Fluticasone Side Effects: Flonase Nasal Spray Warnings

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

What Conditions Does it Treat? | How Does it Work? | How to Use? | Warnings | Side Effects | Interactions

An estimated 50 million Americans experience allergy symptoms each year. Many are interested in reducing their allergy symptoms with the help of an over-the-counter medication. 

Fluticasone, the generic form of the popular nasal spray, Flonase, is one of the most popular choices for the treatment of allergy symptoms. However, people with certain medical conditions may be at increased risk of experiencing fluticasone side effects.

What Is Fluticasone?

Fluticasone is a popular generic medication that is sold over the counter in the form of a nasal spray. 

Best known under the brand name Flonase, the medication was first approved for the treatment of allergies by the U.S. Food and Drug Administration (FDA) in 1994 and was initially available by prescription only. Following the expiration of the original patent in 2014, the medication was approved for purchase over the counter.  

Unlike other popular allergy medications like Benadryl, Zyrtec, and Claritin, which belong to a class of drugs called antihistamines, fluticasone belongs to a class of drugs called corticosteroids. 

Fluticasone is an inhaled corticosteroid, and it works differently to relieve allergy symptoms than antihistamines. While antihistamines target the action of one specific chemical in the body (histamines) that causes allergy symptoms, fluticasone has been shown to have effects on several inflammatory chemicals in the body, including histamines, to offer relief for allergy symptoms. This enhanced ability to target chemicals in the body that contribute to allergy symptoms has been demonstrated in numerous studies that indicate that nasal corticosteroids provide more effective nasal symptom relief than oral antihistamines. 

What Conditions Is Fluticasone Used To Treat?

Fluticasone is a generic medicated nasal spray that is most commonly used for the treatment of symptoms of allergic rhinitis, commonly referred to as hay fever. Allergic rhinitis is a term used to refer to a group of symptoms that begins when a person with allergies is exposed to an environmental allergen.

Allergens are substances that are harmless to most people but elicit a defensive response from the immune system of a person with an allergy to the substance. Allergens can be found both indoors and outdoors. 

Allergens known to contribute to the onset of allergic rhinitis symptoms include indoor allergens like mold, pet dander, and dust mites which commonly contribute to year-round (perennial) allergies. Outdoor allergens known to cause symptoms associated with allergic rhinitis include pollen that is produced by grasses, trees, weeds, and flowers, which are more likely to cause seasonal allergies.  

When an individual with allergic rhinitis is exposed to an allergen, their immune system starts to mount a defensive response. After detecting the presence of the allergen, the body of a person with allergies starts to release chemicals called inflammatory mediators into the bloodstream. These chemicals, which include histamines, bind to receptors on other cells in the body, particularly in the nasal passages, and start to cause the symptoms commonly associated with hay fever, such as runny nose, itchy or watery eyes, nasal congestion, sinus pressure, and itchy nose or throat. 

It is possible for an individual to experience only seasonal allergy symptoms, which most commonly occur in the spring or fall; only perennial allergy symptoms, which occur year round; or both. Many people are allergic to several different allergens, such as certain types of pollen, pet dander, and mold spores, which can cause symptoms to occur year round while peaking during various seasons.

How Does Fluticasone Work?

Corticosteroids like fluticasone work differently from traditional antihistamines, which are one of the most popular treatment options for allergies, to treat allergy symptoms. 

While antihistamines work to block the action of a chemical in the body called histamine, corticosteroids can act directly to help reduce inflammation in the nasal passages, which helps reduce symptoms such as runny nose, sneezing, excess mucus production and other upper respiratory symptoms. Inhaled corticosteroids are considered one of the most effective first-line treatments for allergic rhinitis.

How Do I Use Fluticasone?

Fluticasone is an over-the-counter nasal spray that is sometimes sold under the brand name Flonase. Regardless of whether you purchase the generic or brand-name version of the drug, the nasal spray you purchase will contain 50 mcg of the active ingredient, fluticasone propionate, per dose. 

To use fluticasone, the patient inserts the end of the nasal spray into one nostril while gently pressing the other nostril closed. They then deploy the nasal spray one or two times, depending on the dosing instructions, while inhaling 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 approved for use in adults and children ages four and older. Adults can use fluticasone for up to six months, while the maximum recommended duration for children is two months. Consult a healthcare provider if symptom relief is needed past the recommended duration of treatment.

What Are the Flonase Nasal Spray Warnings?

Fluticasone, a generic drug often sold under the brand name Flonase, is associated with some warnings. While Flonase is generally considered safe for use by most people, corticosteroid nasal sprays like Flonase do carry certain risks of use, particularly for people with certain medical conditions and other health issues. 

If you are considering using a medicated nasal spray like Flonase, make sure to check with your doctor about Flonase nasal spray warnings. 

People with the following medical conditions are considered to be at increased risk when using Flonase, so make sure you give your doctor a complete medical history: 

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

What Are the Side Effects of Fluticasone?

Previously available by prescription only, fluticasone’s low incidence of side effects and strong safety record helped spur its approval by the FDA in 2014 for over-the-counter sales. 

Most people who use fluticasone nasal spray do not experience any side effects. Those who do experience side effects are likely to experience mild side effects that do not need medical attention. 

Among the most common side effects of fluticasone nasal spray are:

  • Burning or irritation in the nose
  • Cough
  • Nosebleeds
  • Asthma symptoms
  • Headache
  • Sore throat

Although it is uncommon, fluticasone is known to cause serious side effects in some people that require medical attention, and the medication can cause an allergic reaction in some individuals. 

Serious side effects of fluticasone that may require medical attention include:

  • Puncture of the nasal septum
  • Sores in the nose
  • Slowed growth rate in children and adolescents
  • Slowed wound healing
  • Severe allergic reaction
  • Glaucoma
  • Cataracts
  • Increased risk of infections
  • Lowered steroid hormone levels 

What Drugs Does Fluticasone Interact With?

Fluticasone is approved for over-the-counter use in part because it is administered topically and does not get absorbed extensively in the bloodstream. Therefore, the risk of drug interactions is low. 

However, it’s still important to compare the list of prescription drugs, over-the-counter medications, dietary supplements, and herbs that a patient is taking to the known list of drug interactions for fluticasone. 

Patients who have questions about drug interactions between their medications should speak to a doctor or pharmacist, who will be able to provide information about whether it is safe to use the medications together and if any changes to the effectiveness of the drugs are anticipated. 

Fluticasone is known to interact with the following medications:

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

Summary

Fluticasone, a generic medication commonly sold under the brand name Flonase, is sold over the counter and is generally considered safe for most people. 

However, people with certain medical conditions, including nose sores, injury, or surgery; eye infections caused by herpes; weakened immune system; liver problems; untreated viral, bacterial, or fungal infection; recent exposure to chickenpox or measles; tuberculosis; and eye problems, such as cataracts or glaucoma are considered to be at increased risk of experiencing serious side effects when using the medication. 

Rare, but serious side effects associated with fluticasone use include puncture of the nasal septum, sores in the nose, slowed growth rate in children and adolescents, decreased wound healing, severe allergic reaction, glaucoma, cataracts, and an increased risk of infections.

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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