Intranasal corticosteroid
ATC code: R01AD12 (Fluticasone furoate (nasal))
Brand names
Flonase Sensimist, Veramyst
A synthetic corticosteroid with high glucocorticoid receptor affinity and very low systemic bioavailability via the nasal route (under 0.5%). Compared with fluticasone propionate, improved receptor binding profile and longer tissue activity. Suppresses inflammatory mediator release and inflammatory cell migration into nasal mucosa. Onset 8 hours after first dose.
First line
First-line for moderate-to-severe allergic rhinitis per ARIA 2020 alongside other intranasal corticosteroids (mometasone, budesonide, fluticasone propionate). Adults and children over 12: 2 sprays (55 mcg) per nostril once daily; children 6–11: 1 spray. Particularly effective with seasonal allergic rhinitis with conjunctivitis symptoms.
First line
First-line for chronic rhinosinusitis per EPOS 2020. Long-term use, usually several months.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Nasal fluticasone furoate is used in children and adults for cold prevention and as nasal mucosal protection outside an allergic rhinitis or nasal polyps indication (approved indications: AEMPS Ficha Técnica, 2024). No clinical studies of prophylactic use for colds exist. The drug can cause nosebleeds, nasal septum perforation on long-term use, hoarseness, and with systemic absorption at high doses HPA axis suppression. If nasal fluticasone furoate was prescribed for cold prevention, consider seeking a second opinion.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
T1 use acceptable when symptomatic measures are insufficient. Budesonide has more pregnancy data and may be preferred.
Systemic bioavailability is low; milk transfer is minimal. Compatible with breastfeeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Fluticasone furoate (nasal) is evaluated for the following indications with varying evidence strength: Chronic rhinosinusitis (evidence tier A), Allergic rhinitis (evidence tier A), Immune support and respiratory infection care (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Fluticasone furoate (nasal) (≥ 1 in 100): Epistaxis, Nasal mucosa irritation, Headache, Pharyngeal dryness. See the Safety section for uncommon and serious reactions.
FDA category C. T1 use acceptable when symptomatic measures are insufficient. Budesonide has more pregnancy data and may be preferred.
Systemic bioavailability is low; milk transfer is minimal. Compatible with breastfeeding.
Fluticasone furoate (nasal) is contraindicated in: Fluticasone hypersensitivity; Untreated nasal mucosal infection; Recent nasal trauma or surgery (until healing). Full list in the Safety section.