What is the proper dosage and usage of Flonase (fluticasone propionate) for adults?

Proper Dosage and Usage of Flonase (Fluticasone Propionate) for Adults

For adults with allergic rhinitis, Flonase (fluticasone propionate) should be administered at a dose of 2 sprays per nostril once daily (total 200 μg daily). 1

Dosing Guidelines

• Initial dosage: 2 sprays in each nostril once daily (total of 4 sprays = 200 μg)
• Maximum dosage: Can be increased to 2 sprays in each nostril twice daily (total of 8 sprays = 400 μg) for more severe symptoms 1, 2
• Administration timing: Preferably in the morning, though evening dosing is also effective 2, 3
• Duration: Regular daily use provides optimal benefit; improvement typically begins within 3 days 3, 4

Proper Administration Technique

1. Shake the bottle gently before each use
2. Prime the pump if using for the first time or after a period of non-use
3. Tilt head slightly forward
4. Insert tip into nostril pointing away from the nasal septum
5. Spray while breathing in gently through the nose
6. Repeat for other nostril

Efficacy and Evidence

Research demonstrates that once-daily dosing of fluticasone propionate is as effective as twice-daily dosing for treating allergic rhinitis 3, 4. Studies show significant improvement in nasal symptoms including congestion, rhinorrhea, sneezing, and itching within 3 days of starting treatment 4.

Common Side Effects

• Headache
• Pharyngitis (sore throat)
• Epistaxis (nosebleeds)
• Nasal burning or irritation
• Nausea or vomiting (less common)
• Cough 1

Important Considerations

• Consistent use: Daily administration is more effective than as-needed use
• Duration before full effect: While some improvement may be seen within days, optimal benefit may take 1-2 weeks of regular use
• Contraindications: History of hypersensitivity to fluticasone or any components of the formulation 1
• Safety profile: Fluticasone has minimal systemic absorption when used as directed, making it safer for long-term use compared to oral antihistamines 2

Clinical Pearls

• Morning dosing may be more convenient and improve adherence 3
• Proper technique is essential for delivering medication to the target area
• Rinsing the nose with saline before administration may improve drug delivery if significant nasal congestion is present
• If symptoms are not controlled with once-daily dosing, increasing to twice daily may provide additional benefit 1, 2

Flonase is available both by prescription and over-the-counter, making it an accessible option for adults with allergic rhinitis.