From the Guidelines
Dymista should be administered at a dose of 1 spray per nostril twice a day for patients 12 years and older with seasonal allergic rhinitis. According to the clinical practice guideline for allergic rhinitis 1, this dosing is recommended for the treatment of seasonal allergic rhinitis in patients 12 years and older. The medication contains 137 µg of azelastine and 50 µg of fluticasone per spray, and it is available by prescription only.
Some key points to consider when prescribing Dymista include:
- The medication is contraindicated in patients under 12 years old due to lack of safety data in this population 1
- Common side effects include bitter taste, epistaxis, somnolence, and headache 1
- Patients should be cautioned about the potential for somnolence, especially at the initiation of treatment, and follow-up with a clinician is advised to assess response and side effects 1
- Dymista can be used as first- or second-line therapy for allergic rhinitis, and its rapid onset of action and targeted delivery make it especially useful in patients with episodic nasal symptoms or as a pretreatment prior to nasal allergen exposure 1
It is essential to weigh the benefits and risks of Dymista and consider alternative treatment options, especially in patients who may be more susceptible to side effects or have comorbid conditions. However, based on the available evidence, the recommended dose of 1 spray per nostril twice a day is the most effective and safe treatment option for patients 12 years and older with seasonal allergic rhinitis 1.
From the FDA Drug Label
DOSING: The dosage of azelastine hydrochloride nasal solution is 1 spray per nostril twice daily for pediatric patients (ages 5-11 years) with seasonal allergic rhinitis For patients age 12 and older with seasonal allergic rhinitis the dosage is one or two sprays per nostril twice daily. For patients age 12 and older with nonallergic vasomotor rhinitis the dosage is two sprays per nostril twice daily. The recommended dose of Dymista is:
- For pediatric patients (ages 5-11 years) with seasonal allergic rhinitis: 1 spray per nostril twice daily
- For patients age 12 and older with seasonal allergic rhinitis: 1 or 2 sprays per nostril twice daily
- For patients age 12 and older with nonallergic vasomotor rhinitis: 2 sprays per nostril twice daily 2
From the Research
Dymista Dose Information
- The recommended dose of Dymista is not explicitly stated in the provided studies, but the studies mention the doses of azelastine and fluticasone propionate used in the trials.
- In the study 3, azelastine was given as 1 spray/nostril bid, with each spray containing 137 μg of azelastine.
- In the same study 3, fluticasone propionate was given as 1 spray/nostril bid, with each spray containing 50 μg of fluticasone propionate.
- In the study 4, azelastine nasal spray was given as 2 sprays per nostril twice daily, and fluticasone nasal spray was given as 2 sprays per nostril once daily.
- In the study 5, the combination of fluticasone propionate and azelastine was given as a nasal spray, with fluticasone propionate at 50 mcg and azelastine at 140 mcg.
Efficacy of Dymista
- The study 6 mentions that Dymista is licensed for the relief of symptoms of moderate to severe seasonal and perennial allergic rhinitis in adults and adolescents, and that it is twice as effective as fluticasone or azelastine alone in providing relief from both nasal and ocular symptoms.
- The study 4 found that the combination of azelastine and fluticasone propionate resulted in a 37.9% improvement in the total nasal symptom score (TNSS), which was significantly better than the improvements seen with either agent alone.
- The study 5 found that the combination of fluticasone propionate and azelastine resulted in a significant reduction in symptoms compared to standalone fluticasone propionate.