Indications Prophylaxis and treatment of seasonal allergic rhinitis symptoms; treatment of perennial allergic rhinitis symptoms; prophylaxis in patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis.

 Contraindications Standard considerations.

 Route/Dosage

Prophylaxis and Treatment of Seasonal Allergic Rhinitis/Treatment of Perennial Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily.

Children 2 to 11 yr: Nasal Inhalation 1 spray in each nostril once daily.

Prophylaxis for Seasonal Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily beginning 2 to 4 wk prior to the anticipated start of the pollen season.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Chest pain. CNS: Headache. EENT: Earache; conjunctivitis; otitis media; pharyngitis; epistaxis/blood tinged mucus; rhinitis; sinusitis; nasal irritation. GI: Vomiting; diarrhea; dyspepsia; nausea. RESPIRATORY: Coughing; upper respiratory tract infection; asthma; bronchitis; wheezing. OTHER: Viral infection; dysmenorrhea; musculoskeletal pain; arthralgia; flu-like symptoms; myalgia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Because other corticosteroids are excreted in human milk, use caution. CHILDREN: Safety and efficacy in children under 2 yr not established. Oral corticosteroids may suppress growth in children and adolescents, particularly with higher doses over extended periods. Immunology: Patients receiving immunosuppressant agents are more susceptible to infections than healthy adults. If a patient is exposed to measles or chickenpox, appropriate prophylaxis and treatment may be indicated.

 Administration/Storage

• For nasal use only.
• Usual dose is 1 to 2 sprays once daily.
• Prime unit with 10 actuations before first use or with 2 actuations if spray has not been used for more than 7 days.
• Have patient prepare nostrils before use by gently blowing nose and pretreating with topical decongestant and saline lavage if indicated.
• Instruct patient in proper administration technique and monitor for proper use.
• Store at controlled room temperature protected from prolonged exposure to direct light.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note history of recent nasal trauma or surgery or nasal septum ulcers.
• If change is made from systemic (oral) to intranasal corticosteroid, observe patient carefully for signs of steroid withdrawal (eg, nausea, fatigue, dizziness, hypotension, depression, joint and muscle pain). Notify health care provider if these signs occur.
• Monitor patient for improvement in nasal symptoms.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read and follow the Patient’s Instructions for Use carefully.
• Advise patient that medication is used once daily to prevent or control nasal symptoms and is not intended to be used on an “as needed” basis.
• Instruct patient that pump must be primed before using for the first time by actuating 10 times or until a fine mist appears. Remind patient that further priming is not necessary unless medication has not been used for more than 1 wk, in which case repriming with 2 actuations or until fine mist appears is advised.
• Instruct patient to shake medication well before each use.
• Instruct patient on the following proper administration technique: blow nose gently to clear nasal passages; if congested, use a topical nasal decongestant 5 to 10 min before medication administration; use saline lavage if necessary to remove secretions; clean outer portion of nose with damp tissue; insert nozzle into nostril; while using finger to keep other nostril closed, inhale while activating the pump; repeat with other nostril.
• Caution patient to not spray directly into the eyes or onto the nasal septum.
• Inform patient that symptoms should begin to improve within 2 days of starting therapy but may take up to 2 wk before max benefit is noted.
• Warn patient that increasing the number of sprays or frequency of use does not increase the effectiveness of the drug but may increase the incidence and severity of side effects.
• Advise patient to contact health care provider if symptoms do not improve or become worse while using this medication.
• If patient is being converted from oral to nasal steroids, review signs and symptoms of adrenal insufficiency that may occur days or weeks after conversion is complete.
• Warn patients who are also taking immunosuppressant doses of corticosteroids to avoid exposure to measles or chickenpox and, if exposed, to seek medical advice without delay.

Indications for Drugs ::

 Action Has potent anti-inflammatory effects on the nasal passages.

 Indications Prophylaxis and treatment of seasonal allergic rhinitis symptoms; treatment of perennial allergic rhinitis symptoms; prophylaxis in patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis.

 Contraindications Standard considerations.

 Route/Dosage

Prophylaxis and Treatment of Seasonal Allergic Rhinitis/Treatment of Perennial Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily.

Children 2 to 11 yr: Nasal Inhalation 1 spray in each nostril once daily.

