Fluticasone Nasal Spray: Allergy Drug Information Guide

Published August 29th, 2021 by Chris Riley
Fact Checked by
Camille Freking
Medically Reviewed:
Dr. Angel Rivera

What is Fluticasone? | Treatment Use | How Does it Work? | How to Use | Warnings | Side Effects | Drug Interactions

 Whether you experience allergy symptoms at certain times of the year or year-round, you know how challenging it can be to keep your symptoms in check without dealing with side effects like drowsiness. 

Fluticasone is a medicated nasal spray that is commonly used to treat allergy symptoms and is less likely to cause side effects like drowsiness.

What Is Fluticasone?

Fluticasone is a popular generic medication that is sold over the counter in the form of a nasal spray. The medication is often marketed under the brand name Flonase but is available for sale under many store brands as well. 

First approved by the U.S. Food and Drug Administration (FDA) in 1994 for the treatment of allergy symptoms, the medication was available for purchase by prescription only until the original patent expired in 2014. Since 2014, it has been popular to purchase fluticasone over the counter without a prescription.

Fluticasone belongs to a class of drugs called corticosteroids; specifically, the medication is classified as a glucocorticoid steroid. Unlike popular allergy medications such as Benadryl and Claritin, which are antihistamines, glucocorticoid steroids work differently to treat allergy symptoms. 

Although they take longer to start working, steroid nasal sprays like fluticasone have been found to be effective at treating allergy symptoms for an extended period of time and are considered safe for daily use on a long-term basis. Fluticasone’s treatment mechanism has been shown in numerous studies to provide more effective allergy symptom relief than oral antihistamines. 

What Is Fluticasone Used To Treat?

The condition mostly commonly treated with fluticasone is allergic rhinitis. The term allergic rhinitis is used to refer to a group of allergy symptoms that are sometimes referred to as hay fever. These symptoms commonly occur in the presence of environmental allergens, which include substances that are found both indoors and outdoors.

Allergens are substances that are generally harmless but can cause an allergic response in some individuals. The immune system of a person with allergies will recognize certain substances that are otherwise harmless, such as pollen, as a foreign invader, setting off a chain of events that culminates in an allergic reaction. 

Allergens are commonly found both indoors and outdoors, and each person’s allergens are different. Whether exposed to indoor allergens like mold, smoke, pet hair, pet dander, dust mites, and perfumes, or outdoor allergens like pollen that is produced by grasses, trees, weeds, and flowers, people with allergies to these substances will start to experience allergy symptoms. 

Outdoor allergens are more commonly associated with seasonal allergy symptoms while indoor allergens are more likely to cause perennial allergy symptoms.

When a person with allergies is exposed to their specific allergen, their body starts to defend itself by preparing an immune system response. The body releases inflammatory mediators, a type of chemical that sends signals to product inflammation, into the bloodstream. 

One of the most well-known inflammatory mediators is histamine, which binds to receptors on cells in the nasal passages and throughout the body. Histamine then directs these cells to start producing the symptoms commonly associated with an allergic reaction, such as runny nose, itchy/watery eyes, nasal congestion, sinus pressure, and itchy nose or throat. 

While most people commonly think of allergy symptoms as occurring on a seasonal basis in the spring or fall, it is possible for people to experience allergies either seasonally or year-round. 

Seasonal allergy symptoms are generally associated with pollen from flowering trees and plants, while perennial allergy symptoms are commonly attributed to allergens like pet dander, cockroaches, and dust mites. People may experience both seasonal allergy symptoms and perennial symptoms depending on the number of substances they are allergic to.

How Does Fluticasone Work?

Glucocorticoid steroids like fluticasone approach the treatment of allergy symptoms in a different manner than traditional allergy medications like antihistamines. 

Antihistamines, which were once the most popular treatment for allergy symptoms by a large margin, work to block the action of a chemical called histamine in the body. Histamine is released when the immune system detects the presence of an allergen, and histamine binds to cells to begin causing allergy symptoms. 

While antihistamines block the action of histamine,  glucocorticosteroids work by blocking allergic responses from six different types of cells in the nasal passages. Histamine is allowed to attach to the cell receptors, but the symptoms caused by the cells are prevented. 

