fluticasone intranasal (OTC)

Brand and Other Names:Flonase Allergy Relief, ClariSpray, more...Flonase Sensimist Allergy Relief, Children's Flonase Allergy Relief, Veramyst
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray

  • 27.5mcg/actuation (Veramyst [Rx discontinued], Flonase Sensimist Allergy Relief [OTC])
  • 50mcg/actuation (Flonase Allergy Relief [OTC], ClariSpray [OTC])
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Perennial Nonallergic Rhinitis

Flonase Allergy Relief: 1 spray in each nostril (100 mcg/day) for maintenance therapy; OTC not for use for >6 months unless instructed by healthcare provider

ClariSpray: 2 sprays in each nostril qDay x 1 wk, THEN 1-2 sprays in each nostril qDay as needed to treat symptoms for up to 6 mo unless directed by physician to use longer

Flonase Sensimist Allergy Relief: 2 sprays in each nostril qDay (ie, 110 mcg/day); after symptoms controlled, may reduce dose to 1 spray in each nostril qDay (ie, 55 mcg/day) for maintenance therapy

Dosage Forms & Strengths

nasal spray

  • 27.5mcg/actuation (Veramyst [Rx discontinued], Flonase Sensimist Allergy Relief [OTC])
  • 50mcg/actuation (Flonase Allergy Relief [OTC], ClariSpray [OTC])
more...

Seasonal/Perennial Allergic Rhinitis

Limit duration of use of OTC nasal corticosteroids to 2 months a year in children unless otherwise directed by physician

Flonase Allergy Relief, Children's Flonase Allergy Relief

  • ≥4-11 years: 1 spray (50 mcg) in each nostril qDay; may increase up to 2 sprays/nostril qDay if not responding adequately, reduce to 1 spray in each nostril qDay once symptoms are controlled
  • >12 years: 2 sprays in each nostril qDay (ie, 200 mcg/day); reduce to 1 spray in each nostril qDay once symptoms are controlled

ClariSpray

  • <4 years: Safety and efficacy not estabished
  • 4-11 years: 1 spray in each nostril qDay for up to 2 months annually unless directed by physician to use longer
  • ≥12 years: 2 sprays in each nostril qDay x 1 wk, THEN 1-2 sprays in each nostril qDay as needed to treat symptoms for up to 6 mo unless directed by physician to use longer

Flonase Sensimist Allergy Relief

  • 2-12 years: 1 spray (27.5 mcg) in each nostril qDay; may increase up to 2 sprays/nostril qDay if not responding adequately, reduce to 1 spray in each nostril qDay once symptoms are controlled
  • >12 years: 2 sprays in each nostril qDay (ie, 110 mcg/day); reduce to 1 spray in each nostril qDay once symptoms are controlled
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Interactions

Interaction Checker

and fluticasone intranasal

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    Contraindicated

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            Adverse Effects

            >10%

            Headache (17%)

            URI (15%)

            1-10%

            Nasal congestion (8%)

            Pharyngitis (6-8%)

            Asthma symptoms (3-7%)

            Fever (1-5%)

            Dysphonia (4%)

            Cough (3-4%)

            Nasal discharge (1-3%)

            Aches and pains (1-3%)

            Flu-like syndrome (1-3%)

            Bronchitis (1-3%)

            Diarrhea (1-3%)

            Abdominal pain (1-3%)

            Nasal ulcer (1%)

            Frequency Not Defined

            Loss of taste

            Postmarketing Reports

            Respiratory, thoracic, and mediastinal disorders: Rhinalgia, nasal discomfort (including nasal burning, nasal irritation, and nasal soreness), nasal dryness, and nasal septal perforation

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            May mask acute infection, including fungal infection, exacerbate viral infections or limit response to vaccines; not for use in untreated localized infection involving nasal mucosa; administer antimicrobial therapy if bacterial infection of sinuses suspected or confirmed; respiratory tract fungal or bacterial infections, parasitic infections, ocular herpes simplex may occur

            Chickenpox and measles: Serious or fatal course in susceptible individuals; unvaccinated or immunologically unexposed children or adults should avoid exposure

            Delays wound healing of nasal septal ulcers, trauma, or surgery; best to administer after healing has occurred

            May increase risk of hypercorticism or hypothalamic-pituitary adrenal (HPA) axis suppression, especially in younger patients receiving high doses for prolonged periods; HPA suppression may lead to adrenal crisis; withdraw or discontinue slowly; pediatric patients may be more sussceptible to systemic toxicity

            Local nasal effects, nasal septum perforation, epistaxis, wheezing, cataracts, glaucoma reported; consider routine eye exams in long-term users or patients who report visual changes

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Unknown whether distributed in breast milk; caution advised

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Potent anti-inflammatory corticosteroid with vasoconstrictive properties

            Available in 2 salt forms, fluticasone propionate (Flonase) and fluticasone furoate (Veramyst)

            Absorption

            Bioavailability: ≤2%

            Onset of action: May take several days to achieve optimum benefit

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            Images

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