Dymista (Azelastine and Fluticasone) - Nasal

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What Is Dymista?

Dymista (azelastine and fluticasone) is a combination of two medications used to relieve nasal symptoms of seasonal allergies.

The two components of Dymista work differently. Azelastine blocks histamine receptors in the body. Histamine is a bodily chemical that is involved in the process of allergic reactions. Fluticasone, on the other hand, is in a class of medications called corticosteroids that reduces swelling (inflammation) in the nasal passages.

Dymista is available by prescription as a nasal suspension.

Drug Facts

  • Generic Name: Azelastine and fluticasone
  • Brand Name(s): Dymista
  • Administration Route(s): Inhalation
  • Drug Availability: Prescription
  • Therapeutic Classification: Nasal agent
  • Available Generically: Yes
  • Controlled Substance: N/A
  • Active Ingredient: Azelastine and fluticasone
  • Dosage Form(s): Spray

What Is Dymista Used For?

The Food and Drug Administration (FDA) approved Dymista for use in children (6 years or older) and adults to treat seasonal allergy symptoms such as sneezing, runny or stuffy nose, itching, and post-nasal drip.

How to Take Dymista

Use this medicine exactly as directed by your healthcare provider. Follow all directions on your prescription label. Ask your pharmacist for any clarification you may need.

Each spray delivers 0.137 milliliters (mL) containing 137 micrograms (mcg) of azelastine hydrochloride and 50 mcg of fluticasone propionate.

Spray Dymista in each nostril twice daily. Shake the bottle gently before each use. Prime Dymista before its first use by releasing six sprays or until a fine mist appears. Whenever Dymista has not been used for 14 days or more, reprime with one spray or until a fine mist appears.

Storage

Store Dymista upright with the dust cap at a controlled room temperature of 68 F to 77 F. Keep away from extreme hot or cold temperatures. Keep out of the reach of children and pets. When traveling, transport Dymista in your carry-on or your checked baggage with its original label.

How Long Does Dymista Take to Work?

Dymista is absorbed through the nostrils in about an hour and starts working to relieve nasal symptoms. It exits the body in a matter of days.

What Are the Side Effects of Dymista?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Using Dymista can cause side effects. Tell your healthcare provider about any side effects you experience, especially if they don’t go away or become worse.

Side Effects

Side effects of Dymista can include:

  • Headache
  • Nose bleeds
  • Upper respiratory infections
  • Diarrhea
  • Hole in nasal septum
  • Nasal discomfort, dryness, or sores
  • Fever
  • Cough, hoarseness, or sore throat 
  • Nasal congestion (stuffy nose)
  • Viral or fungal infections
  • Upper abdominal pain 
  • Ear infection
  • Nausea and vomiting
  • Increased heart rate or heart palpitations
  • Blurred vision
  • Pink eye (conjunctivitis)
  • Eye dryness, irritation, or swelling
  • Chest pain
  • Face and tongue swelling
  • Loss of smell and/or taste
  • Dizziness or drowsiness
  • Involuntary muscle contractions
  • Tingling
  • Anxiety or confusion
  • Difficulty urinating and completely emptying the bladder 
  • Bronchospasm or wheezing
  • Red, itchy skin, hives, or rash
  • Hypertension (high blood pressure)

Common Side Effects

More common side effects of Dymista can include:

  • Change in taste
  • Mild nosebleeds
  • Headache

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 immediately if you think you or someone else is having a medical emergency. 

Serious side effects can include:

Report Side Effects

Dymista may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Dymista Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For nasal dosage form (spray):

For treatment of seasonal allergic rhinitis:

  • Adults and children 6 years of age and older—1 spray in each nostril two times a day. Each spray contains 137 micrograms (mcg) of azelastine and 50 mcg of fluticasone.
  • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Modifications

Avoid Dymista in children under the age of 6. Its safety and effectiveness for seasonal allergic rhinitis have not been studied in this population. Research has also shown that nasal corticosteroids, like the fluticasone in Dymista, may slow a child’s growth.

Missed Dose

If you forget to take a dose of Dymista, do not panic. You can skip the missed dose and resume your regular schedule. Do not try to double-up to make up for the missed one.

Overdose: What Happens If I Take Too Much Dymista?

Overdosing on azelastine and fluticasone can happen when one takes too much of either component of the medication. For azelastine, overdosage may result in increased drowsiness.

Long-term fluticasone propionate overdose may result in signs or symptoms of hypercorticism (high cortisol levels).

Symptoms of high cortisol levels include: 

  • Excess sweating
  • Hairiness
  • Hunger
  • Fatigue
  • High blood pressure
  • An abnormal pad of fat between the shoulder blades
  • Muscle weakness or loss of muscle
  • Acne
  • Anxiety
  • Round swollen face
  • Weight gain

If such changes occur, contact your healthcare provider immediately.

What Happens If I Overdose on Dymista?

If you think you or someone else may have overdosed on Dymista call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Dymista, call 911 immediately.

Precautions

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It is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you or your child should continue to use it. 

