Flonase (Fluticasone) - Nasal

What Is Fluticasone?

Fluticasone is a nasal spray used in both prescription and over-the-counter (OTC) forms to treat symptoms of nonallergic rhinitis, seasonal allergies, or nasal polyps. It belongs to a drug class called steroids, also called corticosteroids. The exact way it works is not known, but it is thought to block substances that cause inflammation.

Fluticasone is available as:

  • Prescription fluticasone to treat non-allergic rhinitis symptoms
  • Prescription Xhance to treat nasal polyps
  • OTC fluticasone (e.g., Flonase Allergy Relief, Flonase Sensimist Allergy Relief, Children's Flonase Relief, and Children's Flonase Sensimist Allergy Relief) to treat seasonal allergies

The Sensimist products use what's called MistPro Technology to deliver a fine mist using a short nozzle.

Fluticasone is administered nasally by spraying it into the nostrils.

Drug Facts

Generic Name: Fluticasone

Brand Name(s): Flonase Allergy Relief, Flonase Sensimist Allergy Relief, Xhance

Drug Availability: Prescription and OTC

Administration Route: Nasal

Therapeutic Classification: Corticosteroids/Nasal corticosteroids

Available Generically: Yes (some versions)

Controlled Substance: N/A

Active Ingredient: Fluticasone propionate

Dosage Form(s): Nasal Spray

What Is Fluticasone Used For?

The Food and Drug Administration (FDA) approved prescription fluticasone for nasal symptoms of perennial (year-round) nonallergic rhinitis in adults and children 4 years and older.

Nonallergic rhinitis is when a person has symptoms that may resemble allergies but are not. Instead, these symptoms are sometimes caused by air, weather, medications, or other medical conditions.

OTC fluticasone nasal sprays help temporarily improve symptoms of hay fever (seasonal allergies) or other upper respiratory allergies, such as a stuffy or runny nose, sneezing, itchy nose, or itchy and watery eyes. Flonase Allergy Relief can be used in adults and children 4 years and older, whereas Flonase Sensimist Allergy Relief can be used in children 2 years and older.

Xhance is a prescription drug that also contains the active ingredient fluticasone. It is specifically indicated for adults with nasal polyps. It is used in a unique way, by blowing on a mouthpiece to activate the medicine to be delivered into a nostril.

How to Use Fluticasone

Read the prescription label and the information leaflet that comes with your prescription. If you are using the OTC Flonase Allergy Relief, read all the information on the package and label. Then, use the medication exactly as directed. Fluticasone is for the nose and should not be sprayed into the eyes or mouth.

If you are prescribed Flonase or use OTC fluticasone nasal sprays:

  • Spray fluticasone into each nostril once daily, unless instructed otherwise by your healthcare provider.
  • Do not share fluticasone with another person, even if they have the same symptoms.
  • Supervise your child using nasal spray.
  • Shake the bottle gently before each use.
  • It may take several days until symptoms start to improve. Contact your healthcare provider if you feel worse or do not feel better after seven days.

Ask your healthcare provider if you have any questions or concerns about fluticasone.

Storage

Store fluticasone upright at room temperature, away from direct light, heat, and moisture. Keep the medication out of reach and sight of children and pets.

How Long Does Fluticasone Take To Work?

You may start to feel better after the first day of taking fluticasone, but expect to feel the full effects after a few days of regular use. Fluticasone should be used once daily, every day, to be the most effective.

What Are the Side Effects of Flonase?

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

Like other medications, fluticasone can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

Common side effects of fluticasone are:

  • Headache
  • Upper respiratory infection: Symptoms such as sore throat, stuffy nose, and cough
  • Bronchitis: Symptoms may include cough and wheezing
  • Nasal irritation, burning, ulcers, and nosebleeds
  • Stomach problems, such as nausea, vomiting, diarrhea, and stomach pain
  • Dizziness
  • Fungal infection of the nose or mouth
  • Nasal septal perforation (a hole in the wall that separates the nostrils): Symptoms may include nose bleeds, crusting in the nose, runny nose, or a whistling sound when you breathe

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or you think you have a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing. Get immediate medical attention.
  • Glaucoma (with long-term use): Glaucoma is a damaged nerve in the eye caused by high pressure. It may not have symptoms or symptoms may include vision disturbances (blurry or distorted vision) or vision loss.
  • Cataracts (with long-term use): Clouding of the lens of the eye, which can cause vision disturbance
  • Immunosuppression (with long-term use): The body's immune system does not work as well to fight off infections
  • Hypercorticism (with long-term use): Also known as Cushing's syndrome, caused by extra cortisol, or stress hormone. Symptoms include a fatty hump between the shoulders, a round face, and stretch marks.
  • Adrenal suppression (with long-term use): Also known as Addison's disease, this is when the adrenal glands do not make enough cortisol. Symptoms may include fatigue, nausea, and dizziness.
  • Growth suppression (with long-term use in children): Because steroids, in general, can affect growth, the healthcare provider will monitor the child's growth while taking Flonase.

