What is the recommended dosing regimen for Ryaltris (olopatadine hydrochloride and mometasone furoate) for allergic rhinitis?

Ryaltris (Olopatadine Hydrochloride and Mometasone Furoate) Dosing for Allergic Rhinitis

The recommended dosing regimen for Ryaltris (olopatadine hydrochloride and mometasone furoate) nasal spray is 2 sprays in each nostril twice daily for patients 12 years of age and older with seasonal allergic rhinitis. 1

Composition and Mechanism

• Ryaltris (GSP301) is a fixed-dose combination nasal spray containing olopatadine hydrochloride 665 μg (antihistamine) and mometasone furoate 25 μg (corticosteroid) per spray 1
• This combination provides both rapid symptom relief through antihistamine action and sustained anti-inflammatory effects through corticosteroid action 2

Age-Specific Dosing

• Adults and adolescents (≥12 years): 2 sprays in each nostril twice daily 1
• Children (6-11 years): 1 spray in each nostril twice daily 1
• Not approved for children under 6 years of age 1

Clinical Efficacy

• Ryaltris demonstrates statistically significant improvement in reflective Total Nasal Symptom Score (rTNSS) compared to placebo 1
• Shows effectiveness for all individual nasal symptoms including congestion, rhinorrhea, sneezing, and itching 1
• Provides improvement in ocular symptoms, particularly for tearing/watering eyes 1
• Improves quality of life measures in pediatric patients with seasonal allergic rhinitis 1

Administration Guidelines

• Prime the bottle before first use 3
• Shake the bottle prior to spraying 3
• Patient should blow their nose prior to using the spray 3
• Keep the head in an upright position during administration 3
• Breathe in gently during spraying 3

Common Side Effects

• Bitter taste (dysgeusia) 4, 5
• Epistaxis (nose bleeds) 4, 1
• Headache 6, 5
• Nasal discomfort/irritation 5

Advantages Over Monotherapy

• Combines the rapid onset of action of antihistamines with the sustained anti-inflammatory effects of corticosteroids 2
• More effective than monotherapy with either antihistamine or intranasal corticosteroid alone for nasal symptom control 7
• Improves patient compliance by reducing the need for multiple medications 2
• Particularly effective for patients with moderate-to-severe allergic rhinitis 2

Important Considerations

• Contraindicated in patients with hypersensitivity to any components of the medication 6
• Should be used regularly rather than as-needed for optimal symptom control 3
• Onset of action is rapid (within 30 minutes) due to the antihistamine component 5
• Full therapeutic benefit may take several days to develop due to the corticosteroid component 3

Alternative Options

• For patients unable to tolerate Ryaltris, alternatives include:
  • Intranasal corticosteroids alone (e.g., mometasone furoate, fluticasone propionate) 6
  • Oral second-generation antihistamines (e.g., loratadine, cetirizine, fexofenadine) 6
  • Intranasal antihistamines alone (e.g., azelastine, olopatadine) 6