Carefully clean a 1-quart glass jar. Rinse well.
Fill the clean jar with tap water or bottled water. You do not need to boil the water.
Add 2 to 3 heaping teaspoons of pickling or canning salt. Do not use table salt. Table salt has additives you don’t want in your nose rinse. Pickling salt is available at the grocery store.
Add 1 rounded teaspoon of baking soda (pure bicarbonate).
Stir or shake before each use.
Store at room temperature.
After a week, pour out any mixture that is left and make a new batch.
NOTE: If the mixture seems too strong, use the same amount of baking soda but less salt; try 1 ˝ to 2 teaspoons of salt. For children, start with the smaller amount of salt. Gradually increase to 2 to 3 teaspoons of salt, or whatever your child will accept.
Rinse your nose two to three times a day. You can never overdo it.
Pour some of the mixture into a clean bowl. Many people like to warm it to about body temperature in a microwave oven. Be sure it is not hot.
Fill the syringe or Water Pik with the mixture from the bowl. Do not put your used syringe into the jar with your mixture because it will contaminate your weekly supply.
Stand over the sink or in the shower. Squirt the mixture into each side of your nose. Aim the stream toward the back of your head, not the top of your head. This lets you spit out some of the salt water.
Most patients find a blue baby bulb syringe available at the local drug stores works
well. Using this, you literally irrigate the nasal passages in the shower. Lean the head forward and vocalize while generously washing out the nose. The salt water just runs out both the nose and mouth. Swallowing some will not hurt you.
NOTE: Most people notice a mild burning feeling the first few times they use the mixture. This feeling usually goes away after a few days use. Warming the solution “nasal hyperthermia” may be of extra benefit.
For young children:
You can put the mixture in a small spray container, like a saline spray or nasal steroid spray bottle.
Squirt into each side of the nose several times.
Do not force your child to lie down. Rinsing the nose is easier when sitting or standing.
If you use a nasal steroid spray such as Flonase, Vancenase, Beconase or Nasacort, always use the salt-water mixture first, then use your nasal steroid spray. The steroid reaches deeper into the nose and sinuses when it is sprayed onto clean, decongested nasal tissues. Always aim your steroids up and out, actually pointing them towards the top of the same side ear.
The Mayo Clinic has popularized using Amphotericin B 100-250 micrograms/ml of sterile water as an irrigation solution. The stability and efficacy have been questioned, but it seems promising. A reasonable option would be to place 2 50 mg IV vials of Ampho B in 1 liter of distilled water and irrigate each nostril with 20 cc
(20 ml) of solution twice a day. Itraconazole (Sporanox), Lamisil, or Diflucan can also be made into a nasal rinse. The Amphotericin nasal rinse needs to be refrigerated, is in sterile water, and has been reported to be difficult to tolerate by many patients. Lamisil and Sporanox are both very expensive.