Follow the directions below after discussing with your physician:

1. Place 4 sprays of Flonase or other prescribed medication(s) into the NeilMed Sinus Rinse bottle, first. This is best accomplished by turning the bottle upside down in the case of the spray bottle(s). Please note, Afrin should be reserved for bleeding purposes only and should not be added to your rinses.

2. Place the salt packet into the NeilMed Sinus Rinse bottle per the package instructions. (Forgetting to put the salt packet into the bottle is the most common mistake patients make. Doing so will cause an unpleasant burning sensation in the nose).

3. Fill the rest of the NeilMed sinus rinse bottle with warm distilled or sterilized water precisely up to the line. Tap water can be sterilized by boiling for at least one minute and then letting cool.

4. Shake the bottle until the solution is well mixed.

5. To irrigate:

• Place your head at approximately a 45-degree angle bending forward over the sink or in the shower.

• Gently squeeze the bottle so the liquid flows into your nostril while pointing the bottle straight up at the ceiling.

• As you begin irrigating, close off your throat by breathing in and out slowly but continuously through your mouth. This will seal off your throat so the fluid runs out the other side of the nose.

• If you want to angle the bottle slightly toward the side you are irrigating, that can be helpful in accessing the sinuses. This can also be accomplished by holding the bottle in the right hand for irrigating the left side of the nose, and the left hand for the right side.

• The solution should flow out the opposite nostril.

• After a good squeeze on one side, switch and irrigate the other.

• Two full squeezes of the bottle to each side should be sufficient.

• Wash the bottle and set it aside to dry.

For Your Safety: Only use distilled or sterile water when mixing sinus rinse solutions. Sterilize tap water by boiling for at least one minute. Let the water cool before making the sinus rinse solution.