From the Guidelines
Fluticasone nasal spray is approved for use in children as young as 4 years old, with a typical starting dose of one spray (50 mcg) in each nostril once daily. The age recommendation for Fluticasone nasal spray is based on the formulation, with Fluticasone propionate (Flonase) approved for children aged 4 years and older 1. For children 4 years and older, the dose may be increased to a maximum of two sprays in each nostril daily if needed. It is essential to monitor children for the lowest effective dose to minimize potential side effects, such as nasal irritation, headache, and occasional nosebleeds. Before use, the bottle should be shaken gently, and the child should clear their nose, then tilt their head slightly forward while spraying away from the nasal septum. Fluticasone works by reducing inflammation in the nasal passages, making it effective for allergic rhinitis symptoms. Growth should be monitored in children using this medication long-term, as intranasal corticosteroids may affect growth velocity, though the effect is typically minimal with nasal formulations compared to oral or inhaled steroids. The specific formulation of Fluticasone furoate (Veramyst) is also approved for children aged 2 years and older, but the recommended dose is 1-2 sprays per nostril every day 1. However, the most relevant and recent evidence supports the use of Fluticasone propionate (Flonase) in children aged 4 years and older. Key considerations for the use of Fluticasone nasal spray in children include:
- Monitoring for potential side effects, such as nasal irritation and headache
- Using the lowest effective dose to minimize side effects
- Shaking the bottle gently before use and spraying away from the nasal septum
- Monitoring growth in children using this medication long-term.
From the FDA Drug Label
Fluticasone Propionate Nasal Spray, USP, is indicated for the management of the nasal symptoms of seasonal and perennial allergic and nonallergic rhinitis in adults and pediatric patients 4 years of age and older. Pediatric patients (4 years of age and older) should be started with 100 mcg (1 spray in each nostril once daily).
The pediatric age of use for Fluticasone nasal spray is 4 years of age and older 2.
- The recommended starting dose for pediatric patients is 100 mcg (1 spray in each nostril once daily).
- The maximum total daily dose should not exceed 200 mcg/day.
From the Research
Pediatric Age of Use for Fluticasone Nasal Spray
- The pediatric age of use for Fluticasone nasal spray varies depending on the specific formulation and study, but it has been investigated in children as young as 2 years old 3, 4.
- For Fluticasone propionate aqueous nasal spray, studies have shown efficacy and safety in children aged 4-11 years 5, 6.
- Fluticasone furoate nasal spray has been studied in children aged 2-12 years, with favorable efficacy and safety profiles observed in this age group 3, 4, 7.
- A subanalysis of three randomized, double-blind, placebo-controlled studies found that Fluticasone furoate nasal spray was safe and well-tolerated in pediatric patients aged 6-11 years with allergic rhinitis 7.
- The studies suggest that Fluticasone nasal spray can be used in pediatric patients, with the specific age range depending on the formulation and individual patient needs, as supported by the findings of 5, 6, 3, 4, 7.