Prophylaxis for Seasonal Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily beginning 2 to 4 wk prior to the anticipated start of the pollen season.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Chest pain. CNS: Headache. EENT: Earache; conjunctivitis; otitis media; pharyngitis; epistaxis/blood tinged mucus; rhinitis; sinusitis; nasal irritation. GI: Vomiting; diarrhea; dyspepsia; nausea. RESPIRATORY: Coughing; upper respiratory tract infection; asthma; bronchitis; wheezing. OTHER: Viral infection; dysmenorrhea; musculoskeletal pain; arthralgia; flu-like symptoms; myalgia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Because other corticosteroids are excreted in human milk, use caution. CHILDREN: Safety and efficacy in children under 2 yr not established. Oral corticosteroids may suppress growth in children and adolescents, particularly with higher doses over extended periods. Immunology: Patients receiving immunosuppressant agents are more susceptible to infections than healthy adults. If a patient is exposed to measles or chickenpox, appropriate prophylaxis and treatment may be indicated.

 Administration/Storage

• For nasal use only.
• Usual dose is 1 to 2 sprays once daily.
• Prime unit with 10 actuations before first use or with 2 actuations if spray has not been used for more than 7 days.
• Have patient prepare nostrils before use by gently blowing nose and pretreating with topical decongestant and saline lavage if indicated.
• Instruct patient in proper administration technique and monitor for proper use.
• Store at controlled room temperature protected from prolonged exposure to direct light.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note history of recent nasal trauma or surgery or nasal septum ulcers.
• If change is made from systemic (oral) to intranasal corticosteroid, observe patient carefully for signs of steroid withdrawal (eg, nausea, fatigue, dizziness, hypotension, depression, joint and muscle pain). Notify health care provider if these signs occur.
• Monitor patient for improvement in nasal symptoms.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read and follow the Patient’s Instructions for Use carefully.
• Advise patient that medication is used once daily to prevent or control nasal symptoms and is not intended to be used on an “as needed” basis.
• Instruct patient that pump must be primed before using for the first time by actuating 10 times or until a fine mist appears. Remind patient that further priming is not necessary unless medication has not been used for more than 1 wk, in which case repriming with 2 actuations or until fine mist appears is advised.
• Instruct patient to shake medication well before each use.
• Instruct patient on the following proper administration technique: blow nose gently to clear nasal passages; if congested, use a topical nasal decongestant 5 to 10 min before medication administration; use saline lavage if necessary to remove secretions; clean outer portion of nose with damp tissue; insert nozzle into nostril; while using finger to keep other nostril closed, inhale while activating the pump; repeat with other nostril.
• Caution patient to not spray directly into the eyes or onto the nasal septum.
• Inform patient that symptoms should begin to improve within 2 days of starting therapy but may take up to 2 wk before max benefit is noted.
• Warn patient that increasing the number of sprays or frequency of use does not increase the effectiveness of the drug but may increase the incidence and severity of side effects.
• Advise patient to contact health care provider if symptoms do not improve or become worse while using this medication.
• If patient is being converted from oral to nasal steroids, review signs and symptoms of adrenal insufficiency that may occur days or weeks after conversion is complete.
• Warn patients who are also taking immunosuppressant doses of corticosteroids to avoid exposure to measles or chickenpox and, if exposed, to seek medical advice without delay.

Drug Dose ::

 Action Has potent anti-inflammatory effects on the nasal passages.

 Indications Prophylaxis and treatment of seasonal allergic rhinitis symptoms; treatment of perennial allergic rhinitis symptoms; prophylaxis in patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis.

 Contraindications Standard considerations.

 Route/Dosage

Prophylaxis and Treatment of Seasonal Allergic Rhinitis/Treatment of Perennial Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily.

Children 2 to 11 yr: Nasal Inhalation 1 spray in each nostril once daily.

Prophylaxis for Seasonal Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily beginning 2 to 4 wk prior to the anticipated start of the pollen season.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Chest pain. CNS: Headache. EENT: Earache; conjunctivitis; otitis media; pharyngitis; epistaxis/blood tinged mucus; rhinitis; sinusitis; nasal irritation. GI: Vomiting; diarrhea; dyspepsia; nausea. RESPIRATORY: Coughing; upper respiratory tract infection; asthma; bronchitis; wheezing. OTHER: Viral infection; dysmenorrhea; musculoskeletal pain; arthralgia; flu-like symptoms; myalgia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Because other corticosteroids are excreted in human milk, use caution. CHILDREN: Safety and efficacy in children under 2 yr not established. Oral corticosteroids may suppress growth in children and adolescents, particularly with higher doses over extended periods. Immunology: Patients receiving immunosuppressant agents are more susceptible to infections than healthy adults. If a patient is exposed to measles or chickenpox, appropriate prophylaxis and treatment may be indicated.

