When to use flonase?

Contents

SIDE EFFECTS

Systemic and local corticosteroid use may result in the following:

  • Epistaxis, nasal ulceration, Candida albicans infection, nasal septal perforation, and impaired wound healing
  • Cataracts and glaucoma
  • Immunosuppression
  • Hypercorticism and adrenal suppression
  • Effect on growth

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.

In controlled US clinical trials, more than 3,300 subjects with allergic and nonallergic rhinitis received treatment with intranasal fluticasone propionate. In general, adverse reactions in clinical trials have been primarily associated with irritation of the nasal mucous membranes, and the adverse reactions were reported with approximately the same frequency by subjects treated with placebo. Less than 2% of subjects in clinical trials discontinued because of adverse reactions; this rate was similar for vehicle placebo and active comparators.

The safety data described below are based on 7 placebo-controlled clinical trials in subjects with allergic rhinitis. The 7 trials included 536 subjects (57 girls and 108 boys aged 4 to 11 years, 137 female and 234 male adolescents and adults) treated with FLONASE 200 mcg once daily over 2 to 4 weeks and 2 placebo-controlled clinical trials which included 246 subjects (119 female and 127 male adolescents and adults) treated with FLONASE 200 mcg once daily over 6 months (Table 1). Also included in Table 1 are adverse reactions from 2 trials in which 167 children (45 girls and 122 boys aged 4 to 11 years) were treated with FLONASE 100 mcg once daily for 2 to 4 weeks.

Table 1: Adverse Reactions with FLONASE Nasal Spray with > 3% Incidence and More Common than Placebo in Subjects ≥ 4 Years with Allergic Rhinitis

Other adverse reactions with FLONASE Nasal Spray observed with an incidence less than or equal to 3% but greater than or equal to 1% and more common than with placebo included: blood in nasal mucus, runny nose, abdominal pain, diarrhea, fever, flu-like symptoms, aches and pains, dizziness, and bronchitis.

Postmarketing Experience

In addition to adverse events reported from clinical trials, the following adverse events have been identified during postapproval use of intranasal fluticasone propionate. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events have been chosen for inclusion due to either their seriousness, frequency of reporting, or causal connection to fluticasone propionate or a combination of these factors.

General Disorders and Administration Site Conditions

Hypersensitivity reactions, including angioedema, skin rash, edema of the face and tongue, pruritus, urticaria, bronchospasm, wheezing, dyspnea, and anaphylaxis/anaphylactoid reactions, which in rare instances were severe.

Ear and Labyrinth Disorders

Alteration or loss of sense of taste and/or smell and, rarely, nasal septal perforation, nasal ulcer, sore throat, throat irritation and dryness, cough, hoarseness, and voice changes.

Eye Disorders

Dryness and irritation, conjunctivitis, blurred vision, glaucoma, increased intraocular pressure, and cataracts.

Cases of growth suppression have been reported for intranasal corticosteroids, including FLONASE .

Read the entire FDA prescribing information for Flonase (Fluticasone Propionate Nasal Spray)

Fluticasone nasal

Generic Name: fluticasone nasal (floo TIK a sone)
Brand Name: Flonase, Veramyst, Xhance, Childrens Flonase, Flonase Sensimist, Good Sense Nasoflow

Medically reviewed by Drugs.com on Jan 9, 2019 – Written by Cerner Multum

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Tips
  • Interactions
  • More

What is fluticasone nasal?

Fluticasone nasal (for the nose) is a steroid medicine that is used to treat nasal congestion, sneezing, runny nose, and itchy or watery eyes caused by seasonal or year-round allergies.

The Xhance brand of fluticasone nasal is for use only in adults. Veramyst may be used in children as young as 2 years old. Flonase is for use in adults and children who are at least 4 years old.

Fluticasone nasal may also be used for purposes not listed in this medication guide.

Important Information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use fluticasone nasal if you are allergic to it.

Fluticasone can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Tell your doctor if you have ever had:

  • sores or ulcers inside your nose;

  • injury of or surgery on your nose;

  • glaucoma or cataracts;

  • liver disease;

  • diabetes;

  • a weak immune system; or

  • any type of infection (bacterial, fungal, viral, or parasitic).

If you use fluticasone nasal without a prescription and you have any medical conditions, ask a doctor or pharmacist if fluticasone nasal is safe for you.

Tell your doctor if you are pregnant or breast-feeding.

How should I use fluticasone nasal?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Do not share this medicine with another person, even if they have the same symptoms you have.

Your dose will depend on the fluticasone brand or strength you use, and your dose may change once your symptoms improve. Follow all dosing instructions very carefully.

A child using the nasal spray should be supervised by an adult.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Shake the nasal spray just before each use.

If you switched to fluticasone from another steroid medicine, you should not stop using it suddenly. Follow your doctor’s instructions about tapering your dose.

It may take several days before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after a week of treatment.

Store fluticasone nasal in an upright position at room temperature, away from moisture and heat. Throw the spray bottle away after you have used 120 sprays, even if there is still medicine left in the bottle.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

An overdose of fluticasone nasal is not expected to produce life threatening symptoms. Long term use of steroid medicine can lead to glaucoma, cataracts, thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid while using fluticasone nasal?

Avoid getting the spray in your eyes or mouth. If this does happen, rinse with water.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using fluticasone nasal.

