Fluticasone nasal: 7 things you should know
Medically reviewed by Carmen Pope, BPharm. Last updated on April 4, 2024.
1. How it works
- Fluticasone nasal spray may be used to treat symptoms of nasal congestion, sneezing, runny nose, and itchy or watery eyes caused by seasonal or year-round allergies.
- Fluticasone is thought to work by controlling the release of prostaglandins and other substances that promote inflammation. Fluticasone reduces inflammation and relieves itching. It can also help constrict (narrow) blood vessels, relieving congestion.
- Fluticasone nasal spray belongs to the group of medicines known as corticosteroids.
2. Upsides
- Fluticasone nasal spray relieves nasal symptoms such as a runny, stuffy nose, sneezing, and nasal itching and it is used to treat conditions such as seasonal or year-round allergic rhinitis and other allergies that cause predominantly nasal symptoms.
- There are several brands of fluticasone nasal spray, and the uses they have been approved for may differ. Flonase is approved for adults and children aged four years and older and Veramyst is suitable for adults and children aged two years and older. Xhance (fluticasone propionate) has a unique exhalation delivery system and is approved to treat chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyps (CRSsNP) in adults only.
- Fluticasone has a strong affinity for the glucocorticoid receptor. This means it is less likely to cause salt and water retention and therefore less likely to cause high blood pressure, low potassium levels, or high sodium levels.
- May be used long-term or short-term.
- Nasal dosage form means that it acts quickly and directly at the site of symptoms.
- Generic fluticasone nasal spray is available.
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Nosebleeds, nasal ulceration, headache, sore throat, nausea, cough, and nasal burning or itching.
- Rarely, nasal perforation may occur. Use of fluticasone nasal spray may lower your immunity, increasing your risk of developing an infection and delaying wound healing.
- Glaucoma and cataracts have been associated with nasal corticosteroid use. Avoid spraying fluticasone near the eyes.
- Using corticosteroids may make you more susceptible to viral infections such as chickenpox, measles, or other types of infection.
- Long-term, continued use of fluticasone nasal spray may reduce a child's growth rate.
- May not be suitable for some people including those with a compromised immune system, with certain eye problems, with certain allergies, with an active infection, taking ritonavir, or with certain other conditions.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Bottom Line
- Fluticasone nasal spray reduces inflammation and nasal symptoms associated with rhinitis; however, it may take up to three days for the full effects to be seen. There are several brands of fluticasone nasal spray, and the uses and ages they have been approved for differ. Nosebleeds are a common side effect.
5. Tips
- Dosage may be given either once or twice daily.
- The maximum dosage should not exceed two sprays per nostril daily.
- The effectiveness of fluticasone nasal spray against the symptoms of allergic rhinitis depends on regular use.
- Shake fluticasone nasal spray well before using. Prime before first use (shake well and release 6 sprays into the air away from the face). Usually, one or two sprays are given into each nostril once a day.
- Xhance has a unique delivery system and looks different from other nasal inhalers. It has a cone-shaped non-flexible nosepiece and a longer flexible mouthpiece. The tapered tip of the cone-shaped nosepiece is gently inserted deep into the nose to expand the nasal passage and create a tight seal between the nosepiece and the nostril. A seal must be maintained as the patient blows into the mouthpiece and actuates the spray pump. Your mouth is placed around the mouthpiece and the device is actuated by pushing the bottle up while continuing to blow forcefully into the mouthpiece. Within the device is a valve that prevents the release of breath until the bottle is pushed. Pushing the bottle also actuates the spray pump, releasing a metered dose of aerosolized medication while simultaneously allowing a “burst” of exhaled breath to pass through the device. This helps deliver the medication deep into your nose. Do not try to inhale or “sniff” when blowing (exhaling) into the mouthpiece. Do not block the other nostril because the exhaled breath must pass around the back of the nasal septum and out the other side of the nose.
- May take several days to reach its full effect when used for allergic rhinitis symptoms. Consider using a decongestant nasal spray initially (for a maximum of three days of use) or taking an antihistamine until fluticasone exerts its effect.
- If no response is seen after several days of use, contact your doctor. Do not exceed the recommended dosage.
- Do not spray fluticasone nasal spray near your eyes or in your mouth.
- See your doctor if you notice a change in your vision, or experience a rash or an allergic-type reaction while using fluticasone nasal spray.
- Do not use fluticasone nasal spray if you have recently had nasal surgery or nasal trauma or if you have a current infection unless your doctor has advised you to do so.
6. Response and effectiveness
- Although fluticasone nasal spray is rapidly absorbed through the nasal tissues, it does not have an immediate effect on rhinitis symptoms. Fluticasone nasal spray may take several days to reach its full effect.
7. Interactions
Medicines that interact with fluticasone nasal spray may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with fluticasone nasal spray. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with fluticasone nasal spray include:
- clarithromycin
- CYP3A4 inhibitors, such as clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole, ritonavir, verapamil, goldenseal or grapefruit
- desmopressin
- esketamine
- HIV medications such as amprenavir or atazanavir
- medications used to treat hepatitis such as boceprevir
- nefazodone
- ritodrine.
Note that this list is not all-inclusive and includes only common medications that may interact with fluticasone nasal spray. You should refer to the prescribing information for fluticasone nasal spray for a complete list of interactions.
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- Drug class: nasal steroids
Patient resources
Other brands
Flonase, Flonase Allergy Relief, Xhance, Flonase Sensimist, Veramyst
Professional resources
Other brands
Flonase, Xhance, Veramyst, Ticanase
Related treatment guides
References
- Fluticasone nasal [Package Insert]. Revised 05/2023. Hikma Pharmaceuticals USA Inc. https://www.drugs.com/pro/fluticasone-nasal-spray.html
- Xhance Product Label. Revised 03/2024. OptiNose US, Inc. https://www.xhance.com/files/XHANCE_Full_Prescribing_Information.pdf
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use fluticasone nasal only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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