What is the recommended dosage of Avamys (fluticasone furoate) for a 14-year-old child with allergic rhinitis?

Avamys Dosage for 14-Year-Old with Allergic Rhinitis

For a 14-year-old with allergic rhinitis, the recommended dose of Avamys (fluticasone furoate) is 2 sprays per nostril once daily (110 μg total daily dose). 1

Initial Dosing

• Start with 2 sprays per nostril once daily for children over 8 years old, which includes your 14-year-old patient 1
• This delivers a total daily dose of 110 μg of fluticasone furoate 1
• Administer in the morning as a single daily dose for optimal compliance and efficacy 1

Maintenance Dosing

• Once symptoms are controlled, reduce to the minimum effective dose for maintenance therapy 1
• The goal is to step down while maintaining adequate symptom control 1

Timing of Effect

• Therapeutic effect begins 3-12 hours after administration, so set expectations appropriately with the patient 1
• Optimal efficacy is reached within days to weeks, not immediately 1
• Regular daily use is essential rather than as-needed administration for best results 1, 2

Administration Technique (Critical for Efficacy)

Proper technique minimizes side effects and maximizes drug delivery:

• Shake the bottle before each use 1
• Have the patient blow their nose before spraying 1
• Keep head in upright position during administration 1
• Use contralateral hand technique (right hand for left nostril, left hand for right nostril) to reduce epistaxis risk 3
• Breathe in gently during spraying 2
• Direct spray away from the nasal septum to minimize local irritation 3

Safety Profile

• Fluticasone furoate has a good safety profile in children with no significant effect on growth at recommended doses 1
• Common side effects include epistaxis, headache, pharyngolaryngeal pain, nasal ulceration, back pain, pyrexia, and cough 1
• Contraindicated if history of hypersensitivity to fluticasone furoate or any formulation components 1

Important Clinical Considerations

• This is first-line therapy for allergic rhinitis, more effective than oral antihistamines or leukotriene receptor antagonists 3
• If inadequate response after appropriate trial, consider adding intranasal antihistamine (azelastine) rather than switching agents 3
• Can be used long-term safely without causing rhinitis medicamentosa, unlike topical decongestants 3
• For seasonal allergic rhinitis, initiate before symptom onset if allergen exposure is predictable 3