From the Research
Flonase (fluticasone propionate) can potentially cause heart palpitations, though this is considered an uncommon side effect, as supported by the most recent and highest quality study available 1.
Background
Fluticasone is a corticosteroid nasal spray primarily used to treat allergic rhinitis symptoms like nasal congestion, sneezing, and runny nose. The potential for Flonase to cause heart palpitations is a concern due to its systemic absorption, which can occasionally affect heart rhythm in sensitive individuals.
Risk Factors
People with pre-existing heart conditions, those taking other medications that affect heart rhythm, or individuals using higher than recommended doses may be at increased risk of experiencing heart palpitations while using Flonase. It is essential to use Flonase exactly as prescribed, typically 1-2 sprays in each nostril once daily, and not exceed the recommended dosage.
Mechanism
The mechanism behind this potential side effect may involve systemic absorption of the medication, which can occasionally affect heart rhythm in sensitive individuals. However, the bioavailability of fluticasone propionate is generally low, with a study showing that the maximum and total exposure to FP was higher for MP29-02-based products compared with FP-BI, but still very low 2.
Recommendations
Most patients can use Flonase safely without experiencing cardiovascular side effects, but any unusual symptoms should be reported to a healthcare provider. If you experience heart palpitations while using Flonase, you should contact your healthcare provider promptly. The American Heart Association has also emphasized the importance of being aware of drugs that may cause arrhythmias and considering the possibility that a patient's arrhythmia could be drug-induced 1.
Key Points
- Flonase can potentially cause heart palpitations, though this is an uncommon side effect.
- People with pre-existing heart conditions or those taking other medications that affect heart rhythm may be at increased risk.
- Use Flonase exactly as prescribed and do not exceed the recommended dosage.
- Report any unusual symptoms to a healthcare provider.
- Be aware of the potential for drug-induced arrhythmias and consider this possibility when evaluating patients with arrhythmias.