Fluticasone nasal side effects

Get emergency medical help if you have signs of an allergic reaction: hives, rash; feeling light-headed; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe or ongoing nosebleeds;

  • noisy breathing, runny nose, or crusting around your nostrils;

  • redness, sores, or white patches in your mouth or throat;

  • fever, chills, body aches;

  • blurred vision, eye pain, or seeing halos around lights;

  • any wound that will not heal; or

  • signs of a hormonal disorder–worsening tiredness or muscle weakness, feeling light-headed, nausea, vomiting.

Steroid medicine can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using fluticasone nasal.

Common side effects may include:

  • minor nosebleed, burning or itching in your nose;

  • sores or white patches inside or around your nose;

  • cough, trouble breathing;

  • headache, back pain;

  • sinus pain, sore throat, fever; or

  • nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Fluticasone nasal dosing information

Usual Adult Dose for Rhinitis:

Fluticasone furoate: 2 sprays (27.5 mcg/spray) in each nostril once a day
Fluticasone propionate: 1 or 2 sprays (50 mcg/spray) in each nostril once a day as needed

Fluticasone furoate:
-When maximum benefit has been achieved and symptoms have been controlled, reducing the dosage to 55 mcg (1 spray in each nostril) once a day may be effective.
Use: Treatment of symptoms of seasonal and perennial allergic rhinitis

Usual Pediatric Dose for Rhinitis:

2 to 11 years:
Fluticasone furoate: 1 spray (27.5 mcg/spray) in each nostril once a day
4 to 11 years:
Fluticasone propionate: 1 spray (50 mcg/spray) in each nostril once a day
12 years or older:
Fluticasone furoate: 2 sprays (27.5 mcg/spray) in each nostril once a day
Fluticasone propionate: 1 or 2 sprays (50 mcg/spray) in each nostril once a day as needed

Fluticasone furoate:
-Children between 2 to 11 years not adequately responding to 55 mcg may use 110 mcg (2 sprays in each nostril) once a day.
-When maximum benefit has been achieved and symptoms have been controlled, reducing the dosage to 55 mcg (1 spray in each nostril) once a day may be effective.
Use: Treatment of symptoms of seasonal and perennial allergic rhinitis

What other drugs will affect fluticasone nasal?

Tell your doctor about all your other medicines, especially:

  • antifungal medicine; or

  • antiviral medicine to treat hepatis C or HIV/AIDS.

This list is not complete. Other drugs may affect fluticasone nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 10.01.

Medical Disclaimer

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Consumer resources

  • Fluticasone Nasal Spray
  • Fluticasone Nasal Spray (Exhaler)
  • Fluticasone Nasal (Advanced Reading)

Other brands: Flonase, Flonase Allergy Relief, Flonase Sensimist, Xhance, Veramyst

Professional resources

  • Fluticasone Propionate eent (AHFS Monograph)
  • … +2 more

Related treatment guides

  • Nasal Polyps
  • Rhinitis
  • Allergic Rhinitis

CVS Pharmacy, Inc. Fluticasone Propionate Nasal Spray, USP Drug Facts

Consumer Information

FLUTICASONE PROPIONATE NASAL SPRAY QUESTIONS & ANSWERS

WHAT FLUTICASONE PROPIONATE NASAL SPRAY IS, HOW TO USE IT, AND WHAT TO EXPECT.

UNDERSTANDING FLUTICASONE PROPIONATE NASAL SPRAY

What Fluticasone Propionate Nasal Spray is, and how it works.

What is Fluticasone Propionate Nasal Spray?

Fluticasone Propionate Nasal Spray is an effective, allergy medicine that you can now buy without a prescription. It works directly in the nose to help block your allergic reactions. Fluticasone Propionate Nasal Spray relieves allergy symptoms caused by pollen, mold, dust and pets.

What is the active ingredient in Fluticasone Propionate Nasal Spray?

The active ingredient in Fluticasone Propionate Nasal Spray is called fluticasone propionate. Fluticasone propionate is a glucocorticoid – a substance produced naturally by your body to help fight inflammation. It works in your nose to relieve your allergy symptoms. Barely any of it travels through your body. It’s been prescribed by doctors for over 20 years, and used effectively by millions.

A glucocorticoid is a kind of steroid that is different from the anabolic (muscle-building) steroids sometimes misused by athletes. In fact, world class athletes are allowed to use glucocorticoids during competition to treat their allergies.

Who should not use Fluticasone Propionate Nasal Spray?

For complete guidance, check the Drug Facts label on the back of the Fluticasone Propionate Nasal Spray package.

Can I use Fluticasone Propionate Nasal Spray for asthma?

No, Fluticasone Propionate Nasal Spray is not a treatment for asthma. Ask your doctor what medicine to take for your asthma.

Can I use Fluticasone Propionate Nasal Spray for colds?

No, use Fluticasone Propionate Nasal Spray to treat only your allergies – not your cold symptoms. If you’re not sure whether your symptoms come from allergies or a cold, ask your doctor.

What happens when you have allergies?

Allergies start when allergens like pollen or pet dander enter your body and trigger your immune system to respond.

Your body’s natural response is to release multiple inflammatory substances, (also referred to as mediators) that cause your allergy symptoms.

How does Fluticasone Propionate Nasal Spray work?

