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Flonase (or fluticasone) is a liquid nasal spray to use only in the nose for treating symptoms of periodic allergic rhinitis (seasonal) and perennial nonallergic rhinitis (year around); however, it will not cure either condition of the nose and nasal sinuses. Rather, it is intended to help to relieve symptoms including nasal swelling, sneezing, stuffy, runny, or itchy nose. Prolonged use can mean that the side effects of using it may become problematic, so it's important to use it cautiously. It is in a class of medication that can cause many and some severe difficulties.

Steps

Before Using Flonase (Fluticasone)

1. Tell your doctor and pharmacist if you are allergic to fluticasone, or to any medication.
   
   
   
2. Tell your doctor and pharmacist any prescription or nonprescription medications, vitamins, nutritional supplements and herbal products you take or took recently. Your doctor may need to change your doses of Flonase or other drugs among your medications––or need to monitor you carefully for possible side effects.
   
   
   
3. Tell your doctor if you have:
   
   
   
   • ever had tuberculosis (a type of infection) in your lungs,
   • cataracts (clouding in the lens of your eye),
   • glaucoma (an eye fluid-pressure disease),
   • sores in your nose now,
   • any type of untreated infection,
   • herpes infection in your eye (a type of infection that causes a sore on the eyelid or eye surface).
   • recently had surgery on your nose
   • recently injured your nose in any way.
4. Tell your doctor, if you are pregnant, plan to become pregnant, or you're breastfeeding. If you become pregnant while using fluticasone, call your doctor immediately.
   
   
   

Using Flonase Properly

1. Get full, official, printed drug information from your pharmacist or doctor. It is usually sprayed in each nostril one time per day––or two times per day, morning and evening. It is sometimes used to treat symptoms long term or for only a number of days. Follow the instructions of your prescription exactly, and ask your doctor or pharmacist to explain anything you may not understand.
   
   
   
   • Do not use any more or less in amount or frequency your doctor has prescribed.
   • Do not swallow nasal spray that may drip into the back of your mouth/throat. If you do accidentally do this, spit it out.
   • Be careful not to get it in your eyes or mouth.
2. Use Fluticasone on the prescribed schedule to work best as instructed, and for the times instructed, or it will not work properly––unless your doctor has told you to "use it as needed". Continue to use fluticasone when you feel well, and do not stop using fluticasone without first talking to your doctor.
   
   
   
3. Tell your doctor immediately should you encounter any problems using this nasal spray which Flonase presents many potential side effects, some serious, with possibly severe complications.^[1] Be especially alert if you've overused it or if you develop sensitivity. Things to be aware of include:
   
   
   
   • Collapse: Call the Emergency Services . If the victim has collapsed or is not breathing, get local emergency services.
   • Overdose: call your local poison control center through 1-800-222-1222.
   • problems in vision (sudden blurriness, spots in field of vision)
   • enlarged face and neck (edema - retaining excess bodily fluids, or possibly unusual musculature sometimes caused by steroids)
   • wheezing breaths, hoarse voice, injury to your nose
   • difficult breathing (similar to asthma), or problems swallowing
   • extreme tiredness (fatigue), muscle weakness (lack of energy)
   • "off schedule" menstruation periods
   • painful white patches in your nose or throat (ulcers)
   • hives, rash, itch, "fresh" or increased pimples/acne
   • symptoms of flu, soreness of throat, swollen throat
   • facial edema: swollen tongue, lips or eyelids, swollen face
   • swollen hands, feet, ankles, lower leg swelling, edema
   • unexpected bruising
4. Beware of Flonase (Fluticasone) causing less serious side effects, as well as the more serious ones. Tell your doctor if any of these less serious symptoms are severe or do not go away:
   
   
   
   • headache, dizziness,
   • bloody mucus in nose, nosebleed
   • runny nose, cough, burning or irritation in the nose
   • nausea, vomiting, stomach pain, diarrhea.
5. Allow a day or a few days for your prescribed use to take effect. The symptoms probably will not begin to improve in less than 12 hours after your first use of Flonase, and it may take several days or longer before you feel the full effect of fluticasone. Your doctor may start you on a higher dose of fluticasone nasal spray for awhile and may then decrease your dose after your symptoms are more controlled.
   
   
   

Preparing to Use the Nasal Spray

1. Shake the pump-bottle gently, then remove the sprayer's dust cover.
   
   
   
2. To use it the first time or after not having used it for a week or more, you must prime it again by following two steps below. If you have used the pump in the past week, skip to the "Application".
   
