Dawaa Reference

acute

Nasal Polyp

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Egyptian National Drug Formulary - endocrine.pdf, Prednisolone monograph (chapter PDF p183) · Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77) · del Toro E, Hardin FML, Portela J. Nasal Polyps. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: May 5, 2025.

Verified against3 documents
  • Egyptian National Drug Formulary - endocrine.pdf, Prednisolone monograph (chapter PDF p183)
  • Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77)
  • del Toro E, Hardin FML, Portela J. Nasal Polyps. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: May 5, 2025.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (7)

  • Suspect polyps with worsening blockage of the nose, nasal or facial congestion, a running nose and loss of smell, the cardinal symptoms of chronic rhinosinusitis [loss of smell · polyp]
  • Ask about aspirin or NSAID sensitivity and about asthma, which together with polyps make the Samter triad [polyp]
  • Red flag: symptoms on one side only, nosebleeds, long-standing ear infection, or repeated bronchitis or pneumonia point elsewhere [nosebleed]
  • It ranges from no symptoms at all to a badly damaged quality of life
  • A blocked nose, a congested face, loss of smell, loss of taste and a runny nose are the set, and they wreck quality of life [blocked nose · loss of smell · runny nose · taste disturbance]
  • Polyps also go with aspirin-exacerbated respiratory disease, with some systemic vasculitides, and with cystic fibrosis [polyp]
  • Polyposis is the end stage of allergy that was never controlled, so clearing the polyps is where treatment starts rather than where it finishes [polyp]

Signs — what you find (4)

  • Anterior rhinoscopy is part of the examination and often shows the polyps or another growth straight away [polyp]
  • On endoscopy they are mobile, smooth, grey, semi-translucent masses coming from the middle meatus or the sphenoethmoid recess, on one or both sides
  • Red flag: a polyp on one side only should always suggest something else, because inflammatory polyps are almost always on both sides [polyp]
  • Benign one-sided causes such as an antrochoanal polyp exist, but cancer stays high on the list and a biopsy is indicated [polyp]

Tests (10)

  • This is a clinical diagnosis, made by anterior rhinoscopy or nasal endoscopy
  • Polyps together with two of the cardinal symptoms confirm chronic rhinosinusitis with polyps
  • Anyone meeting the criteria for chronic rhinosinusitis should have an endoscopic examination in clinic
  • CT of the paranasal sinuses gauges how severe the disease is and guides surgery
  • Scan when adequate medical treatment fails to help, and scan promptly whenever the symptoms or findings are one-sided
  • Most nasal growths should be confirmed under the microscope, and polyps taken out at sinus surgery should go for histology
  • Red flag: an encephalocele can look exactly like an inflammatory polyp at endoscopy and only the CT reveals it; biopsying one can open a CSF fistula
  • If cancer is suspected before surgery, contrast CT shows the bony outlines, how vascular the lesion is and any soft tissue invasion
  • MRI is what shows spread along nerves, into the orbit or inside the skull, and complicated sinusitis
  • On CT polyps are smooth convex enhancing soft tissue; a squamous carcinoma erodes bone, is dark on T2 MRI and enhances evenly with contrast

If not this — what else fits (12)

  • Antrochoanal polyp
  • Inverted papilloma
  • Schneiderian papilloma
  • Squamous cell carcinoma
  • Non-Hodgkin lymphoma
  • Melanoma
  • Esthesioneuroblastoma
  • Haemangiopericytoma
  • Nasal duct cyst
  • Nasal glioma
  • Encephalocele
  • Juvenile nasopharyngeal angiofibroma, rhabdomyosarcoma, haemangioma or chordoma

SourceStatPearls "Nasal Polyps" - disease-level clinical article

Presentation findings are traced to the source above.

1

FLUTICASONE

1st line

Formspray

Adult dose and duration

Half of the 400 mcg mono-dose nasal drop container instilled into each nostril once or twice daily. - As directed; reassess and consider ENT referral if polyps or obstruction persist.

Paediatric dose

Labelled for adults, the elderly, and children over 16 years for this nasal-drop formulation; nasal polyps in a younger child are rare and warrant ENT referral rather than routine treatment (consider cystic fibrosis).

Dose source

Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77)

Why

The formulary specifically indicates fluticasone mono-dose nasal drops for management of nasal polyps and related obstruction, making it the direct first-choice treatment.