Fluticasone Propionate Nasal Spray works right in your nose to help block your allergic reaction at the source to relieve the symptoms that make you uncomfortable.

Fluticasone Propionate Nasal Spray acts on multiple inflammatory substances, including histamine, prostaglandins, cytokines, tryptases, chemokines and leukotrienes.

Most common OTC allergy pills act on histamine alone.

Because of the way it works, it may take several days for Fluticasone Propionate Nasal Spray to reach maximum effect. That’s why it’s best to use Fluticasone Propionate Nasal Spray regularly, once a day.

Fluticasone Propionate Nasal Spray not only relieves sneezing, itchy nose, runny nose and itchy, watery eyes, but also relieves nasal congestion.

Who should not use Fluticasone Propionate Nasal Spray or check with a doctor first?

Some people should not use Fluticasone Propionate Nasal Spray, or need to check with a health professional first. This table offers a quick summary of these situations.

If you…

Here’s what to do…

Are younger than 4

Do not use Fluticasone Propionate Nasal Spray

Are pregnant or breast-feeding

Talk to a health professional before using Fluticasone Propionate Nasal Spray

Have or had glaucoma or cataracts

Talk to your doctor before using Fluticasone Propionate Nasal Spray

Have an injury or surgery to your nose that is not fully healed

Do not use Fluticasone Propionate Nasal Spray

Have ever had an allergic reaction to Fluticasone Propionate Nasal Spray or any of its ingredients

Do not use Fluticasone Propionate Nasal Spray

Are taking a medicine for HIV infection (such as ritonavir)

Talk to your doctor or pharmacist before using Fluticasone Propionate Nasal Spray

Are taking ketoconazole pills (medicine for fungal infection)

Talk to your doctor or pharmacist before using Fluticasone Propionate Nasal Spray

Are using a steroid medicine for asthma, allergies, skin rash, allergic reactions, inflammation or eye conditions

Talk to your doctor or pharmacist before using Fluticasone Propionate Nasal Spray

What problems can Fluticasone Propionate Nasal Spray help with?

Allergies can cause uncomfortable symptoms like congestion and itchy eyes. These symptoms can be triggered by allergens like pollen, mold, dust or pet dander.

Fluticasone Propionate Nasal Spray helps relieve a broad range of symptoms from many allergens.

For example, Fluticasone Propionate Nasal Spray helps with:

Symptoms

Triggers

Nasal

symptoms

Eye
symptoms

Outdoor

allergens

Animal

allergens

Indoor

allergens

Congestion

Runny nose

Sneezing

Itchy nose

Itchy eyes

Watery eyes

Weed pollen

Grass pollen

Tree pollen

Mold spores

Cats

Dogs

Dust

Dust mites

Mold

USING FLUTICASONE PROPIONATE NASAL SPRAY

How to get the best results with Fluticasone Propionate Nasal Spray.

Read the Drug Facts label on the back of the package or the Quick Start Guide on the other side for simple directions on using Fluticasone Propionate Nasal Spray.

Watch for purple color – it shows where there is different information for children ages 4-11, compared to users age 12 or older.

If you still have questions about using Fluticasone Propionate Nasal Spray after reading the Quick Start Guide, read this section for answers.

I know how to use a nasal spray. Why do I have to follow the directions?

If you don’t use the spray bottle correctly, you might not get a full dose. Without a full dose each time, you might not get the relief you deserve.

Follow the simple directions in the Quick Start Guide on other side.

If my symptoms go away, should I stop using Fluticasone Propionate Nasal Spray?

You may be tempted to stop using Fluticasone Propionate Nasal Spray when you start to feel better. It’s important you keep using Fluticasone Propionate Nasal Spray daily as long as you’re exposed to allergens that bother you, like pollen, mold, dust or pet dander. This way you’ll keep feeling relief.

If you suffer allergy symptoms only during certain times, like when pollen levels are high, you may stop using Fluticasone Propionate Nasal Spray when that time ends. If you are age 12 or older and need to use daily for longer than 6 months or age 4-11 and need to use for longer than 2 months a year, check with your doctor.

What if I miss a dose by accident?

If you miss a dose, just use your regular dose the next day. Don’t add an extra dose to make up for it.

Can I keep using Fluticasone Propionate Nasal Spray year round?

Some people suffer from allergies all year. If you are age 12 or older and have used Fluticasone Propionate Nasal Spray for six months or age 4-11 and have used for two months a year, check with your doctor to make sure it’s OK to keep using Fluticasone Propionate Nasal Spray. In fact, it’s a good idea for anyone with persistent allergies to talk with a doctor every so often about symptoms and medicines.

Can I share my Fluticasone Propionate Nasal Spray?

Do not share a bottle of Fluticasone Propionate Nasal Spray. Sharing the bottle can spread germs, because you insert the nozzle in your nose.

Can I spray Fluticasone Propionate Nasal Spray in my eyes or mouth?

No, Fluticasone Propionate Nasal Spray is meant to work only in your nose to relieve your allergy symptoms, including itchy, watery eyes.

Never spray Fluticasone Propionate Nasal Spray in your eyes or your mouth.

Some decongestants may increase blood pressure. Does Fluticasone Propionate Nasal Spray increase blood pressure?

When used as directed, Fluticasone Propionate Nasal Spray does not increase blood pressure.

Won’t I waste product by priming?

