Avamys

Avamys contains fluticasone furoate, a potent intranasal corticosteroid used to treat the symptoms of allergic rhinitis — both seasonal (hay fever) and perennial.

It reduces sneezing, nasal itching, congestion, and rhinorrhoea, and can also improve associated eye symptoms such as watering and itchiness.

Fluticasone furoate has high glucocorticoid receptor affinity and is retained in nasal tissue for a prolonged period, allowing once-daily dosing with sustained 24-hour symptom control.

Its systemic bioavailability is very low (less than 0.5% after intranasal dosing), meaning that the risk of steroid side effects beyond the nose is negligible.

Advantages of Avamys

Current evidence places intranasal corticosteroids as the most effective single treatment class for moderate-to-severe allergic rhinitis.

Avamys is distinguished by its once-daily administration, side-actuated spray mechanism that allows easier self-administration, and favourable tolerability profile.

It can be used alone or alongside oral antihistamines when symptoms are not fully controlled by either treatment on its own.

Preparing the Spray

Shake the bottle gently and remove the cap. If using for the first time or after prolonged non-use, prime the spray by pressing the button firmly until a fine mist appears (usually six presses).

Administration

Blow your nose gently. Tilt your head slightly forward. Insert the nozzle into one nostril, aiming slightly away from the nasal septum. Press the button while breathing in gently through the nose.

Repeat for the other nostril.

Regularity

Use Avamys at the same time each day for best results. Symptom relief may not be immediate — the full benefit builds over several days of regular use.

Adults and Adolescents (12 years and over)

• Starting dose: 2 sprays in each nostril once daily (total 110 micrograms)
• Once symptoms are controlled, reduce to 1 spray in each nostril once daily (55 micrograms)

Children (6-11 years)

• 1 spray in each nostril once daily (55 micrograms)
• May increase to 2 sprays per nostril if needed; revert to 1 spray once controlled

Children Under 6

• Not recommended

No dose adjustment is required for elderly patients or those with renal or hepatic impairment.

Common (up to 1 in 10 patients)

• Nosebleeds (epistaxis) — the most frequently reported effect
• Nasal ulceration

Uncommon (up to 1 in 100 patients)

• Nasal dryness
• Headache
• Unpleasant taste or smell

Rare (up to 1 in 1,000 patients)

• Nasal septal perforation (with long-term use)
• Hypersensitivity reactions including urticaria, rash, and angioedema

Very Rare (fewer than 1 in 10,000 patients)

• Anaphylaxis
• Growth retardation in children (minimal at standard doses)

Nosebleeds are more common in the first few weeks and often resolve with continued use. If frequent or heavy nosebleeds occur, stop the spray and seek advice.

Nosebleeds

Nosebleeds are the most common adverse effect. Aim the spray away from the nasal septum (the central wall between the nostrils) to minimise mucosal trauma.

If persistent bleeding occurs, discontinue and consult your doctor.

Long-Term Use

Prolonged use of any intranasal steroid can rarely cause nasal septal perforation. If you notice persistent crusting, whistling sounds when breathing, or worsening nasal pain, seek medical review.

Immunosuppression

Avoid close contact with people who have chickenpox or measles if you have not had these infections, as corticosteroids may increase susceptibility and severity.

Transfer from Oral Steroids

Patients previously on systemic corticosteroids may experience adrenal insufficiency when switching to intranasal therapy alone. Taper oral steroids under medical supervision.

Do not use Avamys if you have a known hypersensitivity to fluticasone furoate or any of the spray's excipients.

Avamys should not be used in children under 6 years of age.

Exercise caution in patients with nasal surgery, nasal trauma, or nasal ulceration until healing is complete.

Concurrent use with ritonavir or other strong CYP3A4 inhibitors may increase systemic fluticasone exposure — discuss with your prescriber.