If your or your child's symptoms do not improve within a few days or if they become worse, check with your doctor. 

This medicine may increase your risk of having some unwanted effects in the nose. Check with your doctor right away if you or your child have bloody mucus, sores inside the nose, unexplained nosebleeds, or a whistling sound when you breathe while you are using this medicine. 

You may get infections more easily while you are using this medicine. Avoid being around people who are sick or have infections such as chickenpox or measles or if you have never had these infections. This is especially important for children. Tell your doctor right away if you think you have been exposed to chickenpox or measles. 

This medicine may cause thrush (a type of fungus infection) in the nose or throat. Tell your doctor right away if you or your child have white patches in the throat, or pain when you eat or swallow. 

Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want your eyes checked by an eye doctor. 

This medicine may cause dizziness or drowsiness. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert. 

This medicine may increase your risk of having an adrenal gland that is less active than normal. The adrenal gland makes steroids for your body. This is more likely for people who use steroids for a long time or use high doses. Check with your doctor right away if you or your child have any of the following symptoms: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting. 

This medicine may cause children to grow more slowly than normal. This would cause a child not to gain weight or get taller. Talk with your doctor if you think your child is not growing properly or if you have any questions about this. 

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates muscle relaxants, or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are taking this medicine. 

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Dymista?

You should not use Dymista if you have an allergy to the medication or any of its ingredients.

What Other Medications Interact With Dymista?

Certain substances can interact with Dymista, including:

  • Central nervous system (CNS) depressants, such as alcohol
  • CYP3A4 inhibitors, such as ritonavir or ketoconazole
  • Desmopressin

CNS Depressants

Using Dymista with alcohol or other substances that can slow down your central nervous system may cause drowsiness.

CYP3A4 Inhibitors

Medications like ritonavir and ketoconazole inhibit an enzyme called CYP3A4 in the body. When used in combination with Dymista, CYP3A4 inhibitors can significantly increase its levels. This excess can affect levels of a hormone called cortisol in the body.

Cortisol imbalance can lead to diseases like Cushing’s syndrome and adrenal suppression. Consult with your doctor or pharmacist before taking Dymista with CYP3A4 inhibitors.

Desmopressin

Avoid combining Dymista and desmopressin, as the combination may increase the risk of low sodium and water retention.

What Medications Are Similar? 

Medications similar to Dymista include:

  • Patanase (olopatadine)
  • Qnasl (beclomethasone dipropionate)
  • Nasonex (mometasone)

Patanase (Olopatadine)

Patanase is an antihistamine nasal spray like the azelastine component of Dymista. It works by reducing the effects of the natural chemical histamine in the body.

Patanase also does not have a steroid component like Dymista. Therefore, it bypasses some of the severe adverse effects of steroids like glaucoma/cataracts, weakened immune system, or growth suppression in children.

Qnasl (Beclomethasone Dipropionate)

Qnasl is a steroid nasal spray like the fluticasone component of Dymista. It prevents the release of substances in the body that cause inflammation.

However, it’s missing the antihistamine component (azelastine) that Dymista has. Therefore, it doesn’t have some of the severe adverse effects of antihistamines like drowsiness.

Qnasl can be used in children as young as 4 years old.

Nasonex (Mometasone)

Nasonex is also a steroid nasal spray like the fluticasone component of Dymista. It doesn’t have the antihistamine component (azelastine) that Dymista has, so it bypasses some of the severe adverse effects of antihistamines. Children as young as two years old can use this medication.

This is a list of drugs also prescribed to reduce the risk of strokes and heart attacks. It is NOT a list of drugs recommended to take with Dymista. In fact, you should not take these drugs together.

Ask your pharmacist or a healthcare provider before using other medicines for stroke or heart attack prevention. They may contain ingredients similar to azelastine and fluticasone.

Frequently Asked Questions

  • What is Dymista used for?

    Dymista is used to treat the nasal symptoms of allergies in adults and children aged 6 years and older. These symptoms may include sneezing, runny nose, congestion, and itching.

  • What are the side effects of Dymista?

    Since Dymista is used nasally, it can cause local adverse reactions, including nose bleeds, nasal dryness or congestion, nasal sores, holes in the septum, or loss of smell or taste.

    It can also affect other areas of the upper respiratory system to cause cough, sore throat, face and tongue swelling, and ear infections. Other adverse effects include diarrhea, headache, dizziness, or rash.

  • How long does Dymista last in the body?

    Dymista leaves the body within a few days through the urine and feces.

How Can I Stay Healthy While Taking Dymista?

Allergies can be downright annoying. Its nasal symptoms can be frustrating to deal with and make breathing difficult. Dymista is a medication that takes on the challenge of relieving those nasal symptoms of allergies. 

Dymista is sprayed in each nostril twice daily. Shake the bottle gently before each use. If you keep forgetting to take it, consider setting alarms on your phone or calendar. 

Contact your healthcare provider if you have any questions about the medication.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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  1. Food and Drug Administration. Dymista [package insert]. Updated April 2021.