Flixonase

Flixonase is a nasal spray containing fluticasone propionate, an intranasal corticosteroid used for the treatment and prevention of allergic rhinitis (hay fever) and perennial rhinitis.

It is one of the most widely used nasal corticosteroids, effective against nasal congestion, sneezing, rhinorrhoea (runny nose), and itching.

Fluticasone propionate acts locally on the nasal mucosa, reducing inflammation mediated by mast cells, eosinophils, and other immune cells.

It inhibits the release of histamine, prostaglandins, leukotrienes, and cytokines, providing comprehensive suppression of the allergic inflammatory cascade.

The result is effective relief of both nasal and, to some extent, ocular symptoms of allergic rhinitis.

Flixonase has very low systemic bioavailability (less than 2%) due to extensive first-pass metabolism, making systemic side effects rare at recommended doses.

It is available over the counter in many countries for seasonal allergic rhinitis and on prescription for other indications.

Shake the bottle gently before each use. Clear the nose by blowing gently. Insert the nozzle into one nostril, angling it slightly towards the outer wall of the nose (away from the septum).

Spray once while breathing in gently. Repeat in the other nostril. Use once or twice daily as directed.

Regular daily use is essential for optimal effect — it takes several days to reach full benefit. Do not use more than the recommended dose.

Adults and children over 12 years: 2 sprays into each nostril once daily, preferably in the morning. May reduce to 1 spray per nostril once daily for maintenance once symptoms are controlled.

Maximum: 2 sprays per nostril twice daily (400 micrograms daily) for short periods under medical supervision. Children 4-11 years: 1 spray per nostril once daily.

Common (1 in 10 to 1 in 100): epistaxis (nosebleed), nasal dryness and irritation, and unpleasant taste or smell.

Uncommon (1 in 100 to 1 in 1,000): headache, nasal septum perforation (rare, usually with prolonged high-dose use or incorrect technique), and pharyngitis.

Rare (less than 1 in 1,000): hypersensitivity reactions including bronchospasm, rash, and angioedema.

Systemic corticosteroid effects (growth retardation, adrenal suppression, cataracts, glaucoma) are extremely unlikely at recommended nasal doses but theoretically possible with prolonged high-dose use.

Direct the spray away from the nasal septum to reduce the risk of nosebleeds and septal irritation. If persistent nosebleeds occur, stop treatment and consult your doctor.

Transfer from systemic corticosteroids to nasal steroids requires monitoring for adrenal insufficiency.

Concurrent use of other corticosteroids (inhaled, oral, or topical) contributes to total steroid exposure. Avoid in patients with untreated nasal infections.

Known allergy to fluticasone propionate or any excipient. Recent nasal surgery or trauma (until healing is complete). Untreated nasal infections, including herpes simplex of the nose.

Active pulmonary tuberculosis.