Flunisolide nasal prep

Indications

Flunisolide nasal prep is used for: Seasonal Allergic Rhinitis

Adult Dose

Seasonal Allergic Rhinitis 2 sprays each nostril BID; may increase to TID/QID

Child Dose

Seasonal Allergic Rhinitis <6 years: Safety and efficacy not established 6-14 years: 1 spray each nostril TID, or 2 sprays each nostril BID

Renal Dose

Administration

Prime spray by actuating 5-6 times first before use, if it has not been used for >4 days, or if it has been disassembled for cleaning

Contra Indications

Hypersensitivity Do not use with untreated local infection involving the nasal mucosa Recent nasal surgery/injury

Precautions

Replacement of systemic corticosteroids with topical administration can be accompanied by signs of adrenal insufficiency: some patients may experience withdrawal symptoms Intranasal corticosteroids may cause a reduction in growth velocity when administered to pediatric patients Rare reports of nasal septal perforation Temporary or permanent loss of sense of smell or taste reported Because of the inhibitory effect of corticosteroids on wound healing, a nasal corticosteroid should be used with caution in patients who have experienced recent nasal septal ulcers, recurrent epistaxis, nasal surgery or trauma, until healing has occurred Systemic corticoid effects typical of Cushing's syndrome are minimal with recommended doses of topical steroids, this potential increases with excessive doses Corticosteroids are known to cause immunosuppression resulting in increased susceptibility to infection

Pregnancy-Lactation

Pregnancy There are no studies in pregnant women to inform a drug-associated risk for birth defects or miscarriage; there are clinical considerations with use in pregnant women to inform a drug-associated risk; in animal reproduction studies, flunisolide administered to pregnant rats and rabbits during of organogenesis produced fetal structural abnormalities; dose in rats and rabbits was approximately 3 and 1 times maximum recommended human daily dose, respectively Lactation There is no information on presence of flunisolide in human milk, or effects on breast fed child, or on milk production; because other corticosteroids are excreted in human milk, exercise caution when administering therapy to nursing women The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition

Interactions

Side Effects

Side effects of Flunisolide nasal prep : >10% Nasal burning/stinging (13-44%) Aftertaste (8-17%) 1-10% Nausea Epistaxis Nasal dryness Pharyngitis Cough increased <1% Hoarseness Nasal ulceration Abnormal sense of smell Sinusitis Vertical growth suppression

Mode of Action

Elicits potent glucocorticoid and weak mineralocorticoid effects; provides direct anti-inflammatory actions to nasal mucosa