It’s not a waste to prime the pump, because it helps you get a full dose. Getting a full dose is important for getting the relief you deserve. See the Quick Start Guide for when and how to prime the pump.

Don’t worry about running out due to priming. There is enough medicine in the spray bottle to allow for priming sprays plus the number of sprays labeled on the bottle.

Always point the spray bottle away from your face when priming.

How long should a bottle of Fluticasone Propionate Nasal Spray last?

This table shows roughly how long your bottle will last. It assumes you follow the instructions for priming the pump, and that those age 12 or older use two sprays in each nostril every day while children age 4-11 use one spray in each nostril every day.

After you’ve used the number of sprays shown on the label, each spray may not deliver a full dose — even if there is liquid left in the bottle.

If the label says…

The bottle should last age 12+…

The bottle should last age 4-11…

30 sprays

1 week

2 weeks

60 spray

2 weeks

4 weeks

120 sprays

4 weeks

8 weeks

150 sprays

5 weeks

10 weeks*

*Check with a doctor if a child 4-11 needs to use longer than 2 months a year

Is Fluticasone Propionate Nasal Spray OK to use with other medicines?

You should tell your doctor about all the medicines you take, including Fluticasone Propionate Nasal Spray. Fluticasone Propionate Nasal Spray can be used with most non-prescription and prescription medicines. However, there are a few medicines to look out for because they may cause the level of Fluticasone Propionate Nasal Spray in your body to become too high.

Just to be safe, check this table to see if you’re taking any of these medicines.

If you’re taking…

Here’s what to do…

Medicines for HIV infection (such as ritonavir)

Talk to your doctor or pharmacist before using Fluticasone Propionate Nasal Spray

Medicines with glucocorticoids Including some medicines for skin rash such as eczema, asthma, inflammation, allergic reactions, or eye conditions

Talk to your doctor or pharmacist before using Fluticasone Propionate Nasal Spray

Ketoconazole Pills for fungal infection

Talk to your doctor or pharmacist before using Fluticasone Propionate Nasal Spray

What are the differences in the way children age 4-11 should use Fluticasone Propionate Nasal Spray?

Children age 4-11 should use a lower dose of Fluticasone Propionate Nasal Spray for a shorter period of time.

Ages

Children 4-11 years of age

Users 12 years of age and older

Dosage

1 spray in each

nostril once daily

Up to 2 sprays

in each nostril once daily

Duration before checking with a doctor

Up to 2 months of use a year

Up to 6 months of daily use

Why is the use of Fluticasone Propionate Nasal Spray for children age 4-11 limited to 2 months a year before checking with a doctor?

When used long-term, intranasal glucocorticoids like Fluticasone Propionate Nasal Spray may cause the growth rate of some children to be slower. Whether this will affect a child’s ultimate height is not known. As a precaution, children should use for the shortest amount of time necessary to achieve symptom relief. Talk to your child’s doctor if your child needs to use the spray for longer than 2 months a year.

WHAT TO EXPECT

What it’s like to use Fluticasone Propionate Nasal Spray.

How soon will I get relief?

You may start to feel relief the first day you use Fluticasone Propionate Nasal Spray. Keep using it every day, though. It takes several days before Fluticasone Propionate Nasal Spray builds up to full effectiveness.

How long will the relief last?

Fluticasone Propionate Nasal Spray is meant to control your symptoms every day, all day and all night. To help you get this lasting relief, it’s important to use Fluticasone Propionate Nasal Spray regularly, once a day.

Does Fluticasone Propionate Nasal Spray cause a “rebound” effect?

No, Fluticasone Propionate Nasal Spray does not cause a rebound effect.

Some nasal decongestant sprays may cause your nasal passages to swell up even more when you use them too often or for longer than their label says you should (three days). This is sometimes called a “rebound effect.”

Fluticasone Propionate Nasal Spray is a different kind of medicine and does not cause any rebound effect. You can use Fluticasone Propionate Nasal Spray for up to six months if you are age 12 or older or up to two months a year if you are age 4-11 before checking with a doctor.

Will Fluticasone Propionate Nasal Spray make me drowsy?

No, Fluticasone Propionate Nasal Spray does not cause drowsiness. Some allergy medications can cause drowsiness, but Fluticasone Propionate Nasal Spray does not.

Why does Fluticasone Propionate Nasal Spray have a smell?

The light floral scent you may notice comes from one of the important ingredients in the Fluticasone Propionate Nasal Spray formula. No fragrance is added to Fluticasone Propionate Nasal Spray.

What if little or nothing is spraying out?

Try priming the spray bottle. It may take a few pumps to get the dispenser spraying again.

If that doesn’t work, the spray nozzle may be clogged. You can clean it following the directions in the Quick Start Guide on the other side.

What if I feel stinging in my nose, or I sneeze?

Some people may feel a slight stinging, or may sneeze, after spraying Fluticasone Propionate Nasal Spray in their nostrils.

This feeling should go away in a few seconds.

What if I feel or taste the medicine in my throat?

Generally, you can avoid this by taking a shallower breath next time you spray Fluticasone Propionate Nasal Spray into your nostrils. For example, take the kind of breath you would use to smell a flower.

What if I have chicken pox, measles or tuberculosis or come into contact with someone who does?

Stop using Fluticasone Propionate Nasal Spray and ask your doctor.

