Flonase Nasal Spray for Over-the-Counter Allergies Treatment

Medication May Also Improve Snoring, Sleep Apnea

Flonase is a prescription nasal spray, sold under the generic name of fluticasone propionate nasal, that is used most often for the treatment of allergies. It is a topical steroid spray that is available over-the-counter and can help to improve nasal congestion and may be useful to reduce snoring and as an adjunctive treatment for obstructive sleep apnea.

Nasal spray
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Flonase is a prescription medication that can be used to treat conditions such as allergic and non-allergic rhinitis. These often lead to nasal congestion, a runny nose, and difficulty breathing through the nose. These difficulties breathing during sleep may result in snoring, upper airway resistance syndrome, or even obstructive sleep apnea. In addition, Flonase can be used to decrease the size of nasal polyps or enlarged turbinates.

How It Works

Flonase is a corticosteroid nasal spray. It is applied as a squirt into the nostril and the solution helps to decrease inflammation in the tissues of the nose. It is unknown how precisely it works. In general, it acts to reduce chemicals in the body called cytokines. Cytokines are important to the immune system and they may be present and cause inflammation as a result of allergen exposure.

Who Should Not Use It

Flonase should not be used if you have an open sore, wound, or ulcer within your nose. It may affect the ability of this would to naturally heal. The safety of the medication in pregnancy and lactation is unknown. If you are pregnant or nursing, you should discuss the safety and risks versus benefits with your physician.

There are certain conditions where Flonase should be used with caution or not at all. If you have had recent treatment with other corticosteroid medications, you may not want to use it. In addition, certain eye conditions such as increased intraocular pressure, glaucoma, or cataracts may be a contraindication. If you have an untreated infection, especially with tuberculosis, Flonase should be used with caution. In addition, children should be followed carefully if long-term use occurs.

Flonase has the potential to interact with other medications, so you should review all drugs that you are taking with your doctor if you are using or plan to use Flonase.

Side Effects

As with any drug, there is the potential for harmful side effects with the use of Flonase. Although you would not be expected to experience most side effects—and would likely not experience any of them—some of the more common that can occur with the use of Flonase include:

  • Headache
  • Upper respiratory symptoms (like the common cold)
  • Nosebleeds (epistaxis)
  • Nasal burning or irritation
  • Nausea or vomiting
  • Cough
  • Diarrhea
  • Stomach pain
  • Bronchitis
  • Dizziness
  • Infection with candida (yeast) in the nose or mouth
  • Nasal septal perforation (a hole in the cartilage separating each side of the nose)
  • Nasal ulcer or sore

Potential Serious Reactions

A severe allergic reaction with difficulty breathing called anaphylaxis may occur with the use of Flonase. With the long-term use of the medication, these more serious side effects may occur more rarely:

  • Glaucoma
  • Cataracts
  • Suppression of the immune system
  • High cortisol levels
  • Adrenal suppression
  • Growth suppression (in children)

Other Considerations

There are people who should use Flonase with caution or not at all, as noted above. In particular, you should not use Flonase if you have an open sore in your nose. If you are pregnant or nursing, you should discuss the safety and risks versus benefits with your physician.

It is recommended that you have a routine examination of your nose if you use the medicine for more than 2 months. Children and adolescents should have their growth monitored in long-term use. If you have a history of eye problems, you should have routine eye examinations to ensure no complications develop.

If you have any difficulties with the use of Flonase, you should be in close contact with your prescribing health provider. As it is now available over-the-counter, you may also discuss its use with your pharmacist.

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Article Sources
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  1. Newton JR, Ah-see KW. A review of nasal polyposis. Ther Clin Risk Manag. 2008;4(2):507-12. doi:10.2147/tcrm.s2379

  2. USFDA. Flonase (fluticasone propionate) nasal spray Initial U.S. Approval: 1994. Updated January 2019.

Additional Reading
  • "Flonase." Epocrates Rx Pro. Version 5.1.1, 2013. Epocrates, Inc. San Mateo, California.