How to Help a Patient with Rhinitis Medicamentosa Induced by Nasal Decongestants: A Clinical Study

Objective: to evaluate the feasibility and rationale for including the medical device Humer Decongestant (hyperosmolar solution with Captomucil^® complex) as a component of a comprehensive approach to decongestant-induced rhinitis medicamentosa (RM), the cornerstone of which is the cessation of adrenomimetics. Materials and methods. Between September and December 2025, 12 patients with verified RM (study group) and 10 healthy volunteers (control group) were examined. All study group patients received a comprehensive approach comprising gradual or complete cessation of nasal adrenomimetics alongside application of Humer Decongestant (1–2 sprays per nostril, 3–4 times daily). Assessment included: mucociliary clearance (gelatin films with methylene blue), subjective nasal airflow assessment by VAS (0–10), anterior active rhinomanometry (OPTIMUS rhinomanometer), olfactometry (Sniffin’ Sticks test; T, D, I, TDI parameters), nasal cytology, videoendoscopy, and quality of life assessment by SNOT-22. Follow-up duration was one month. Results. At baseline, mucociliary clearance in RM patients was significantly impaired compared to controls (24.5±0.3 min vs. 14.5±0.2 min, p<0.01). After 15 days it recovered to 16.8±0.2 min (p<0.01), approaching normal values. VAS score decreased from 8.3±0.3 to 3.1±0.3 (p<0.05). Total SNOT-22 score declined from 55.22±1.12 to 25.33±1.12 (p<0.01), nearly three times exceedin­g the minimal clinically important difference (MCID≈8.9). Olfactory improvement was of conductive type, with significant increases in Sniffin’ Sticks T and I scores (p<0.01). Rhinomanometry confirmed reduced nasal resistance without pharmacological α-receptor stimulation. Post-treatment nasal cytology approached a conditionally normal pattern. Complete cessation of adrenomimetics was achieved in 7 (58.3%) patients; the remainder substantially reduced their use. No patient resumed prior decongestant use during the one-month follow-up. Conclusions. Incorporating Humer Decongestant into a comprehensive approach to RM alongside adrenomimetic withdrawal facilitates mucociliary restoration, reduction of nasal resistance, conductive olfactory improvement, and quality-of-life enhancement. Its effects are mediated through the mucolytic action of Captomucil^® and the osmotic decongestant effect of the hyperosmolar solution, without risk of vasoplegia or drug dependence.