accessed June 2025.
  6. NHS. Nasal Polyps. Available at: https://www.nhs.uk/conditions/nasal-polyps/. Last accessed April 2025.
  7. Mayo Clinic. Nasal polyps: diagnosis and treatment. Available at: https://www.mayoclinic.org/diseases-conditions/nasal-polyps/diagnosis-treatment/drc-20351894. Last accessed April 2025.
  8. Cleaveland Clinic. Nasal Polyps. Available at: https://my.clevelandclinic.org/health/diseases/15250-nasal-polyps. Last accessed April 2025.
  9. Medical News Today. Treatment guide: Biologics for nasal polyps. Available at: https://www.medicalnewstoday.com/articles/biologics-for-nasal-polyps. Accessed April 2025.
  10. Fokkens WJ, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020 Rhinology. 2020. Feb;58(Suppl S29):1-464.