What is the onset of action of Fluticasone (Flonase)?

From the Guidelines

Flonase typically starts working within 3 to 12 hours after the first dose, as indicated by the onset of therapeutic effect of intranasal corticosteroids 1. The therapeutic effect of Flonase, which is an intranasal corticosteroid, is known to occur between 3 and 12 hours after administration, according to a study published in the Journal of Allergy and Clinical Immunology 1. Some key points to consider when using Flonase include:

• The clinical response to intranasal corticosteroids does not appear to vary significantly between different types, including Flonase 1
• As-needed dosing of Flonase can be effective, but continuous use may be more efficacious 1
• Flonase is also effective in treating nonallergic rhinitis and may benefit ocular allergy symptoms associated with allergic rhinitis 1
• When given in recommended doses, Flonase is not generally associated with clinically significant systemic side effects, such as effects on the hypothalamic-pituitary-adrenal axis, ocular pressure, or bone density 1
• Local side effects, such as nasal irritation and bleeding, are rare and can be avoided with proper administration technique 1

From the FDA Drug Label

Fluticasone Propionate Nasal Spray, USP, may begin to work within 12 hours of the first dose, but it takes several days of regular use to reach its greatest effect.

• Onset of action: Flonase may start working within 12 hours of the first dose.
• Time to maximum effect: It takes several days of regular use to reach its greatest effect 2.
• Key point: Maximum benefit may not be reached for several days 2.

From the Research

Onset of Therapeutic Effect of Flonase

• The onset of therapeutic effect of fluticasone propionate, the active ingredient in Flonase, has been studied in several clinical trials 3.
• According to these studies, the onset of therapeutic effect of fluticasone propionate occurs within 12 hours after administration of the initial dose, and as early as 2 to 4 hours in some patients 3.
• A review of 22 studies found that numerically greater improvements in total nasal symptom score (TNSS) for fluticasone propionate compared with placebo were found in 19 of the 20 studies within 12 hours of the administration of the first dose 3.
• Pairwise comparisons showed statistically significant improvement for TNSS within 12 hours postdose in five of the studies for fluticasone propionate compared with placebo and in none for placebo compared with fluticasone propionate 3.

Comparison with Other Treatments

• Fluticasone propionate has been compared with other treatments for allergic rhinitis, including antihistamines and other intranasal corticosteroids 4, 5, 6, 7.
• Studies have shown that fluticasone propionate is superior to second-generation antihistamines in the management of allergic rhinitis 6.
• Combination therapy of fluticasone propionate with an oral antihistamine has been found to have efficacy comparable with that of intranasal corticosteroid alone 7.

Clinical Efficacy and Safety

• Fluticasone propionate has been found to have a good safety profile, with low systemic absorption and no significant differences in plasma or urinary cortisol compared with placebo or an oral antihistamine 6.
• The clinical efficacy and safety of fluticasone propionate have been reviewed in several studies, including a review of its use since its launch 5.