Saturday, November 24, 2007

How Do Drugs Work - Nasal Steroid Sprays

Hello Everyone,

The folks with allergies are still out there and in South Texas allergy season doesn't end anytime soon. So far, we have talked about antihistamines and decongestants that are used to treat allergy symptoms. There is another class of medications to use in your fight against seasonal allergies and these are the nasal corticosteroids.

Nasal corticosteroids, also know as Inhaled Nasal Steroids, reduce swelling and secretions by decreasing histamine and prostaglandins along with other substances in the nose. Nasal corticosteroids have been shown to improve symptoms of sneezing, itching of the nose, runny nose, and congestion.

According to the Joint Council of Allergy, Asthma and Immunology (JCAAI), nasally inhaled corticosteroids are the most effective medication class for controlling symptoms of allergic rhinitis. They also recommend that the inhaled nasal corticosteroids should be used as first line therapy for the treatment of allergy symptoms. The American Academy of Allergy, Asthma and Immunology (AAAAI) also recommend nasal corticosteroids for the initial management of allergy symptoms.1

Drugs in this Class

Beclomethasone Nasal Inhalation (Beconase AQ) 2x/day
Budesonide Nasal Inhaler (Rhinocort Aqua) 1x/day
Flunisolide Nasal Inhalation (Nasarel) 2 - 3x/day Generic available
Fluticasone Nasal Inhalation (Flonase) 1x/day Generic Available
Fluticasone Nasal Inhalation (Veramyst) 1x/day
Mometasone Nasal Spray (Nasonex) 1x/day
Triamcinolone Nasal Inhalation (Nasacort HFA) 1x/day
Triamcinolone Nasal Spray (Nasacort AQ) 1x/day

These medications are only available with a prescription. Therefore, you must schedule a visit to your doctor's office to get a prescription.

Most scientific studies state that the effectiveness between all nasal corticosteroids are similar. Since individual responses may vary, you may have to try several different brands to see which drug is the most effective for you.

These medications do not provide the immediate relief that other types of medication can. It is recommended that these corticosteroid nasal sprays be started before symptoms occur. So if you know that cedar season is coming, you should plan ahead and start your therapy. Remember, corticosteroid nasal sprays are not intended to relieve acute symptoms so they need to be used on a regular (daily) basis. Once control has been achieved the dosage should be reduced to the minimum dose to control your symptoms.

Side effects are generally minimal with nasal irritation (burning/stinging sensation) and taste disturbances (dysgeusia) being the most common.

As always, follow the prescribing directions. If you have any questions, please talk with your Pharmacist or Physician or email me.

Thanks for your support,

Dr. Paul

1. American Academy of Allergy, Asthma and Immunology. Practice parameters for diagnosis and management of rhinitis. Available at: Accessed November 23 2007.

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