 Administration/Storage

• For nasal use only.
• Usual dose is 1 to 2 sprays once daily.
• Prime unit with 10 actuations before first use or with 2 actuations if spray has not been used for more than 7 days.
• Have patient prepare nostrils before use by gently blowing nose and pretreating with topical decongestant and saline lavage if indicated.
• Instruct patient in proper administration technique and monitor for proper use.
• Store at controlled room temperature protected from prolonged exposure to direct light.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note history of recent nasal trauma or surgery or nasal septum ulcers.
• If change is made from systemic (oral) to intranasal corticosteroid, observe patient carefully for signs of steroid withdrawal (eg, nausea, fatigue, dizziness, hypotension, depression, joint and muscle pain). Notify health care provider if these signs occur.
• Monitor patient for improvement in nasal symptoms.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read and follow the Patient’s Instructions for Use carefully.
• Advise patient that medication is used once daily to prevent or control nasal symptoms and is not intended to be used on an “as needed” basis.
• Instruct patient that pump must be primed before using for the first time by actuating 10 times or until a fine mist appears. Remind patient that further priming is not necessary unless medication has not been used for more than 1 wk, in which case repriming with 2 actuations or until fine mist appears is advised.
• Instruct patient to shake medication well before each use.
• Instruct patient on the following proper administration technique: blow nose gently to clear nasal passages; if congested, use a topical nasal decongestant 5 to 10 min before medication administration; use saline lavage if necessary to remove secretions; clean outer portion of nose with damp tissue; insert nozzle into nostril; while using finger to keep other nostril closed, inhale while activating the pump; repeat with other nostril.
• Caution patient to not spray directly into the eyes or onto the nasal septum.
• Inform patient that symptoms should begin to improve within 2 days of starting therapy but may take up to 2 wk before max benefit is noted.
• Warn patient that increasing the number of sprays or frequency of use does not increase the effectiveness of the drug but may increase the incidence and severity of side effects.
• Advise patient to contact health care provider if symptoms do not improve or become worse while using this medication.
• If patient is being converted from oral to nasal steroids, review signs and symptoms of adrenal insufficiency that may occur days or weeks after conversion is complete.
• Warn patients who are also taking immunosuppressant doses of corticosteroids to avoid exposure to measles or chickenpox and, if exposed, to seek medical advice without delay.

Contraindication ::

 Action Has potent anti-inflammatory effects on the nasal passages.

 Indications Prophylaxis and treatment of seasonal allergic rhinitis symptoms; treatment of perennial allergic rhinitis symptoms; prophylaxis in patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis.

 Contraindications Standard considerations.

 Route/Dosage

Prophylaxis and Treatment of Seasonal Allergic Rhinitis/Treatment of Perennial Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily.

Children 2 to 11 yr: Nasal Inhalation 1 spray in each nostril once daily.

Prophylaxis for Seasonal Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily beginning 2 to 4 wk prior to the anticipated start of the pollen season.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Chest pain. CNS: Headache. EENT: Earache; conjunctivitis; otitis media; pharyngitis; epistaxis/blood tinged mucus; rhinitis; sinusitis; nasal irritation. GI: Vomiting; diarrhea; dyspepsia; nausea. RESPIRATORY: Coughing; upper respiratory tract infection; asthma; bronchitis; wheezing. OTHER: Viral infection; dysmenorrhea; musculoskeletal pain; arthralgia; flu-like symptoms; myalgia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Because other corticosteroids are excreted in human milk, use caution. CHILDREN: Safety and efficacy in children under 2 yr not established. Oral corticosteroids may suppress growth in children and adolescents, particularly with higher doses over extended periods. Immunology: Patients receiving immunosuppressant agents are more susceptible to infections than healthy adults. If a patient is exposed to measles or chickenpox, appropriate prophylaxis and treatment may be indicated.