What if I’m having severe sinus pain?

If you feel severe pain in your face, have thick nasal discharge, or think you may have a sinus infection, stop using Fluticasone Propionate Nasal Spray and see your doctor. Your doctor may want to consider if other medicines are needed.

What if my symptoms aren’t better after one week?

If you have used Fluticasone Propionate Nasal Spray for a week and your allergy symptoms are not getting better, stop use and ask your doctor. You may have an infection.

Does Fluticasone Propionate Nasal Spray have side effects?

Serious side effects are rare with Fluticasone Propionate Nasal Spray because Fluticasone Propionate Nasal Spray works in your nose, and barely any of it travels through your body. However, like all medicines, Fluticasone Propionate Nasal Spray can cause side effects in some people.

Here are some side effects that have been reported when using Fluticasone Propionate Nasal Spray. If you have any concerns about side effects, talk with your doctor.

Side effect

What could happen

What to do

Allergic reaction to the product

• Sudden swelling of face or tongue • A rash • Wheezing or feeling faint

If you feel any of these symptoms, stop using Fluticasone Propionate Nasal Spray and see a doctor right away.

Nose injury

• Severe or frequent nosebleeds

Apply pressure to your nose. Stop using Fluticasone Propionate Nasal Spray and see a doctor.

• Constant whistling sound that does not go away

This could be a sign of damage to your nose. Stop using Fluticasone Propionate Nasal Spray and see a doctor right away.

Eye conditions such as cataracts or glaucoma

• Cloudy vision • Reduced vision

Have a yearly eye exam to check for these conditions. Read the Drug Facts on the back of the Fluticasone Propionate Nasal Spray package for more details.

Growth effects

• Slower growth rate in some children while using product

Talk to your doctor if you are concerned or if a child age 4-11 needs to use Fluticasone Propionate Nasal Spray for longer than two months a year.

Other side effects

• Headaches or sneezing • Bad taste or smell • Minor nosebleeds • Dry or irritated nose or throat.

Talk to your doctor or pharmacist if you are concerned.

STILL HAVE QUESTIONS? Call 1-800-719-9260

FLUTICASONE PROPIONATE NASAL SPRAY

QUICK START GUIDE

HOW TO START GETTING ALLERGY RELIEF RIGHT NOW

USE THE RIGHT DOSE

Fluticasone Propionate Nasal Spray works best when you use it daily. Here’s how to get started.

Children age 4-11

An adult should supervise use

Use one spray in each nostril once daily.

Don’t use more than one spray in each nostril per day.

If you miss a dose, just use your regular dose the next day. Don’t add an extra dose.

Check with a doctor if a child needs to use Fluticasone Propionate Nasal Spray for longer than two months a year.

Users age 12 or older

In your first week

Use two sprays in each nostril every day.

Don’t use more than two sprays in each nostril per day.

After your first week

If your symptoms are under control, you may reduce to one spray in each nostril every day. If your symptoms get worse, go back to two sprays in each nostril.

If you miss a dose, just use your regular dose the next day. Don’t add an extra dose.

WARNING:

Do not spray in your eyes. Only for use in your nose.

KEEP IT CLEAN

A clean spray nozzle helps ensure a full dose. Clean it weekly, or if it’s clogged. Don’t try to unblock nozzle with pin or sharp object — that can damage it.

Remove spray nozzle by grasping at base and pulling up.

Rinse under running tap, and dry at room temperature.

Aim away from your face and gently replace spray nozzle until you hear a soft click.

If spray nozzle is clogged, soak in warm water. Then repeat steps 2 and 3.

GET THE RELIEF YOU NEED.

Fluticasone Propionate Nasal Spray can relieve your allergy symptoms. For best results, it’s important to get a full dose.

Here’s how, in five easy steps.

Gently shake spray bottle.

Remove clear cap.

Do this when:

• Starting new bottle • Haven’t used it in a week • Just cleaned nozzle

Otherwise go to Step 3.

Aim away from face. Grasp spray bottle as shown. Pump until fine mist appears.

Pumped six times and still no mist? Spray nozzle may be clogged. See KEEP IT CLEAN.

Blow nose gently to clear nostrils.

Close one nostril and put tip of spray nozzle in other nostril.

Put just the tip into your nose.

Aim slightly away from center of nose.

While sniffing gently, press down on spray nozzle once or twice (according to dosing instructions). You’ll feel a light mist in your nose. Breathe out through your mouth.

Repeat in other nostril.

Wipe spray nozzle with clean tissue and replace cap.

Distributed By

Perrigo®

Allegan, MI 49010

1G700 00 J4:

Brand Names: Childrens Flonase, Flonase, Flonase Sensimist, Good Sense Nasoflow, Veramyst, Xhance

Generic Name: fluticasone nasal

  • What is fluticasone nasal?
  • What are the possible side effects of fluticasone nasal?
  • What is the most important information I should know about fluticasone nasal?
  • What should I discuss with my healthcare provider before using fluticasone nasal?
  • How should I use fluticasone nasal?
  • What happens if I miss a dose?
  • What happens if I overdose?
  • What should I avoid while using fluticasone nasal?
  • What other drugs will affect fluticasone nasal?
  • Where can I get more information?