As a result, glucocorticosteroids are very effective at reducing symptoms of inflammation in the nasal passages, and symptoms such as runny nose, sneezing, excess mucus production, and other upper respiratory symptoms are minimized. 

Today, glucocorticosteroids are considered one of the most effective treatment mechanisms for allergic rhinitis.

How Do I Use Fluticasone?

Fluticasone can be purchased in its generic form under many different store brands or under the brand name of Flonase. Regardless of the brand you purchase, the formulas will contain the same amount, 50 mcg, of the active ingredient in each dose. The nasal spray is available in formulas for both adults and children depending on the age of the patient. 

In order to use a medicated nasal spray like fluticasone, insert the end of the nasal spray into one nostril while gently pressing the other nostril closed with one finger. Next, press down on the nasal spray trigger one or two times, depending on your dosing instructions, while inhaling deeply after each spray. Then switch to the other nostril and deploy the same number of sprays as indicated on the instructions, inhaling deeply after each spray.

Fluticasone is recommended for a maximum use period of six months in adults. Children should not use fluticasone for more than two months unless directed by a doctor. The medication is approved for use in adults and children ages four and older. 

What Are the Fluticasone Nasal Spray Warnings?

As an over-the-counter medication, fluticasone is considered safe for use by most people. However, people with some medical conditions may not be able to use corticosteroid nasal sprays like fluticasone safely. 

If you are experiencing allergy symptoms and are considering using a steroid nasal spray like fluticasone, it’s important to talk to your doctor about medical conditions you may have that could prevent you from using the drug safely. 

People with the following are considered to be at increased risk when using fluticasone: 

  • Nose sores, injury, or surgery
  • Liver problems
  • Any untreated viral, bacterial, or fungal infection
  • Eye infections caused by herpes
  • Weakened immune system
  • Eye infections
  • Tuberculosis
  • Recent exposure to chickenpox or measles
  • Eye problems such as cataracts or glaucoma

What Are the Fluticasone Side Effects?

Fluticasone was approved for purchase over the counter by the FDA in 2014 due in part to its relatively low incidence of side effects and strong safety record. Most patients who use fluticasone for the treatment of allergic rhinitis will not experience any side effects while taking the medication. 

When side effects are experienced, they are generally mild in nature and do not require medical attention. The  most common side effects of fluticasone nasal spray include:

  • Cough
  • Bloody nose
  • Burning, irritation, or inflammation in the nose
  • Asthma symptoms
  • Sore throat
  • Headache

In rare instances, fluticasone can cause serious side effects that require medical attention. It is possible to experience an allergic reaction to fluticasone. Serious side effects of fluticasone that may require medical attention include:

  • Nose bleeds and sores in the nose
  • Slowed growth rate in children and adolescents
  • Puncture of the nasal septum
  • Decreased wound healing
  • Severe allergic reaction
  • Cataracts
  • Worsening of infections even with eye drops 
  • Glaucoma

What Drugs Does Fluticasone Interact With?

Fluticasone reports relatively few drug interactions, which helps to make the medication safe for purchase over the counter. Nonetheless, patients should give their doctors a complete list of all prescription drugs, over the counter medications, dietary supplements, and herbs that they are taking in order to screen for potential interactions.  

If you have questions about how the medications or supplements you take may interact with fluticasone, speak to a doctor or pharmacist to obtain information about the safe use of the medication. 

Fluticasone is known to interact with the following medications:

  • Nelfinavir
  • Atazanavir
  • Indinavir
  • Saquinavir
  • Ritonavir
  • Lopinavir

Summary

Fluticasone nasal spray is an effective long-term treatment for allergies that can be purchased over the counter. The medication belongs to a class of drugs called glucocorticoid steroids and works by blocking allergic responses from six different types of cells in the nasal passages. 

Because of its working mechanism, fluticasone and other drugs in its class work more slowly to treat allergy symptoms but can prevent allergy symptoms when used on a regular basis. The medication is most commonly associated with side effects like cough, bloody nose, and headache.

Sources:

Allergy Facts | Asthma and Allergy Foundation of America 

Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials | U.S. National Library of Medicine 

Allergic rhinitis | U.S. National Library of Medicine 

FLONASE (fluticasone propionate) nasal spray | U.S. Food and Drug Administration 

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