Flixonase aqueous nasal spray (Fluticasone)
How does it work?
Flixonase aqueous nasal spray contains the active ingredient fluticasone propionate, which is a type of medicine known as a corticosteroid (or steroid). Corticosteroids are hormones produced naturally by the adrenal glands that have many important functions, including control of inflammatory responses.
Fluticasone is a synthetic corticosteroid and is adminstered by nasal spray to decrease inflammation in the nasal passages.
People who suffer from nasal allergies (allergic rhinitis), such as hay fever, tend to experience a variety of symptoms as a result of their allergy, including a runny, itchy or blocked nose, sneezing and sinus discomfort. These symptoms are a result of inflammation in the nasal passages.
The inflammation occurs when the nasal passages are exposed to foreign particles (allergens), for example, pollen, dust mites or pet fur. The allergens cause the cells in the nose to release chemicals that help to produce immune and allergic responses. These result in inflammation in the nasal passages and the symptoms of the allergy.
When administered into the nose, fluticasone is absorbed into the cells of the nasal passages. It works by preventing these cells from releasing the chemicals that trigger the allergic response. This stops the allergic reaction from happening, so the nasal inflammation is reduced and the symptoms relieved.
The nasal spray will not relieve the symptoms of nasal allergies immediately, and it can take three to four days to have its full effect. It is therefore most effective to start using the nasal spray a few days before you expect to get symptoms, for example before the start of the pollen season, or if you know you are going to be in contact with pets that give you the allergy. For maximum benefit, the spray should be used regularly while you are still being exposed to the allergen to keep the nasal inflammation under control.
What is it used for?
- Preventing and treating symptoms of seasonal nasal allergies (seasonal allergic rhinitis) such as hay fever.
- Preventing and treating symptoms of nasal allergies that occur throughout the year (perennial allergic rhinitis), for example due to pet allergies or dust mite allergies.
This nasal spray is suitable for adults and children aged four years and over.
How do I use it?
- You should preferably start using this nasal spray a few days before you expect to come into contact with the allergen and continue using it regularly all the time you are still exposed to the thing you are allergic to. Follow the instructions given by your doctor.
- Follow the instructions provided with the nasal spray. You should shake the bottle gently before use.
- Before you use the nasal spray for the first time it needs to be primed by pumping it into the air a few times until a fine mist is produced. Hold the bottle upright and away from you while you are doing this. If the nasal spray hasn't been used for a few days you should reprime it in this way before using it again.
- Follow this link for general instructions on how to use a nasal spray.
- Adults and children aged 12 years and over should use two sprays into each nostril once a day. Once your symptoms are under control you should reduce your dose to one spray in each nostril once a day. The spray should preferably be used in the morning, though it can be used any time of day if necessary. If your symptoms are very bad your doctor may ask you to use two sprays in each nostril twice a day to begin with, and then reduce to once a day once the symptoms have improved. You should always use the lowest dose necessary to relieve your symptoms. Do not use more than your doctor has prescribed.
- Children aged 4 to 11 years should use one spray in each nostril once a day. The spray should preferably be used in the morning, though it can be used any time of day if necessary. If your child's symptoms are very bad your doctor may ask you to use one spray in each nostril twice a day to begin with, and then reduce to once a day once the symptoms have improved. Follow the instructions given by your doctor. You should always use the lowest dose necessary to relieve your child's symptoms. Do not use more than your doctor has prescribed.
- If you forget to use your nasal spray just leave out the forgotten dose. Don't use a double dose to make up for a missed dose.
- This medicine is only intended for use in the nose and must not be taken by mouth.
- Take care to avoid getting the spray in the eyes.
- When taken in high doses for long periods of time, corticosteroids have the potential to cause glaucoma, cataracts, slowed growth in children and adolescents, and to decrease the functioning of the adrenal glands (glands that produce natural steroid hormones). These side effects on other areas of the body are called systemic side effects and are extremely unlikely to occur with this nasal spray, because the amount of fluticasone absorbed into the bloodstream from the nose is very low. However, as a precaution, your doctor will prescribe the lowest effective dose needed to control your symptoms. You should not exceed this prescribed dose. If your child is using this nasal spray for long periods of time your doctor may want to monitor their height to make sure their growth is not being affected. For further information discuss this with your doctor.
Use with caution in
- People with an infection in the nasal passages or sinuses (the infection should be treated).
- People who have recently had nasal surgery or an injury to the nose (this medicine should not be used until the nose has healed).
- People with tuberculosis affecting the lungs.
Not to be used in
- Children under four years of age.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. Only minimal amounts of the medicine pass into the bloodstream after using the nasal spray. It should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the developing baby. Seek further medical advice from your doctor.
- It is unlikely that this medicine will pass into breast milk after application into the nose. However, it should be used with caution by mothers who are breastfeeding, and only if the benefits to the mother outweigh any risks to the nursing infant. Seek medical advice from your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Very common (affect more than 1 in 10 people)
Common (affect between 1 in 10 and 1 in 100 people)
- Dryness and irritation of the nose and throat.
- Unpleasant taste and smell.
Very rare (affect fewer than 1 in 10,000 people)
- Perforation of the nasal septum.
- Raised pressure in the eye or glaucoma.
- Allergic reactions such as narrowing of the airways (bronchospasm), swelling of the lips, throat and tongue (angioedema), itchy blistering rash or anaphylactic shock.
Side effects similar to those associated with corticosteroids taken by mouth may occur if this medicine is absorbed into the bloodstream. The risk of this when using a steroid nasal spray is very low, but may be more likely if the medicine is used at high doses for prolonged periods of time. See the warning section above or talk to your doctor or pharmacist for more details.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
This medicine is only absorbed into the bloodstream in very small amounts after application into the nose. As such, it is unlikely to significantly affect other medicines that you are taking. However, if you are taking any other medicines, including those bought without a prescription and herbal medicines, you should tell your doctor or pharmacist before you start treatment with this medicine. This is particularly important if you are or have recently been using any other medicines that contain corticosteroids, for example tablets, injections, eye or nose drops, creams, asthma inhalers, or other similar nasal sprays. This is because there may be an increased chance of adverse effects if you are using more than one type of steroid medication and your doctor may want to monitor you more closely.
The following medicines may slow the breakdown of any fluticasone that is absorbed into your bloodstream:
- protease inhibitors such as ritonavir for HIV infection
- telaprevir for hepatitis C
- the antifungals ketoconazole and itraconazole.
These medicines can therefore increase your exposure to fluticasone and so increase the risk of side effects on the rest of the body. These are called systemic side effects, for example, decreased production of natural steroid hormones by the adrenal glands (adrenal suppression) and Cushing's syndrome.
Due to this risk, this nasal spray is not recommended for people who are taking ritonavir.
The antifungals ketoconazole and itraconazole should be used with caution in people using this nasal spray. Long courses of treatment with these antifungals should be avoided.
Other medicines containing the same active ingredient
- Avamys nasal spray.
- Boots allergy relief nasal spray.
- Dymista nasal spray (this also contains the antihistamine azelastine).
- Flixonase nasule drops.
- Nasofan nasal spray.
- Pirinase hayfever nasal spray.