From the Research
Fluticasone furoate (FF) is the most effective intranasal corticosteroid for treating postnasal drip in pediatric patients, as demonstrated by its significant improvement in nasal symptom scores and favorable safety profile in children aged 2-11 years with perennial allergic rhinitis 1.
Key Points to Consider
- The typical starting dose of fluticasone furoate is 55 microg once daily, which can be increased to 110 microg if needed, as shown in a study where FF 55 microg demonstrated significant improvement compared to placebo 1.
- Fluticasone propionate (Flonase) is another option, but its efficacy in pediatric patients is supported by older studies, such as a 1997 study that showed significant decrease in total symptom scores in children with perennial allergic rhinitis 2.
- Mometasone furoate (Nasonex) is also an option, but its efficacy and safety in pediatric patients are not as well-established as fluticasone furoate, with limited studies available, such as a 2000 study that discussed the risk-benefit assessment of intranasal triamcinolone acetonide in allergic rhinitis, but not specifically mometasone furoate 3.
- It is essential to teach children to aim the spray toward the outer wall of the nostril rather than the septum and continue use consistently for at least 1-2 weeks as benefits may take time to appear.
- If symptoms don't improve after 2-3 weeks of consistent use, it is crucial to consult a pediatrician as the post-nasal drip may have another cause requiring different treatment.
Safety and Efficacy
- Fluticasone furoate has a favorable safety profile, with no findings of clinical concern identified from safety assessments, including nasal and ophthalmic examinations, and hypothalamic-pituitary-adrenal assessments 1.
- The most common adverse effects of intranasal corticosteroids include sneezing, dry mucosa, nasal irritation, sinus discomfort, throat discomfort, epistaxis, and headache, as reported in a 2000 study on the risk-benefit assessment of intranasal triamcinolone acetonide in allergic rhinitis 3.
- Posterior subcapsular cataract formation has not been seen with fluticasone furoate, and growth and hypothalamic pituitary axis function studies have shown no significant effects, as demonstrated in a 2009 study on the safety and tolerability of fluticasone furoate in pediatric patients aged 6-11 years with allergic rhinitis 4.