II. Indications
- High potency Intranasal Steroid for Allergic Rhinitis (age >=4 years)
III. Dosing
- Approved for age >=4 years
- As of 2015, over-ther-counter without a prescription
- Adult (and age >=12 years): 2 sprays per nostril daily
- Child (ages 4 to 11 years): 1 spray per nostril daily
IV. Medications
- Fluticasone Propionate Nasal Inhaler (Flonase)
- Combination Agents
- Fluticasone with Azelastine (Dymista)
- Expensive (up to $200/month) and add little to benefit of generic nasal Corticosteroids alone
- Alternatively, use OTC Azelastine (Astepro) and a generic generic nasal Corticosteroid
- (2022) Presc Lett 29(5): 25-6
- Fluticasone with Azelastine (Dymista)
- Xhance (fluticasone nose and mouth device, for Nasal Polyps)
- Patient blows into mouth piece while activating device 93 mcg bid
- Theoretically penetrates more deeply into nose (hence reaching Nasal Polyps)
- Unproven benefit and expensive ($425/month in 2018)
- Similar effect likely with Nasal Saline pre-treatment and 2 standard fluticasone sprays bid
- (2018) Presc Lett 25(7): 41
V. Safety
- Pregnancy Category C
- Unknown safety in Lactation
VI. Adverse Effects
VII. Drug Interactions
- CYP3A4 Inhibitors (Ritonavir, Cobicistat, Ketoconazole, Erythromycin)
VIII. Resources
- Fluticasone Propionate (DailyMed)
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Related Studies
| xhance (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| XHANCE 93 MCG EXHALATION DELIVERY NASAL SPRAY | $34.06 per ml | |