What are the dispensing instructions for Flonase (fluticasone propionate)?

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Dispensing Instructions for Flonase (Fluticasone Propionate)

For Flonase (fluticasone propionate) nasal spray, the dispensing instructions are age-dependent: children 4-11 years should receive 1 spray per nostril once daily, while adults and children 12 years and older should receive 2 sprays per nostril once daily. 1

Age-Specific Dosing Guidelines

Children 4-11 years:

  • 1 spray per nostril once daily
  • Maximum duration: 2 months per year before consulting a doctor 2
  • Total daily dose: 50 μg per nostril (100 μg total)

Adults and Children ≥12 years:

  • 2 sprays per nostril once daily
  • Maximum duration: 6 months of daily use before consulting a doctor 2
  • Total daily dose: 100 μg per nostril (200 μg total)

Administration Instructions

  1. Prior to first use: Prime the pump by pressing down 6 times or until a fine mist appears
  2. For regular use:
    • Shake the bottle gently before each use
    • Tilt head slightly forward
    • Insert the nozzle into one nostril, pointing away from the nasal septum
    • Press down firmly to deliver the spray while breathing in gently
    • Repeat for the other nostril

Important Dispensing Considerations

  • Fluticasone propionate is available as a 50 μg per spray aqueous formulation 1
  • The medication is indicated for allergic rhinitis and nonallergic rhinitis 1
  • Contraindicated in patients with hypersensitivity to the medication or its components 1
  • Common side effects include headache, pharyngitis, epistaxis, nasal burning/irritation, nausea, vomiting, asthma symptoms, and cough 1

Special Populations

  • Children under 4 years: Not approved for use in this age group 1
  • Pregnancy: Consult physician before use
  • Patients on HIV medications (ritonavir) or ketoconazole: Should consult with healthcare provider before using 2
  • Patients using other steroid medications: Should consult with healthcare provider before using 2

Patient Education Points

  • Emphasize that regular, consistent use is necessary for optimal effect
  • Inform patients that it may take several days to reach maximum effectiveness 2
  • Advise against sharing the nasal spray bottle to prevent spreading germs 2
  • Instruct patients not to spray the medication in eyes or mouth 2
  • Clarify that this medication is not for treatment of asthma or cold symptoms 2

Storage and Handling

  • Store at room temperature
  • Keep away from direct heat and sunlight
  • Discard after the labeled number of sprays has been used, even if the bottle still contains liquid

Once-daily dosing of fluticasone propionate has been shown to be as effective as twice-daily dosing of the same total dose, making it a convenient option for patients 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Asthma and Allergic Rhinitis Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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.

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