Fluticasone nasal (for the nose) is a steroid medicine that is used to treat nasal congestion, sneezing, runny nose, and itchy or watery eyes caused by seasonal or year-round allergies.

The Xhance brand of this medicine is for use only in adults. Veramyst may be used in children as young as 2 years old. Flonase is for use in adults and children who are at least 4 years old.

Fluticasone nasal may also be used for purposes not listed in this medication guide.

What are the possible side effects of fluticasone nasal?

Get emergency medical help if you have signs of an allergic reaction: hives, rash; feeling light-headed; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe or ongoing nosebleeds;
  • noisy breathing, runny nose, or crusting around your nostrils;
  • redness, sores, or white patches in your mouth or throat;
  • fever, chills, body aches;
  • blurred vision, eye pain, or seeing halos around lights;
  • any wound that will not heal; or
  • signs of a hormonal disorder–worsening tiredness or muscle weakness, feeling light-headed, nausea, vomiting.

Steroid medicine can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.

Common side effects may include:

  • minor nosebleed, burning or itching in your nose;
  • sores or white patches inside or around your nose;
  • cough, trouble breathing;
  • headache, back pain;
  • sinus pain, sore throat, fever; or
  • nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about fluticasone nasal?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Flonase is the brand name for fluticasone nasal spray, a prescription drug used to prevent and reduce nasal inflammation.

Doctors prescribe Flonase to treat symptoms of seasonal and year-round allergies.

Flonase is a corticosteroid, a class of drugs (also referred to as steroids) that’s used to reduce inflammation in the nasal passages, lungs, and skin, and is sometimes given orally for more severe conditions.

In 2006, the Food and Drug Administration (FDA) approved the sale of fluticasone propionate nasal spray (the generic form of Flonase).

Flonase works by reducing inflammation and swelling in the nose, which can lead to a number of allergy symptoms, including:

  • Sneezing
  • Congested or stuffy nose
  • Runny nose
  • Itchy nose

Other nasal steroids are available over-the-counter, such as Rhinocort (budesonide).

Veramyst (fluticasone furoate) is a prescription steroid that’s ideal for people who benefit from fluticasone yet do not tolerate the occasional dripping into the throat linked to Flonase.

Other Uses for Fluticasone

Fluticasone is also available (under other brand names) as an aerosol inhaled by mouth, and as a topical cream or ointment applied to the skin.

Flovent (fluticasone oral inhalation) helps people with asthma breathe more easily and reduces tightness in the chest. It can also treat asthma-related wheezing and coughing.

There is research suggesting that inhaled steroids such as fluticasone may benefit people with stable chronic obstructive pulmonary disease (COPD).

A study published in the International Journal of Chronic Obstructive Pulmonary Disease in 2014 found that a once-daily dry powder inhaler combination therapy could improve people’s adherence to long-term inhaled therapy as well as their prognosis.

In the United States, GlaxoSmithKline markets fluticasone as Flovent for the treatment of asthma, as well as the combination of fluticasone and salmeterol as Advair for the treatment of asthma and COPD.

Additionally, doctors prescribe topical fluticasone to reduce inflammation and relieve symptoms associated with certain skin conditions, including:

  • Itching
  • Redness
  • Dryness
  • Scaling

PharmaDerm, a division of Fougera Pharmaceuticals, manufactures topical fluticasone and sells it under the brand name Cutivate.

Flonase Warnings

You may not experience the full benefits of Flonase for two weeks or more after starting treatment.

Fluticasone may also make it harder for your body to fight off infections. While taking the drug, your body may be less able to manage the stress of surgery, illness, severe asthma attack, or injury.

While taking fluticasone, you should avoid people who are sick, especially those with chickenpox or measles. If you get one of these infections or if you develop related symptoms, call your doctor right away.

Flonase could increase your risk for developing osteoporosis, a condition that causes the bones to become thin and break easily. If you’re already at greater risk for osteoporosis, it’s important to have your bone density assessed both before and during treatment.

Research shows that in rare cases, people taking fluticasone for a long period of time may develop glaucoma or cataracts.

Before taking fluticasone, be sure to let your doctor know if you’ve ever had any of the following:

  • Glaucoma
  • Cataracts
  • Other illnesses
  • Recurring infections (such as herpes)
  • Allergies
  • Tuberculosis
  • Liver disease

Also let your doctor know if you’ve never had chickenpox or measles and never got a vaccination against those diseases.

Although fluticasone can help prevent asthma attacks, it will not stop an attack that has already begun. Don’t use fluticasone during an asthma attack.

You should also let your doctor know if you have any type of surgery planned, including dental procedures.

Flonase and Pregnancy

Be sure your doctor knows if you are pregnant, may become pregnant, or are breastfeeding.

There’s not enough evidence to know whether Flonase is safe for pregnant women or breastfeeding infants.

Evidence also is lacking on whether nasal or inhaled fluticasone is safe or effective for treating kids younger than 4.

Children older than 4 who take the drug may grow more slowly, and it’s unclear whether their final adult height will be shorter than it would have been had they not taken fluticasone.

Children 3 months and older can use topical fluticasone with caution. There’s no evidence of safety or effectiveness of the drug when used on young children for longer than 4 weeks.

Dymista vs. Flonase: differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Coughing, sneezing, runny nose (or nasal congestion), itchy and watery eyes, oh my! Every year, more than 50 million Americans suffer from these bothersome allergy symptoms. It can be overwhelming to decide what medication(s) to use to treat your symptoms.

