Dymista Uses and Side Effects

Azelastine HCL and Fluticasone Propionate

Dymista (azelastine and fluticasone) is a combination nasal spray medication containing azelastine hydrochloride (0.1%) and fluticasone propionate (0.037%). It comes in a dose of 50 micrograms (mcg) per spray and is used to treat symptoms related to seasonal allergies.

Man using nasal spray
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Because Dymista is a combination nasal spray, symptoms related to seasonal allergies are approached by interacting with two different pathways within the body.

The first component in Dymista, azelastine, is an H1 antagonist. This type of medication blocks the effects of histamine throughout the body and helps to reduce the further release of histamine. Histamine and other mediators within the body assist in the allergic response, particularly inflammation.

By blocking histamine and stabilizing mast cells, Dymista may be able to relieve nasal passages of the “stuffy,” congested feeling related to inflammation as well as relieve itching and sneezing.

Azelastine also helps improve the movement of the cilia (the tiny hairs that line the respiratory tract) in your airways, which helps to improve the transportation of mucus.

The second way that Dymista helps relieve symptoms related to seasonal allergies is due to the second component of the combination nasal spray, fluticasone. Fluticasone is a corticosteroid, which is a synthetic version of cortisol, the naturally occurring adrenal hormone.

Corticosteroids help to constrict blood vessels and decrease inflammation in the nasal cavity when used in spray form. Both actions help to relieve congestion associated with seasonal allergies. Note that a condition called rebound congestion, which can occur with some nasal decongestant sprays, is not a factor when using Dymista.

How to Use Dymista

Dymista is only for use as a nasal spray. The first time you use it, you will need to prime the spray’s pump by pressing six times until you see a fine spray. You will probably need to repeat this process if you haven’t used your Dymista nasal spray for 2 weeks.

Here are a few tips for using Dymista.

  • Gently shake the Dymista nasal spray bottle.
  • For best results, it is important to blow your nose before use in order to clear your nasal passages.
  • Tilt your head down while spraying into your nose.
  • Be sure to keep the tip of the nasal spray 1/4 to 1/2 inches into your nose while spraying.
  • Avoid spraying the side of your nasal passage between both your nostrils.
  • The bottle must be upright when spraying.
  • Close your other nostril and sniff immediately after you have pressed the pump.
  • Spray the other nostril in the same fashion.
  • After use, you will want to wipe the top of the applicator off and replace the cap.
  • Avoid contact with your eyes. If eye contact occurs, flush eyes for 10 minutes or longer. Seek medical attention if necessary.

Dymista Side Effects

The most common side effects related to use of Dymista include:

Dymista may cause drowsiness, so you should use caution when operating any machinery or driving until you know how your body reacts to the medication. You should also avoid other depressants, such as alcohol, when using Dymista since they can worsen levels of sedation or drowsiness.

Because Dymista contains fluticasone, which is a corticosteroid, chronic use can lead to suppression of your adrenal system. Follow the instructions of your healthcare provider if you want to stop this medication. Suppression is most likely to occur when using this medication in combination with prednisone at a dose of 20 milligrams or more. The fluticasone component of Dymista can also cause a delay in healing wounds in your nasal passage, possibly increasing or prolonging the duration of infections.

If you have a history of increased intraocular pressure, open-angle glaucoma, or cataracts, you should see an ophthalmologist and discuss this with your healthcare provider prior to use. If you develop any vision changes during use of Dymista, you should stop using the nasal spray until you can discuss further with your healthcare provider and ophthalmologist.

Can Dymista Interfere With Other Medications?

The majority of interactions with Dymista are related to medications that depress your central nervous system or brain function. These include antihistamines, antidepressants, sleep aid medications, and other medications that can cause drowsiness as a side effect. Check with your healthcare provider when starting new medications.

Before Taking Dymista

Before you start Dymista, you should see your healthcare provider to review your medical history as well as review your current medications. In particular, your healthcare provider will want to know if you have any sores in your nose, since delayed healing may occur with the use of Dymista. If you are planning on pregnancy. your practitioner will evaluate whether or not Dymista use should be avoided, since its risks during pregnancy are unknown.

Only use Dymista under healthcare provider approval and supervision if you are unvaccinated or if you have not had chickenpox or measles, because Dymista can increase the severity of these illnesses.

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  1. FDA.gov. DYMISTA (azelastine hydrochloride and fluticasone propionate). Highlights of prescribing information. Revised February 2015.

Additional Reading
  • UpToDate.com. Azelastine and Fluticasone: Drug information.