From the Guidelines
Ryaltris (azelastine hydrochloride and fluticasone propionate) is recommended for allergic rhinitis at a standard dosage of 1 spray in each nostril twice daily, as it has been shown to provide the greatest symptom reduction compared to monotherapy with either agent alone 1. Each spray delivers 137 mcg of azelastine hydrochloride and 50 mcg of fluticasone propionate. The medication should be used regularly at approximately the same time each day for optimal effectiveness, not just when symptoms appear. Before first use, prime the bottle by spraying 6 times into the air away from the face. If unused for 14 days or more, re-prime with 1 spray. When administering, shake gently, tilt your head slightly forward, insert the spray tip into one nostril while blocking the other, and breathe in gently while spraying. Ryaltris combines an antihistamine (azelastine) that blocks histamine receptors to reduce sneezing, itching, and runny nose with a corticosteroid (fluticasone) that reduces inflammation in nasal passages. Common side effects include altered taste, nose bleeds, and headache. Improvement typically begins within 30 minutes, but consistent use for several days provides the best results. The medication should not be stopped abruptly but tapered off under medical supervision.
Some key points to consider when using Ryaltris include:
- The combination of azelastine and fluticasone propionate has been shown to provide greater symptom reduction than either agent alone 1.
- The medication should be used regularly for optimal effectiveness.
- Common side effects are generally mild and temporary.
- Improvement in symptoms can be seen within 30 minutes, but consistent use is necessary for optimal results.
It's also important to note that the Joint Task Force on Practice Parameters recommends the combination of an intranasal corticosteroid and an intranasal antihistamine for initial treatment of moderate to severe seasonal allergic rhinitis in persons aged 12 years or older 1. However, the recommendation is graded as weak due to concerns about the limited data and potential adverse effects. Overall, Ryaltris is a effective treatment option for allergic rhinitis, and its use should be tailored to the individual patient's needs and medical history.
From the FDA Drug Label
Adult patients may be started on a 200-mcg once-daily regimen (two 50-mcg sprays in each nostril once daily). An alternative 200-mcg/day dosage regimen can be given as 100 mcg twice daily (one 50-mcg spray in each nostril twice daily). Pediatric patients (4 years of age and older) should be started with 100 mcg (1 spray in each nostril once daily). Treatment with 200 mcg (2 sprays in each nostril once daily or 1 spray in each nostril twice daily) should be reserved for pediatric patients not adequately responding to 100 mcg daily
The recommended treatment and dosage for allergic rhinitis using Ryaltris (azelastine and fluticasone) is not directly stated in the provided drug label, which only discusses fluticasone. However, based on the information provided for fluticasone, the dosage regimens are as follows:
- Adults: 200-mcg once-daily regimen (two 50-mcg sprays in each nostril once daily) or 100 mcg twice daily (one 50-mcg spray in each nostril twice daily)
- Pediatric patients (4 years of age and older): 100 mcg (1 spray in each nostril once daily), with 200 mcg (2 sprays in each nostril once daily or 1 spray in each nostril twice daily) reserved for those not adequately responding to 100 mcg daily 2
From the Research
Recommended Treatment and Dosage for Allergic Rhinitis using Ryaltris
Ryaltris is a combination of azelastine and fluticasone, used for the treatment of allergic rhinitis. The recommended dosage for Ryaltris is:
- 1 spray per nostril twice daily, as needed [@\1@, @\2@]
- The dosage can be adjusted based on the severity of symptoms and patient response
Efficacy of Azelastine and Fluticasone Combination
Studies have shown that the combination of azelastine and fluticasone is more effective than either agent alone in reducing symptoms of allergic rhinitis [@\3@, @\5@]
- The combination therapy has been shown to improve nasal symptoms such as congestion, runny nose, and sneezing [@\3@]
- Azelastine and fluticasone have comparable efficacy in symptom control, with azelastine having a faster onset of action [@\4@]
Safety and Tolerability
Azelastine and fluticasone have been shown to be well-tolerated and safe for use in patients with allergic rhinitis [@\1@, @\2@, @\4@]
- Common side effects include bitter taste, which can be minimized with correct dosing technique [@\1@]
- Azelastine may be considered a safer replacement for fluticasone for long-term use in patients with allergic rhinitis [@\4@]