Cautions
  • Given as a nasal drop, not swallowed: the dose is a 400 mcg mono-dose drop instilled into each nostril.
  • A unilateral polyp, especially with bleeding, needs ENT referral to exclude a tumour rather than being treated as routine polyposis.
  • Polyps in a child are rare and warrant work-up for cystic fibrosis.
  • Local irritation, dryness, or epistaxis can occur.
  • Refer to ENT if polyps are large or symptoms persist despite treatment.
Egyptian brands
Egyptian brandManufacturerIndicative price
RHINORELIEF NASAL SUSP. 50 MCG/METERED SPRAY DOSEARAB DRUG COMPANY (ADCO)32.00 EGP
TICANASE 0.05% NASAL SPRAY 12 GMEUROPEAN EGYPTIAN PHARM. IND.70.00 EGP
FLIX NASAL SPRAY 50 MCG/METERED SPRAY DOSEEVA PHARMA76.00 EGP
FLOHALE HFA 250MCG/DOSE AEROSOL 120 DOSESCIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY95.00 EGP
FLIXONASE 50 MCG/METERED NASAL SPRAY 120 DOSEGLAXO SMITHKLINE133.00 EGP
2

PREDNISOLONE

add-on - not a substitute

Formoral.solid

Adult dose and duration

Oral, added short-term to intranasal steroid for larger or more symptomatic polyps: initial 5-60 mg/day as a single daily dose or in 2-4 divided doses, using the lowest dose that controls symptoms. - Short course only; ENT/specialist input on exact duration and tapering is advised, since the formulary gives only its general oral corticosteroid dosing framework, not a polyp-specific regimen. Do not withdraw abruptly, particularly after doses of 40 mg or more or courses of 3 weeks or more.

Paediatric dose

The formulary's general paediatric anti-inflammatory dosing (0.1-2 mg/kg/day) is specialist-set and is not reproduced here; nasal polyps in a child need ENT referral rather than routine oral steroid treatment.

Dose source

Egyptian National Drug Formulary - endocrine.pdf, Prednisolone monograph (chapter PDF p183)

Why

A short course of oral corticosteroid is commonly added to intranasal steroid treatment to shrink larger or more symptomatic nasal polyps; the formulary provides only its general systemic corticosteroid dosing framework rather than a polyp-specific regimen, so this is used adjunctively and short-term, ideally with ENT guidance on course length.

Cautions
  • The formulary gives only the general oral corticosteroid dosing framework for prednisolone - it does not specify a nasal-polyp-specific dose or course length, so use the shortest effective course and taper per general corticosteroid principles, ideally with ENT input.
  • Do not withdraw abruptly, particularly after doses of 40 mg or more or courses of 3 weeks or more.
  • Systemic steroid side effects (hyperglycaemia, mood change, GI irritation, infection risk) increase with dose and duration - avoid repeated or prolonged courses.
  • A unilateral polyp, especially with bleeding, needs ENT referral to exclude a tumour before treating as routine polyposis.
Egyptian brands
Egyptian brandManufacturerIndicative price
HOSTACORTIN H 5MG 30 TAB.SANOFI12.00 EGP (0.40/unit)
PREDNISOLONE 5 MG 20 TABS.ARAB DRUG COMPANY (ADCO)24.00 EGP (1.20/unit)
PREDILONE 5MG 10 TAB. (25 STRIPS PACK)KAHIRA250.00 EGP (25.00/unit)
PREDNISOLONE-EVA 5 MG 30 ORODISPERSIBLE TABS.EVA PHARMA79.50 EGP
SOLUPRED ORO 5 MG 30 ORODISPERSIBLE TABS.SANOFI WINTHROP > SANOFI84.00 EGP
PREDNISOLONE 20 MG 20 ORODISPERSIBLE TABS.ARAB DRUG COMPANY (ADCO)115.00 EGP
XILONE 20 MG 20 ORODISPERSABLE TABS.EUROPEAN EGYPTIAN PHARM. IND.142.00 EGP
DISPRELONE-OD 20 MG 30 ORODISPERSABLE TABS.ANDALOUS PHARMA202.50 EGP
ACETASEE 1% EYE DROPS (SUSP.) 5 ML? strength differs? different route - not oral solidRAMEDA7.50 EGP
PREDNIS 5MG/5ML SYRUP 100 ML? strength differs? different route - not oral solidPHAROPHARMA9.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.