From the Guidelines
Flonase is generally considered safe for people with cataracts, as intranasal corticosteroids are not associated with a significant risk of incident cataract. The use of Flonase (fluticasone propionate) has minimal systemic absorption, which reduces the risk of cataract formation or progression compared to oral or injectable steroids 1. According to recent systematic reviews, there is no significant association between the use of intranasal corticosteroids and the risk of cataract formation 1.
Key points to consider:
- Long-term use of oral or injectable steroids can increase the risk of developing cataracts, but this is not the case with nasal steroid sprays like Flonase 1.
- A well-balanced diet rich in fruits and vegetables, long-term increased physical activity, and exercise may decrease the risk of cataract, but the use of Flonase does not negatively impact this 1.
- Patients with cataracts should be counseled and monitored, especially if they are taking medications that may be associated with cataract formation, but Flonase is not a significant concern in this regard 1.
- It is essential to inform your ophthalmologist about all medications you're taking, including over-the-counter nasal sprays like Flonase, to ensure comprehensive care 1.
If you notice any changes in vision while using Flonase, it is crucial to contact your eye doctor promptly, but there's no need to avoid this medication solely due to having cataracts 1.
From the FDA Drug Label
Rare instances of wheezing, nasal septum perforation, cataracts, glaucoma, and increased intraocular pressure have been reported following the intranasal application of corticosteroids, including fluticasone propionate. The use of Flonase (fluticasone propionate) may be associated with an increased risk of cataracts.
- Key points:
- Cataracts have been reported as a rare instance following the intranasal application of corticosteroids, including fluticasone propionate.
- Patients with pre-existing cataracts should use Flonase with caution.
- It is recommended to consult a physician before using Flonase if you have cataracts 2.
From the Research
Flonase Safety with Cataracts
- The safety of Flonase (fluticasone propionate) with cataracts has been evaluated in several studies 3, 4, 5, 6.
- A study published in 1998 found that intranasal corticosteroids, including fluticasone propionate, did not increase the risk of ocular hypertension or posterior subcapsular cataracts (PSCs) in patients with rhinitis 3.
- A systematic review and meta-analysis published in 2019 found that the use of intranasal corticosteroids, including fluticasone propionate, was not associated with a significant risk of elevating intraocular pressure (IOP) or developing PSCs in patients with allergic rhinitis 4.
- A study published in 2013 found that fluticasone propionate irrigations did not suppress salivary cortisol levels or result in ocular changes, including PSCs, in patients with chronic rhinosinusitis 5.
- Another study published in 2013 found that fluticasone furoate nasal spray, a related medication to fluticasone propionate, did not increase the risk of PSCs or IOP in patients with perennial allergic rhinitis over a 2-year period 6.
- A recent international consensus statement on allergy and rhinology published in 2023 provides a comprehensive evaluation of allergic rhinitis, including the use of intranasal corticosteroids like fluticasone propionate, but does not specifically address the safety of Flonase with cataracts 7.
Key Findings
- The available evidence suggests that Flonase is safe to use in patients with cataracts, as it does not increase the risk of ocular hypertension or PSCs 3, 4, 5, 6.
- However, it is essential to note that the evidence is based on studies with limited follow-up periods, and long-term safety data are needed to confirm these findings.
- Patients with cataracts should consult their healthcare provider before using Flonase, as individual circumstances may vary 3, 4, 5, 6.