   
   
3. Hold the pump applicator between your forefinger and middle finger with the bottom of the bottle supported by your thumb––while holding it vertically.
   
   
   
4. Avoid both your face and body when priming and preparing. Caution: point the applicator pump away from yourself during this process.
   
   
   
5. Before using the pump the first time, press down and let off pressure (pumping it) six times. If you have already used the pump before, but not in 6 days or fewer, then press down and release the pump only until you see a fine spray, while holding it vertically but away from the body and face.
   
   
   

Application

1. Blow your nose until you have cleared your nostrils.
   
   
   
2. Be sure to keep the bottle upright, and hold one nostril closed with a finger. Lean your head slightly forward and carefully place the nasal applicator into the other nostril.
   
   
   
3. Hold the pump with the applicator between your forefinger and middle finger and the bottom supported by your thumb.
   
   
   
4. While breathing in through your nose, use your forefinger and middle finger to press firmly down on the applicator (with fingers) and on the thumb and expel a spray.
   
   
   
5. Take a normal breath in through that nostril but breathe out through your mouth to not lose the medication.
   
   
   
6. To use a second spray in that same nostril, repeat the application steps, only if your doctor told you to use two sprays per dose. Repeat the steps in the other nostril.
   
   
   
7. Wipe the applicator with clean tissue and replace the dust cover.
   
   
   

Taking Extra Precautions

1. Carry a card or wear a medical identification (ID) bracelet to let emergency personnel know that you may need corticosteroids in an emergency, such as during hospitalization.
   
   
   
2. Call your doctor right away if you get sick. Be sure that all healthcare providers who treat you know that you recently replaced your oral steroid with fluticasone inhalation/spray.
   
   
   
3. Watch out for infections. Corticosteroid such as fluticasone may decrease your ability to fight infection.
   
   
   
4. Stay away from people who are sick and wash your hands often. Be especially careful to stay away from people who have chicken pox or measles. Tell your doctor right away if you find out that you have been around someone who has one of these viruses.
   
   
   
5. Before you have surgery, including dental surgery, tell the doctor or dentist that you're using Flonase (fluticasone).
   
   
   

Tips

• Flonase is a steroid: corticosteroid [kawr-tuh-koh-ster-oids, -steer- ] noun Biochemistry -- any of a class of steroids, such as aldosterone, hydrocortisone, or cortisone, do occur in nature, especially as a secretion of the adrenal cortex, but also as a synthesized product.
  
  Also called cor·ti·coid  [kawr-tuh-koid]^[2] Fluticasone exerts its beneficial effects by inhibiting several types of cells and chemicals involved in allergic, immune and inflammatory responses from the over-activity in these processes. When used as a nasal inhaler or spray, the medication goes directly to the lining within the nose, and little is absorbed into the rest of the body.
• If you have been taking oral steroids (caps or tabs), your doctor may need to gradually decrease your steroid dose after you begin using fluticasone (corticosteroid).
• Be cautious because your body may be less able to cope with stress such as:
  • surgery, illness,
  • severe asthma attack,
  • or injury during this time.
• Keep a record of the number of times you sprayed using that bottle and discard the bottle after you use a total of 120 sprays, and throw it away even when it still contains some liquid.
• Special caution is needed for several months as your body adjusts to the change in steroid medication. If you have any other medical conditions, such as arthritis, or eczema (a skin disease), they may worsen when your oral steroid dose is decreased.
  • Tell your doctor if this happens, or if you experience any of the following symptoms during this time:
    • extreme tiredness, muscle weakness or pain;
    • sudden pain in stomach, lower body or legs;
    • loss of appetite; weight loss; upset stomach; vomiting; diarrhea;
    • dizziness; fainting;
    • depression; irritability;
    • darkening of skin (jaundice).
• Each bottle of fluticasone nasal spray is for only 120 sprays. The bottle may not be emptied after 120 sprays are used but when contents are getting low, then each additional spray may not give the accurate amount of medication.

Warnings =

• Take note that children may grow more slowly using Flonase. It is unknown whether fluticasone use will decreases the full adult height that children would otherwise reach. Talk to your child's doctor about the other risks, as well as this, from using this medication with your child.

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Sources and Citations

• Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online at http://ift.tt/V7HoJ4
• Nih.gov "Medlineplus, Drug Info, Meds" report used information with the "American Society of Health-System Pharmacists, Inc. Disclaimer", AHFS® Consumer Medication Information. © Copyright, 2011. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland, USA.

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