Dymista and Flonase (fluticasone propionate) are medications used in treating allergy symptoms in children and adults. Dymista is a combination medication that contains both an antihistamine and a steroid (corticosteroid), and Flonase contains a steroid only. While Dymista is available in brand name only, Flonase is available by prescription in generic form, and over the counter (OTC) in brand name as well as generic. While they both treat allergies, there are differences in the two medications.

What are the main differences between Dymista and Flonase?

Dymista contains two medications, azelastine hydrochloride (an antihistamine) and fluticasone propionate (a steroid). Dymista is indicated to treat seasonal allergic rhinitis in patients six years and older who need treatment with both azelastine and fluticasone to relieve symptoms. It is currently available in brand name only, and by prescription only. Each actuation (one spray) contains 50 mcg of fluticasone and 137 mcg of azelastine.

Flonase is a nasal steroid and contains fluticasone propionate. It is indicated for the management of perennial nonallergic rhinitis (chronic symptoms of postnasal drip, runny or stuffy nose, sneezing) symptoms in adults and children four years and older. It is available in generic form by prescription, and over the counter in both brand (as Flonase Sensimist, Children’s Flonase Sensimist, and Children’s Flonase Allergy Relief) and generic form. Each actuation (one spray) contains 50 mcg of fluticasone.

Main differences between Dymista and Flonase
Dymista Flonase
Drug class H1 receptor antagonist (antihistamine) and corticosteroid Corticosteroid
Brand/generic status Brand only Rx: generic
OTC: brand and generic
Generic Name Azelastine hydrochloride and fluticasone propionate Fluticasone propionate
Dosage Form Nasal spray Nasal spray
Standard dosage 1 spray in each nostril twice daily Adults: 2 sprays in each nostril daily
Adolescents & children 4 years and older: 1 spray in each nostril daily
Duration of treatment Varies by symptoms Varies by symptoms
Used By Children 6 years and older, adults Children 4 years and older, adults

Conditions treated by Dymista and Flonase

Dymista is indicated for the relief of symptoms of seasonal allergic rhinitis in patients six years and older who need both azelastine and fluticasone treatment for relief of symptoms.
Flonase is indicated in patients four years and older for the management of nasal symptoms of perennial nonallergic rhinitis.

Condition Dymista Flonase
Nasal symptoms of perennial nonallergic rhinitis No Yes
Seasonal allergic rhinitis Yes No

Is Dymista or Flonase more effective?

In a clinical study of the safety and efficacy of Dymista in adults and adolescents 12 years of age and older, Dymista was found to have a significant effect on nasal symptoms as compared to each component (azelastine, fluticasone) alone as well as placebo.

In an analysis of fluticasone nasal spray, patients in two out of three trials experienced a significant decrease in nasal symptoms as compared to placebo.

Generally, either Dymista or Flonase can be very helpful in managing symptoms. The most effective medication should be determined by your doctor taking into account your medical condition(s) and medical history, as well as other medications you are taking.

Coverage and cost comparison of Dymista vs. Flonase

Dymista is available by prescription in brand name only. The cost without insurance is approximately $231. Insurance usually covers Dymista; copays will vary but you can use a SingleCare coupon and get Dymista for around $183. Medicare Part D generally does not cover Dymista.

Some insurances require a prior authorization for Dymista, and your doctor will have to provide more details to the insurance as to why you need this medication. If your insurance does not cover Dymista at all or denies the prior authorization request, your doctor may instead call in separate prescriptions for Flonase (fluticasone) and Astepro (azelastine), which are the two components of Dymista, both available in generic, and should be covered by insurance.

Flonase is available by prescription in generic form only, and OTC in brand or generic. You can buy the brand name drug over the counter; it is generally not covered by insurance or Medicare Part D. However, you can get generic fluticasone propionate for around $17 by using a SingleCare savings card or coupon.

Dymista Flonase
Typically covered by insurance? Varies; may require prior authorization Yes, the generic prescription version
Typically covered by Medicare? Not usually Yes, the generic prescription version
Standard dosage 1 spray in each nostril twice daily Adults: 2 sprays in each nostril daily
Children: 1 spray in each nostril daily
Typical Medicare copay $80-221 $40-75
SingleCare cost $183 $17

Common side effects of Dymista and Flonase

Because both drugs contain fluticasone, the possible side effects of Dymista and Flonase are similar. Most patients tolerate both drugs very well; serious side effects are rare. The most common side effects of Flonase are headache, sore throat, nosebleeds, nasal irritation, nausea/vomiting, asthma symptoms, and cough. The most common side effects of Dymista are altered sense of taste, nosebleeds, and headache. Consult your healthcare provider for a complete list of side effects.

Side effects Dymista: Applicable? Dymista: Frequency Flonase: Applicable? Flonase: Frequency
Headache Yes 2% Yes 16.1%
Sore throat No Yes 7.8%
Nosebleed Yes 2% Yes 6.9%
Nasal irritation No Yes 3.2%
Nausea/vomiting No Yes 2.6%
Altered sense of taste Yes 4% No

Source: DailyMed (Dymista), DailyMed (Flonase)

Drug interactions of Dymista and Flonase

Because both drugs contain fluticasone, the adverse effects are similar. With desmopressin, which is used for bedwetting, concurrent use with Flonase or Dymista could lead to water retention and low sodium levels.

