Nasal corticosteroid sprays help to shrink nasal tissue swelling over time. However nasal corticosteroids do not reach the inside of the sinus cavities. These sprays also keep drainage pathways open. They can relieve sinus inflammation caused by allergies, decrease nonallergic inflammation and shrink nasal polyps. Nasal corticosteroids have also been shown to decrease the severity and duration of acute sinusitis.
Nasal corticosteroids are most effective if they are used on a daily basis. Unlike decongestant nasal sprays, nasal corticosteroids are not addictive and do not cause a rebound effect. They can be applied to the nose through sprays, aerosols by nasal nebulizers, or by nasal drops.
Brand Name Ingredient Beconase AQ® beclomethasone Flonase® fluticasone Nasarel® flunisolide Nasonex® mometasone
There is some concern about the use of nasal corticosteroids in children. Physicians and parents are concerned about growth suppression. This concern is mostly focused on the long term regular use of nasal corticosteroids, frequent repeated short term use of oral corticosteroids, or persistent use of high dose inhaled corticosteroids for asthma. Fortunately very little corticosteroid is absorbed into the bloodstream from the majority of nasal corticosteroid sprays. Corticosteroid effects can be further minimized by using brands that permit only low absorption into the bloodstream and/or have been shown through studies not to affect growth. Children using any form of corticosteroids should have their height tracked using a stadiometer. Long term height assessments can then be used to assess whether growth suppression is an issue before it becomes a significant problem.
In a pharmacokinetic study comparing flunisolide nasal solution (flunisolide nasal spray .025%) (29 mcg per spray) with flunisolide nasal solution (flunisolide nasal spray .025%) (25 mcg per spray), the original formulation, the two formulations were not bioequivalent. The total absorption of flunisolide nasal solution (29 mcg per spray) was 25% less than that of flunisolide nasal solution (25 mcg per spray), and the peak plasma concentration was 30% lower. The clinical significance of these differences is likely to be small, particularly since clinical efficacy is attributable to a local effect on nasal mucosa (see Pharmacodynamics ).
Information for Patients: Patients should use NASAREL at regular intervals since its effectiveness depends on its regular use. Patients should take the medication as directed and should not exceed the prescribed dose. A decrease in symptoms can be expected to occur within a few days of initiating therapy in allergic rhinitis patients. Patients should contact their physician if the condition worsens, if sneezing or nasal irritation occurs, or if symptoms do not improve by 3 weeks.
Persons taking immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles . Patients should also be advised that if they are exposed, medical advice should be sought without delay.
For proper use of this unit and to attain maximum improvement, the patient should read and follow the accompanying Patient Instructions carefully.