Flonase: 7 things you should know - Drugs.com (2024)

Medically reviewed by Carmen Pope, BPharm. Last updated on Oct 9, 2023.

1. How it works

• Flonase is a brand (trade) name for fluticasone nasal spray.
• Flonase (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.
• Fluticasone belongs to the group of medicines known as corticosteroids. Specifically, it is a glucocorticoid type of corticosteroid.

2. Upsides

• Flonase relieves nasal symptoms such as a runny, stuffy nose, sneezing, and nasal itching in adults and children aged four years and older.
• Indicated for the relief of perennial nonallergic rhinitis (nasal congestion and stuffiness that occurs all year round) in adults and children aged 4 years and older
• Fluticasone - the active ingredient in Flonase - 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).
• Flonase is available as a generic under the name fluticasone propionate nasal spray.

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.
• Also occasionally more serious nasal effects may occur and the use of Flonase may delay wound healing. Do not use Flonase if you have recently had nasal surgery or nasal trauma.
• Glaucoma and cataracts have been associated with nasal corticosteroid use. Use exactly as directed and avoid spraying Flonase 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 Flonase nasal spray may reduce growth velocity in children.
• 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, and certain other conditions.
• Flonase may interact with some medicines that have a strong effect on hepatic enzymes, specifically CYP3A4, such as antivirals used for HIV (such as ritonavir, atazanavir), clarithromycin, itraconazole, ketoconazole, and nefazodone.
• There are no adequate and well-controlled studies of Flonase in pregnant women. Animal studies have indicated teratogenic effects of corticosteroids at low dosages which means Flonase should only be used during pregnancy if the benefits outweigh the risks; however, rodents are more prone to teratogenic effects than humans. Natural corticosteroid production increases during pregnancy and many women may not need additional corticosteroids during pregnancy. Hypoadrenalism has occurred in infants born to mothers receiving corticosteroids during pregnancy. It is not known if fluticasone propionate is excreted into breast milk; however, other corticosteroids have been detected in breast milk.

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

• Flonase reduces inflammation and nasal symptoms associated with rhinitis; however, Flonase may cause nose bleeds and it takes about three days for the full effects to be seen.

5. Tips

• Dosage may be given either once or twice daily. Shake Flonase gently before use.
• If you are using Flonase for the first time, or if it has been more than a week since you have taken a dose, you will need to prime it. This can be done by giving the nasal spray a good shake and releasing 6 sprays into the air away from the face.
• In adults, the dosage for Flonase is usually 2 sprays in each nostril once daily, or 1 spray in each nostril twice daily. The dosage may be reduced to 1 spray in each nostril once daily after a few days. The maximum total daily dose of Flonase is 2 sprays in each nostril daily.
• If no response is seen after several days of use, contact your doctor. Do not exceed the recommended dosage.
• The effectiveness of Flonase is dependent on regular use.
• Flonase may take several days to reach its full effect when used for allergic rhinitis symptoms. Consider using a decongestant nasal spray initially (maximum three days use) or taking an antihistamine until Flonase exerts its effect.
• Do not spray Flonase 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 Flonase.
• Talk to your doctor before using Flonase during pregnancy or while breastfeeding.

6. Response and effectiveness

• Although the active ingredient in Flonase, fluticasone, is rapidly absorbed through the nasal tissues, it does not have an immediate effect on rhinitis symptoms. It may take several days of Flonase use to see a significant reduction in symptoms.

7. Interactions

Medicines that interact with Flonase nasal spray may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Flonase 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 Flonase nasal spray include:

• clarithromycin
• CYP3A4 inhibitors, such as clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole, ritonavir, verapamil, goldenseal, or grapefruit
• desmopressin
• esketamine
• herbals such as echinacea
• 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 Flonase nasal spray. You should refer to the prescribing information for Flonase nasal spray for a complete list of interactions.

References

• Flonase (fluticasone nasal spray) [Package Insert]. Revised 03/2023. RemedyRepack Inc. https://www.drugs.com/pro/flonase.html

Further information

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

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

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