All of the drugs listed in the table below interact (with both Flonase and Dymista) in a way that significantly increases steroid levels in the body, which could increase the risk of steroid side effects. This is due to an enzyme called CYP3A4, which is involved in many drug interactions.

Drug Drug class Dymista Flonase
Norvir (ritonavir), Invirase (saquinavir), Rescriptor (delavirdine), Crixivan (indinavir), etc. HIV/AIDS medications Yes Yes
DDAVP (desmopressin) Bedwetting medication Yes Yes
Biaxin (clarithromycin) Antibiotic Yes Yes
Nizoral (ketoconazole), Sporanox (itraconazole) Antifungals Yes Yes

Warnings of Dymista and Flonase

Warnings of Flonase

Patients should be periodically monitored for adverse effects on the nasal mucosa, such as nosebleeds, fungal infection, and impaired wound healing. Flonase should not be used in patients with recent nasal ulcers, nasal surgery, or nasal trauma.

Other warnings to watch out for:

  • Patients who notice vision changes, patients with a history of increased intraocular pressure, or patients who use Flonase long-term should see an ophthalmologist to check for glaucoma and cataracts.
  • Hypersensitivity reactions, such as anaphylaxis or rash, have been reported. Flonase should be stopped if these effects occur.
  • Use with caution in patients with existing tuberculosis; fungal, bacterial, viral, or parasitic infection; ocular herpes simplex, as Flonase could cause worsening of the infection. More serious or even fatal cases of chickenpox or measles can occur in susceptible patients.
  • Patients should be monitored for adrenal suppression. When the body doesn’t make enough steroid hormone, symptoms may include tiredness, weakness, nausea, vomiting, low blood pressure. Flonase should be slowly discontinued if changes occur.
  • Monitor the growth of pediatric patients due to the possibility of reduced growth velocity; use the lowest effective dose.

Due to the lack of available data, Flonase should only be used in pregnancy or while breastfeeding if the benefit to the mother outweighs the risk to the fetus. Consult your OB/GYN for advice.

Warnings of Dymista

Because Dymista also contains fluticasone, which is found in Flonase, all of the above Flonase warnings apply to Dymista as well. The following warnings also apply, due to the azelastine component of Dymista.

  • Dymista may cause drowsiness; patients should use caution while driving or operating machinery.
  • Avoid alcohol or other CNS depressants with Dymista because the combination may cause impairment and decreased alertness.

The manufacturer recommends only using Dymista during pregnancy if the benefit is greater than the risk. Consult your OB/GYN for guidance. Dymista is not recommended while breastfeeding; the manufacturer recommends either stopping Dymista or stopping breastfeeding.

Frequently asked questions about Dymista vs. Flonase

What is Dymista?

Dymista is a combination nasal spray that has an antihistamine and a steroid to help relieve symptoms of seasonal allergies in adults and children.

What is Flonase?

Flonase is a steroid nasal spray that helps manage nasal symptoms of perennial nonallergic rhinitis (chronic symptoms of postnasal drip, runny or stuffy nose, sneezing) in adults and children.

Are Dymista and Flonase the same?

No. Flonase contains the steroid fluticasone propionate; Dymista contains fluticasone propionate along with an antihistamine, azelastine.

Is Dymista or Flonase better?

It depends on your symptoms; everyone is different. Consult your healthcare professional for personalized advice based on your medical history and symptoms. Most people do well with one of these medications, or another similar medication such as Nasonex (mometasone) or Nasacort (triamcinolone).

How long should you use Dymista nasal spray?

The length of treatment varies by symptoms as well as side effects. Consult your physician for advice.

Can you use Flonase and Dymista together?

Generally, these drugs are not used together. One or the other would suffice.

What are the side effects of long term use of the antihistamine?

Dymista, which contains the antihistamine azelastine, was shown to be well-tolerated after one year of use. The FDA approval of Dymista was based on long-term safety data. The most common side effects were altered sense of taste, nosebleed, and headache. Consult your healthcare provider about the appropriate duration of treatment for you.

Remember, the most effective medication should only be determined by your doctor who will look at the whole picture of your medical condition(s), health history, and other medications that could interact with Flonase or Dymista.

Should I use Flonase or Nasacort for my allergies?

If your child uses one of these sprays, another potential side effect is a slightly reduced rate of growth. To reduce the risk of that, don’t allow them to use it for longer than two months a year. If their allergy symptoms last for longer than that, talk to your doctor about other options. And tell your doctor if your child also uses inhaled steroids to treat asthma or a topical steroid for itchy skin—using those with a steroid spray could increase the risk of slowed growth. Another option is to try a cromolyn spray instead. It’s not as effective, but it is not associated with growth problems and is very safe for children.

If the steroid sprays don’t provide enough relief for you, considering adding an antihistamine spray (such as azelastine or olopatadine). Those are available by prescription, but studies show the combination can provide more relief than the steroid spray alone. Another option is an antihistamine pill, like fexofenadine (Allegra and generic), loratadine (Claritin and generic), or cetirizine (Zyrtec and generic). And if you’re already taking one of those and it’s working to relieve your symptoms, our medical advisers say there’s no need to switch or add a steroid or antihistamine spray.

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