From the Guidelines
Yes, you can use Flonase (fluticasone propionate) and Astepro (azelastine) together for environmental allergies, as the combination of an intranasal corticosteroid and an intranasal antihistamine may be recommended for initial treatment of moderate to severe seasonal allergic rhinitis in persons aged 12 years or older. These medications work through different mechanisms and can complement each other for better symptom control. Flonase is a nasal corticosteroid that reduces inflammation, while Astepro is an antihistamine nasal spray that blocks histamine receptors. According to a study published in the Annals of Internal Medicine 1, the combination of an intranasal corticosteroid and an intranasal antihistamine has been shown to provide additive benefits in reducing nasal symptoms. Some key points to consider when using these medications together include:
- Administering them about 5-10 minutes apart, typically using Astepro first, followed by Flonase
- Following the standard dosing for adults, which is typically 1-2 sprays of Astepro in each nostril twice daily, and 1-2 sprays of Flonase in each nostril once or twice daily
- Being aware of potential side effects such as nasal irritation, headache, or nosebleeds, and contacting a healthcare provider if they occur
- Consulting a doctor before combining these medications if you have glaucoma, cataracts, or other medical conditions. The study 1 also noted that the combination of fluticasone propionate and azelastine has been shown to provide greater symptom reduction than either medication alone, with reductions in symptom scores ranging from −5.31 to −5.7.
From the Research
Combination Therapy for Environmental Allergies
- Flonase (fluticasone propionate) and Astepro (azelastine hydrochloride) are two common medications used to treat allergic rhinitis.
- Studies have shown that using these medications together can be an effective treatment option for patients with allergic rhinitis 2, 3.
- A systematic review and meta-analysis found that combination therapy with intranasal azelastine and fluticasone propionate was superior to monotherapy or placebo in reducing Total Nasal Symptom Score 3.
Efficacy and Safety of Combination Therapy
- A study comparing the effects of azelastine and fluticasone nasal sprays found that both medications had comparable efficacy in symptom control, but azelastine had fewer side effects 4.
- Another study found that the combination of azelastine and fluticasone in a single delivery device was effective and safe in children and adolescents with allergic rhinitis 2.
- The current evidence supports the use of combination intranasal azelastine and fluticasone as a second-line therapy in patients with allergic rhinitis that is not controlled with monotherapy 3.
Considerations for Using Flonase and Astepro Together
- Patients should consult their healthcare provider before using Flonase and Astepro together, as they may have individual concerns or interactions with other medications.
- The safety and efficacy of using Flonase and Astepro together in children under the age of 4 is not well established, and further studies are needed to determine the optimal treatment approach for this age group 2.