From the Guidelines
Fluticasone takes between 3 and 12 hours to start working, as evidenced by its onset of therapeutic effect 1. The therapeutic effect of intranasal corticosteroids, such as fluticasone, does not appear to vary significantly between different types 1. Some key points to consider when using fluticasone include:
- The clinical response to intranasal corticosteroids can occur within a few hours, but significant improvement in symptoms may take longer 1
- As-needed dosing of fluticasone propionate can be effective in treating seasonal allergic rhinitis, but may not be as effective as continuous use 1
- Intranasal corticosteroids, including fluticasone, are generally not associated with clinically significant systemic side effects when given in recommended doses 1
- Local side effects, such as nasal irritation and bleeding, are rare and can be avoided with proper administration technique 1 It is essential to use fluticasone consistently and as prescribed to achieve optimal effectiveness, and if no improvement is noticed after 1-2 weeks, consulting a healthcare provider may be necessary to adjust the dosage or consider alternative medications.
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. A decrease in nasal symptoms has been noted in some patients 12 hours after initial treatment with Fluticasone Propionate Nasal Spray, USP. Maximum benefit may not be reached for several days
Time to onset of action: Fluticasone may start to work within 12 hours of the first dose.
- However, it takes several days of regular use to reach its greatest effect.
- Maximum benefit may not be reached for several days 2 3
From the Research
Onset of Therapeutic Effect
- The onset of therapeutic effect of fluticasone propionate (FP) aqueous nasal spray occurs within 12 hours after administration of the initial dose 4.
- In some patients, the onset of therapeutic effect can be as early as 2 to 4 hours after administration of the first dose of FP aqueous nasal spray 4.
- Symptom improvement with fluticasone propionate was evident within 3 days of treatment in patients with seasonal allergic rhinitis 5.
Comparison of Fluticasone Formulations
- Fluticasone furoate (FF) has shown the highest affinity and selectivity for the glucocorticoid receptors and the longest tissue retention compared with other available intranasal steroids, including fluticasone propionate (FP) 6.
- There is scientific evidence of therapeutic advantages of FF over FP 6.
Treatment Regimens
- Regular use of fluticasone furoate (FF) nasal spray tended towards a greater improvement in total nasal symptom score (TNSS) compared to as-needed use in patients with moderate to severe perennial allergic rhinitis 7.
- As-needed use of FF nasal spray had similar improvement in TNSS and Rhinoconjunctivitis Quality of Life-36 Questionnaire score compared to regular use, but with half the cumulative FF dose 7.