Long-Term Side Effects

While many people tolerate fluticasone well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as: 

  • Sinus infection or sore throat
  • Back and joint pain
  • Tooth pain
  • Cough
  • Dry skin
  • Nosebleeds
  • Laryngitis (losing the voice due to inflammation of the voice box)
  • Menstrual irregularities
  • Rash or discolored skin
  • Acne
  • Anxiety/irritability
  • Loss of smell
  • Weight gain

Moderate long-term side effects can include:

Severe long-term side effects may include:

Report Side Effects

Fluticasone 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 healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Fluticasone 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 polyps:
    • For nasal dosage form (spray):
      • Xhance™:
        • Adults—At first, 1 spray (93 micrograms [mcg]) fluticasone in each nostril two times a day. Some patients may need 2 sprays in each nostril two times a day. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
  • For symptoms of hay fever:
    • For nasal dosage form (spray):
      • Fluticasone propionate:
        • Adults—At first, 2 sprays in each nostril once a day. Some patients may need 1 spray in each nostril two times a day (morning and evening). Your doctor may adjust your dose as needed.
        • Children 4 years of age and older—At first, 1 spray in each nostril once a day. Some patients may need 200 mcg or 2 sprays in each nostril once a day.
        • Children younger than 4 years of age—Use is not recommended.
      • Veramyst®:
        • Adults and children 12 years of age and older—At first, 2 sprays in each nostril once a day. Your doctor may decrease your dose to 55 mcg or 1 spray in each nostril once a day.
        • Children 2 to 11 years of age—At first, 1 spray in each nostril once a day. Your child's doctor may need to increase the dose up to 2 sprays in each nostril once a day depending on your child's condition.
        • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Modifications

You may need to use caution when taking fluticasone if you are 65 years or older, especially if you have other medical problems. People with liver or kidney problems should consult their healthcare provider before using fluticasone. If you are pregnant, planning to become pregnant, or breastfeeding, consult a healthcare provider before using fluticasone.

Missed Dose

If you miss a dose of fluticasone, take it as soon as you can. If it is almost time for the next dose, skip the missed dose. Do not use two doses together to try to make up for a missed dose.

Overdose: What Happens If I Take Too Much Fluticasone?

If using fluticasone nasally and as prescribed, it is unlikely that you will overdose. Chronic use may lead to some long-term side effects.

What Happens If I Overdose on Fluticasone?

If you think you or someone else may have used too much fluticasone, call a healthcare provider or the Poison Control Center (800-222-1222).

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

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

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

This medicine may cause holes or ulcers in the cartilage of the nose and delay wound healing. Make sure your doctor knows if you have had nose surgery, a nose injury, or an infection in your nose in the last few months before using this medicine.

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 be checked by an ophthalmologist (eye doctor).

This medicine may cause serious allergic reactions, including anaphylaxis. This can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

You may get infections more easily while using this medicine. Tell your doctor right away if you have been exposed to someone with chickenpox or measles. Also tell your doctor if you develop white patches or sores in your nose while you are using this medicine. This could be symptoms of a candida or yeast infection.

Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor if you have more than one of these symptoms while you are using this medicine: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

This medicine may decrease bone mineral density when used for a long time. A low bone mineral density can cause weak bones or osteoporosis. Talk with your doctor if you have concerns about this.

This medicine may slow down a child's growth. If you think your child is not growing properly while using this medicine, talk with your doctor.

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 Fluticasone?

Fluticasone is not appropriate for everyone. You should not take this medication if you are allergic to fluticasone (or any steroids) or any of the inactive ingredients in fluticasone.

Other people who should not take fluticasone include:

  • People with an unhealed nasal septal ulcer
  • People with an unhealed nasal wound

Fluticasone may be prescribed with caution in some people, only if the healthcare provider determines it is safe. This includes:

  • People with liver problems
  • People who have recently taken steroids for a length of time
  • People who have been exposed to the measles or varicella virus
  • People with an untreated infection, including tuberculosis
  • People with ocular herpes simplex virus infection (a serious eye infection that can cause vision loss and blindness)
  • People with cataracts or glaucoma or who are at risk for glaucoma

What Other Medications Interact With Fluticasone?

Tell your healthcare provider about all your medicines, including prescription and OTC medicines, and vitamins or supplements. 