 Administration/Storage

• For nasal use only.
• Usual dose is 1 to 2 sprays once daily.
• Prime unit with 10 actuations before first use or with 2 actuations if spray has not been used for more than 7 days.
• Have patient prepare nostrils before use by gently blowing nose and pretreating with topical decongestant and saline lavage if indicated.
• Instruct patient in proper administration technique and monitor for proper use.
• Store at controlled room temperature protected from prolonged exposure to direct light.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note history of recent nasal trauma or surgery or nasal septum ulcers.
• If change is made from systemic (oral) to intranasal corticosteroid, observe patient carefully for signs of steroid withdrawal (eg, nausea, fatigue, dizziness, hypotension, depression, joint and muscle pain). Notify health care provider if these signs occur.
• Monitor patient for improvement in nasal symptoms.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read and follow the Patient’s Instructions for Use carefully.
• Advise patient that medication is used once daily to prevent or control nasal symptoms and is not intended to be used on an “as needed” basis.
• Instruct patient that pump must be primed before using for the first time by actuating 10 times or until a fine mist appears. Remind patient that further priming is not necessary unless medication has not been used for more than 1 wk, in which case repriming with 2 actuations or until fine mist appears is advised.
• Instruct patient to shake medication well before each use.
• Instruct patient on the following proper administration technique: blow nose gently to clear nasal passages; if congested, use a topical nasal decongestant 5 to 10 min before medication administration; use saline lavage if necessary to remove secretions; clean outer portion of nose with damp tissue; insert nozzle into nostril; while using finger to keep other nostril closed, inhale while activating the pump; repeat with other nostril.
• Caution patient to not spray directly into the eyes or onto the nasal septum.
• Inform patient that symptoms should begin to improve within 2 days of starting therapy but may take up to 2 wk before max benefit is noted.
• Warn patient that increasing the number of sprays or frequency of use does not increase the effectiveness of the drug but may increase the incidence and severity of side effects.
• Advise patient to contact health care provider if symptoms do not improve or become worse while using this medication.
• If patient is being converted from oral to nasal steroids, review signs and symptoms of adrenal insufficiency that may occur days or weeks after conversion is complete.
• Warn patients who are also taking immunosuppressant doses of corticosteroids to avoid exposure to measles or chickenpox and, if exposed, to seek medical advice without delay.

Drug Precautions ::

 Action Has potent anti-inflammatory effects on the nasal passages.

 Indications Prophylaxis and treatment of seasonal allergic rhinitis symptoms; treatment of perennial allergic rhinitis symptoms; prophylaxis in patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis.

 Contraindications Standard considerations.

 Route/Dosage

Prophylaxis and Treatment of Seasonal Allergic Rhinitis/Treatment of Perennial Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily.

Children 2 to 11 yr: Nasal Inhalation 1 spray in each nostril once daily.

Prophylaxis for Seasonal Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily beginning 2 to 4 wk prior to the anticipated start of the pollen season.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Chest pain. CNS: Headache. EENT: Earache; conjunctivitis; otitis media; pharyngitis; epistaxis/blood tinged mucus; rhinitis; sinusitis; nasal irritation. GI: Vomiting; diarrhea; dyspepsia; nausea. RESPIRATORY: Coughing; upper respiratory tract infection; asthma; bronchitis; wheezing. OTHER: Viral infection; dysmenorrhea; musculoskeletal pain; arthralgia; flu-like symptoms; myalgia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Because other corticosteroids are excreted in human milk, use caution. CHILDREN: Safety and efficacy in children under 2 yr not established. Oral corticosteroids may suppress growth in children and adolescents, particularly with higher doses over extended periods. Immunology: Patients receiving immunosuppressant agents are more susceptible to infections than healthy adults. If a patient is exposed to measles or chickenpox, appropriate prophylaxis and treatment may be indicated.

 Administration/Storage

• For nasal use only.
• Usual dose is 1 to 2 sprays once daily.
• Prime unit with 10 actuations before first use or with 2 actuations if spray has not been used for more than 7 days.
• Have patient prepare nostrils before use by gently blowing nose and pretreating with topical decongestant and saline lavage if indicated.
• Instruct patient in proper administration technique and monitor for proper use.
• Store at controlled room temperature protected from prolonged exposure to direct light.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note history of recent nasal trauma or surgery or nasal septum ulcers.
• If change is made from systemic (oral) to intranasal corticosteroid, observe patient carefully for signs of steroid withdrawal (eg, nausea, fatigue, dizziness, hypotension, depression, joint and muscle pain). Notify health care provider if these signs occur.
• Monitor patient for improvement in nasal symptoms.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read and follow the Patient’s Instructions for Use carefully.
• Advise patient that medication is used once daily to prevent or control nasal symptoms and is not intended to be used on an “as needed” basis.
• Instruct patient that pump must be primed before using for the first time by actuating 10 times or until a fine mist appears. Remind patient that further priming is not necessary unless medication has not been used for more than 1 wk, in which case repriming with 2 actuations or until fine mist appears is advised.
• Instruct patient to shake medication well before each use.
• Instruct patient on the following proper administration technique: blow nose gently to clear nasal passages; if congested, use a topical nasal decongestant 5 to 10 min before medication administration; use saline lavage if necessary to remove secretions; clean outer portion of nose with damp tissue; insert nozzle into nostril; while using finger to keep other nostril closed, inhale while activating the pump; repeat with other nostril.
• Caution patient to not spray directly into the eyes or onto the nasal septum.
• Inform patient that symptoms should begin to improve within 2 days of starting therapy but may take up to 2 wk before max benefit is noted.
• Warn patient that increasing the number of sprays or frequency of use does not increase the effectiveness of the drug but may increase the incidence and severity of side effects.
• Advise patient to contact health care provider if symptoms do not improve or become worse while using this medication.
• If patient is being converted from oral to nasal steroids, review signs and symptoms of adrenal insufficiency that may occur days or weeks after conversion is complete.
• Warn patients who are also taking immunosuppressant doses of corticosteroids to avoid exposure to measles or chickenpox and, if exposed, to seek medical advice without delay.

