Can using Flonase (fluticasone) increase the risk of developing thrush?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 8, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Yes, using Flonase (fluticasone) can increase the risk of developing thrush, which is a fungal infection caused by Candida yeast. This side effect occurs because fluticasone is a corticosteroid nasal spray that can suppress the local immune system in the nasal passages and throat, creating an environment where yeast can overgrow. The risk is higher when using higher doses or when using the medication for extended periods. To reduce your risk of developing thrush while using Flonase, rinse your mouth with water after each use and spit the water out rather than swallowing it. Also, gargle with water to clear any medication that may have reached the back of your throat. Make sure to properly clean the nasal applicator according to package instructions. If you develop symptoms of thrush such as white patches in your mouth or throat, pain when swallowing, or an unusual taste in your mouth, contact your healthcare provider promptly as you may need antifungal treatment while continuing or adjusting your Flonase regimen.

Some key points to consider:

  • The risk of developing thrush is higher with prolonged or high-dose use of Flonase 1.
  • Rinsing your mouth with water and gargling can help reduce the risk of thrush 1.
  • Proper cleaning of the nasal applicator is important to prevent infection 1.
  • If symptoms of thrush occur, antifungal treatment may be necessary while continuing or adjusting Flonase use 1.

It's essential to follow the guidelines for managing candidiasis, as outlined in the clinical practice guidelines for the management of candidiasis: 2016 update by the Infectious Diseases Society of America 1. This includes being aware of the potential risks and taking steps to prevent thrush when using Flonase.

From the FDA Drug Label

In clinical studies with fluticasone propionate administered intranasally, the development of localized infections of the nose and pharynx with Candida has occurred only rarely. Patients using Fluticasone Propionate Nasal Spray, USP, over several months or longer should be examined periodically for evidence of Candida infection or other signs of adverse effects on the nasal mucosa Candida Intranasal corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculous infections of the respiratory tract; untreated local or systemic fungal or bacterial infections; systemic viral or parasitic infections; or ocular herpes simplex

Using Flonase (fluticasone) may increase the risk of developing thrush, a type of Candida infection, especially with long-term use 2. It is essential to use the medication as directed and to have regular check-ups with a healthcare provider to monitor for any signs of Candida infection.

  • Key points:
    • Rare cases of localized Candida infections have been reported in clinical studies.
    • Patients should be examined periodically for signs of Candida infection.
    • Intranasal corticosteroids, like Flonase, should be used with caution in patients with certain infections.

From the Research

Risk of Thrush with Flonase Use

  • The use of inhaled corticosteroids, such as fluticasone propionate (Flonase), can increase the risk of developing oral thrush, a type of candidiasis 3.
  • A study found that patients prescribed fluticasone propionate/salmeterol xinafoate (FP/SAL) had a higher risk of developing oral thrush compared to those prescribed budesonide/formoterol fumarate dihydrate (BUD/FOR) 3.
  • The risk of oral thrush was also found to be dose-dependent, with higher daily doses of FP/SAL increasing the risk of oral thrush 3.
  • However, it's worth noting that the studies provided do not specifically investigate the risk of thrush associated with Flonase use, but rather with inhaled corticosteroids in general, including fluticasone propionate 3.
  • Other studies discuss the mechanisms of antifungal resistance and the development of new antifungal treatments, but do not provide direct evidence on the risk of thrush with Flonase use 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.