It’s compounded at Mayo and they ship it to me. They’ve told me most insurance companies don’t pay, but so far mine has. They told me they take orders from out of state, nonMayo docs.

I’ve don’t usually have a lot or sinus pressure (even when frontal sinus was opaque), but can get lots of PND and the spray really helps. Keep in mind I’ve had sinus issues for many years and don’t have a normal frame of reference.

Note-I have a separate Ipratropium to use as needed mid day since its duration of action is 6 hours and I had felt the triple spray started wearing off. I usually only need it if I’m outside part of day.