Drug Side Effects ::

 Action Has potent anti-inflammatory effects on the nasal passages.

 Indications Prophylaxis and treatment of seasonal allergic rhinitis symptoms; treatment of perennial allergic rhinitis symptoms; prophylaxis in patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis.

 Contraindications Standard considerations.

 Route/Dosage

Prophylaxis and Treatment of Seasonal Allergic Rhinitis/Treatment of Perennial Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily.

Children 2 to 11 yr: Nasal Inhalation 1 spray in each nostril once daily.

Prophylaxis for Seasonal Allergic Rhinitis

Adults and Children at least 12 yr: Nasal Inhalation 2 sprays in each nostril once daily beginning 2 to 4 wk prior to the anticipated start of the pollen season.

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Chest pain. CNS: Headache. EENT: Earache; conjunctivitis; otitis media; pharyngitis; epistaxis/blood tinged mucus; rhinitis; sinusitis; nasal irritation. GI: Vomiting; diarrhea; dyspepsia; nausea. RESPIRATORY: Coughing; upper respiratory tract infection; asthma; bronchitis; wheezing. OTHER: Viral infection; dysmenorrhea; musculoskeletal pain; arthralgia; flu-like symptoms; myalgia.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Because other corticosteroids are excreted in human milk, use caution. CHILDREN: Safety and efficacy in children under 2 yr not established. Oral corticosteroids may suppress growth in children and adolescents, particularly with higher doses over extended periods. Immunology: Patients receiving immunosuppressant agents are more susceptible to infections than healthy adults. If a patient is exposed to measles or chickenpox, appropriate prophylaxis and treatment may be indicated.

 Administration/Storage

• For nasal use only.
• Usual dose is 1 to 2 sprays once daily.
• Prime unit with 10 actuations before first use or with 2 actuations if spray has not been used for more than 7 days.
• Have patient prepare nostrils before use by gently blowing nose and pretreating with topical decongestant and saline lavage if indicated.
• Instruct patient in proper administration technique and monitor for proper use.
• Store at controlled room temperature protected from prolonged exposure to direct light.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Note history of recent nasal trauma or surgery or nasal septum ulcers.
• If change is made from systemic (oral) to intranasal corticosteroid, observe patient carefully for signs of steroid withdrawal (eg, nausea, fatigue, dizziness, hypotension, depression, joint and muscle pain). Notify health care provider if these signs occur.
• Monitor patient for improvement in nasal symptoms.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read and follow the Patient’s Instructions for Use carefully.
• Advise patient that medication is used once daily to prevent or control nasal symptoms and is not intended to be used on an “as needed” basis.
• Instruct patient that pump must be primed before using for the first time by actuating 10 times or until a fine mist appears. Remind patient that further priming is not necessary unless medication has not been used for more than 1 wk, in which case repriming with 2 actuations or until fine mist appears is advised.
• Instruct patient to shake medication well before each use.
• Instruct patient on the following proper administration technique: blow nose gently to clear nasal passages; if congested, use a topical nasal decongestant 5 to 10 min before medication administration; use saline lavage if necessary to remove secretions; clean outer portion of nose with damp tissue; insert nozzle into nostril; while using finger to keep other nostril closed, inhale while activating the pump; repeat with other nostril.
• Caution patient to not spray directly into the eyes or onto the nasal septum.
• Inform patient that symptoms should begin to improve within 2 days of starting therapy but may take up to 2 wk before max benefit is noted.
• Warn patient that increasing the number of sprays or frequency of use does not increase the effectiveness of the drug but may increase the incidence and severity of side effects.
• Advise patient to contact health care provider if symptoms do not improve or become worse while using this medication.
• If patient is being converted from oral to nasal steroids, review signs and symptoms of adrenal insufficiency that may occur days or weeks after conversion is complete.
• Warn patients who are also taking immunosuppressant doses of corticosteroids to avoid exposure to measles or chickenpox and, if exposed, to seek medical advice without delay.

Drug Mode of Action ::  

 Action Has potent anti-inflammatory effects on the nasal passages.