Dymista Nasal Spray Dosing
The recommended dose of Dymista (azelastine/fluticasone) nasal spray is 1 spray per nostril twice daily for patients 12 years and older with seasonal allergic rhinitis. 1
FDA-Approved Dosing
- Adults and adolescents ≥12 years: 1 spray per nostril twice daily 1
- Each spray delivers: 137 µg of azelastine hydrochloride and 50 µg of fluticasone propionate 1
- Not approved for children under 12 years of age 1
Administration Instructions
- Prime the delivery system with 4 sprays before initial use or until a fine mist appears 2
- If 3 or more days have elapsed since last use, reprime with 2 sprays until a fine mist appears 2
- Avoid spraying directly into the eyes 2
- Direct the spray away from the nasal septum using contralateral hand technique to reduce epistaxis risk by four-fold 3, 4
Clinical Context for Use
Dymista is indicated specifically for moderate to severe seasonal allergic rhinitis when monotherapy with either an intranasal antihistamine or corticosteroid alone is insufficient. 5 This combination provides more than 40% greater symptom reduction compared to fluticasone propionate alone, representing a clinically meaningful improvement over single-agent therapy 3, 4
Common Side Effects
- Bitter taste (most common, can be minimized with proper technique) 1
- Epistaxis (nose bleeds) 1
- Headache 1
- Somnolence 1
Important Caveats
- Do not use as first-line therapy - intranasal corticosteroids alone should be tried first for allergic rhinitis 3
- The combination is reserved for patients who have inadequate response to monotherapy with either component 5
- Onset of action occurs within 12-24 hours, but maximal efficacy requires days to weeks of regular use 6, 4
- This is maintenance therapy, not rescue therapy - continue regular use even when symptoms improve 3