Examples of Intranasal Corticosteroids
Fluticasone propionate is a highly effective intranasal corticosteroid that can be used once daily for the treatment of allergic rhinitis. 1
Common Intranasal Corticosteroid Options
Intranasal corticosteroids are the most effective medications for treating allergic rhinitis. Examples include:
- Fluticasone propionate (most commonly cited in evidence)
- Mometasone furoate
- Budesonide
- Beclomethasone dipropionate
- Triamcinolone acetonide
- Flunisolide
Fluticasone Propionate: Key Features
Efficacy
- Provides significant relief of nasal symptoms including congestion, rhinorrhea, sneezing, and itching 1
- Onset of action occurs between 3-12 hours, with some patients experiencing relief as early as 3-4 hours 1
- Can be used effectively on an as-needed basis, though continuous use is more efficacious 1
- Maintains adequate symptom control when administered once daily at 200 micrograms 2
Administration
- Typically administered as 200 micrograms once daily for adults 3
- For children 4-11 years old, 100 micrograms once daily (half the adult dose) is effective 4
- Relief may begin on the first day of use, but several days of consistent use are needed for full effectiveness 3
Safety Profile
- Does not cause rebound effects like decongestant sprays 3
- Does not cause drowsiness unlike some antihistamines 3
- When given in recommended doses, not generally associated with clinically significant systemic side effects 1
- Most common side effects include nasal dryness/burning, epistaxis (nosebleeds), and headache 5
Clinical Considerations
Advantages Over Other Treatments
- More effective than oral and intranasal antihistamines for relieving nasal symptoms 1
- More effective than the combined use of antihistamine and leukotriene receptor antagonist in most studies 1
- Also effective for treating ocular symptoms associated with allergic rhinitis 6
Use in Special Populations
- In children, studies with fluticasone propionate have shown no effect on growth at recommended doses 1
- Safe for use up to 6 months in patients 12 years or older, and up to 2 months per year in children 4-11 years 3
Practical Tips
- Because a patent nasal airway is necessary for optimal delivery, a nasal decongestant spray may be helpful for several days when initiating treatment 1
- If symptoms don't improve after one week of use, discontinue and consult a doctor as there may be an infection 3
Beyond Allergic Rhinitis
Intranasal fluticasone propionate is also effective for:
- Perennial allergic rhinitis
- Nonallergic rhinitis, especially NARES (non-allergic rhinitis with eosinophilia syndrome) 1
- Vasomotor rhinitis 1
Intranasal corticosteroids represent the most effective first-line therapy for allergic rhinitis, with fluticasone propionate being a well-documented example that combines high efficacy with a favorable safety profile when used as directed.