What is not true about nasal corticosteroids regarding contraindications in senile rhinitis, tuberculosis, or a 50mcg dosage per spray?

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Last updated: March 24, 2025View editorial policy

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From the Guidelines

Nasal corticosteroids are not contraindicated in senile rhinitis, as they do not cause clinical or histologic atrophic changes in the nasal mucosa. The statement that is not true about nasal corticosteroids regarding contraindications is that they are contraindicated in senile rhinitis. According to the study by 1, nasal steroids may be safely used for treatment of allergic rhinitis in the elderly, as they do not cause any clinical or histologic atrophic changes in the nasal mucosa. Some key points to consider when prescribing nasal corticosteroids include:

  • Nasal corticosteroids come in various dosages, with common formulations ranging from 27.5mcg to 200mcg per spray, and a 50mcg dosage per spray is a valid formulation for some medications, such as fluticasone propionate or mometasone furoate.
  • Nasal corticosteroids are not contraindicated in senile rhinitis, but rather may be a safe treatment option for allergic rhinitis in this population.
  • However, nasal corticosteroids may be contraindicated in certain conditions, such as tuberculosis, due to their immunosuppressive effects. It is essential to carefully evaluate the patient's specific diagnosis and medical history before prescribing nasal corticosteroids, as their use depends on various patient factors, including the presence of underlying conditions such as tuberculosis.

From the Research

Nasal Corticosteroids Contraindications

  • There is no evidence to suggest that a 50mcg dosage per spray of nasal corticosteroids is contraindicated in senile rhinitis, tuberculosis, or any other condition 2.
  • Nasal corticosteroids are widely used and are as safe and effective as antihistamines in controlling symptoms of rhinitis, with no specific contraindications mentioned for senile rhinitis or tuberculosis 3.
  • The primary focus of treatment for allergic rhinitis in elderly patients is the same as in young patients, with second-generation antihistamines and nasal glucocorticosteroids being first-line therapies, and no contraindications mentioned for senile rhinitis or tuberculosis 4.
  • Intranasal corticosteroids are one of the most common types of medication prescribed in patients with rhinitis or rhinosinusitis symptoms, including those with non-allergic rhinitis, with no specific contraindications mentioned for senile rhinitis or tuberculosis 2.
  • It is essential to note that while nasal corticosteroids are effective in treating allergic rhinitis, they may have adverse effects such as epistaxis, and their use should be monitored closely 5.

Dosage and Efficacy

  • Intranasal corticosteroid dosage in the review ranged from 50 µg to 2000 µg daily, with no specific contraindications mentioned for a 50mcg dosage per spray 2.
  • Intranasal corticosteroids probably improve patient-reported disease severity as measured by total nasal symptom score compared with placebo at up to four weeks, but the evidence is uncertain for longer-term follow-up 2.
  • The efficacy of nasal corticosteroids compared to antihistamines has been studied, with results showing that topical nasal corticosteroids perform superiorly to antihistamine nasal sprays in improving sleep, daytime sleepiness, sneezing, ocular and nasal pruritus, and nasal congestion 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Intranasal corticosteroids for non-allergic rhinitis.

The Cochrane database of systematic reviews, 2019

Research

Topical nasal sprays: treatment of allergic rhinitis.

American family physician, 1994

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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