Fluticasone should not be used in combination with strong CYP3A4 inhibitors because these drugs can cause higher levels of fluticasone. This can lead to an increased risk of steroid side effects that would be less likely to occur under normal circumstances. These drugs include:

Other drug interactions may occur with fluticasone. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Fluticasone is a nasal steroid. Examples of other nasal steroids include:

  • Flunisolide nasal spray
  • Nasacort Allergy (triamcinolone) nasal spray
  • Nasonex (mometasone) nasal spray
  • Omnaris, Zetonna (ciclesonide) nasal spray
  • Qnasl, Beconase AQ (beclomethasone) nasal spray
  • Rhinocort Allergy Spray (budesonide) nasal spray

Sometimes, nasal steroids are used with other types of nasal sprays for allergies. One example of a combination drug is Dymista which contains fluticasone and azelastine (an antihistamine). Another is called Ryaltris, which is not yet on the market. It is a combination nasal spray containing olopatadine (an antihistamine) and mometasone (a steroid).

Nasal antihistamines are also available as single-ingredient products. Some examples are:

  • Astelin, Astepro (azelastine) nasal spray
  • Patanase (olopatadine) nasal spray

There are also other types of nasal sprays used for nasal symptoms of allergy such as:

  • Ipratropium nasal spray
  • Cromolyn nasal spray

This list is a list of drugs also used for nasal symptoms and allergies. It is NOT a list of drugs recommended to take with fluticasone. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is fluticasone used for?

    Nonprescription fluticasone (e.g., Flonase Allergy Relief) is used to improve symptoms such as sneezing, a runny or stuffy nose, and itchy, watery eyes caused by allergies. Prescription fluticasone can also be used for these symptoms when they are not caused by allergies (nonallergic rhinitis).

  • How does fluticasone work?

    Fluticasone is a nasal steroid. It is thought to work by blocking substances that cause swelling (inflammation).

  • What drugs should not be taken with fluticasone?

    Fluticasone should not be combined with certain drugs that affect an enzyme called CYP3A4. Some examples include certain antifungals, some antibiotics, and certain HIV medications.

  • How long does it take for fluticasone to work?

    Fluticasone may start to relieve your symptoms after the first day, and the full effect can be seen after a few days of using fluticasone regularly. However, fluticasone should be used once daily to be the most effective.

  • What are the side effects of fluticasone?

    Stomach problems are common side effects of fluticasone. These can include stomach pain, nausea, vomiting, and diarrhea. Upper respiratory infection symptoms (sore throat, stuffy nose, and cough) and bronchitis (symptoms may include cough and wheezing) can commonly occur.

    Other common side effects include headache, dizziness, and fungal infection of the nose or mouth. In addition, nasal problems such as nasal irritation, burning, ulcer, and nosebleeds, can occur, as well as nasal septal perforation.

  • How do I stop taking fluticasone?

    Fluticasone should be taken every day, once a day, for a period of time to be most effective. Ask your healthcare provider when you should stop taking Flonase.

How Can I Stay Healthy While Taking Fluticasone?

To be most effective, use fluticasone once a day, every day. It is not a drug that you take as needed. You can ask your healthcare provider how long to take it.

If you experience allergy symptoms, it may be helpful to consult an allergist/immunologist who can perform allergy testing and recommend the best treatment for you. If you are at risk of a severe allergic reaction, you should carry an epinephrine injection with you at all times and wear a medical alert identification.

In addition to taking fluticasone, you can also try some of these non-pharmacological measures to help prevent allergy symptoms:

Monitor pollen and mold counts. You can use various apps, along with general news and weather reports.

  • Close doors and windows when at home and in your car.
  • Take a shower (washing both your body and hair), then change into clean clothes after spending time outside.
  • Wear an N95 mask when outside.
  • Use an air purifier and a humidifier.

Some people experience nasal problems from taking fluticasone nasal spray. Contact your healthcare provider if you experience a severe or bothersome side effect such as bleeding or burning. For a mildly dry nose without complications, ask your healthcare provider if you can use a saline nasal spray or a lubricating nasal gel or spray (such as Rhinaris) to make you more comfortable.

Avoid people who are sick or have an infection. Call your healthcare provider if you are exposed to chickenpox or measles. These conditions can be serious or cause death in people who are taking fluticasone.

Medical Disclaimer

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

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. U.S. National Library of Medicine's DailyMed. Label: Fluticasone- fluticasone propionate spray, metered.

  3. U.S. National Library of Medicine’s DailyMed. Label: Flonase Sensimist Allergy Relief.

  4. U.S. National Library of Medicine’s DailyMed. Label: Flonase Allergy Relief.

  5. U.S. National Library of Medicine's DailyMed. Label: Xhance.

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By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.