Nasal sprays (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card.  This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids.  For more information, including which patients should receive the card, see HIS for details.  Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.

Supplementary notes

Sterimar nasal spray is non-formulary and is NOT recommended to be prescribed in NHS Highland.

Nasal douching has been increasingly found to be of benefit for nasal problems; clears crusting, improves mucociliary clearance and flushes away pollen and other allergens.

  • Patient information can be found on: Catarrh | NHS inform.
    This includes the advice: Use a saline nasal rinse several times a day – these can be bought from a pharmacy or made at home with half a teaspoon of salt in a pint of boiled water that’s been left to cool.
  • BSACI has a useful Nasal Douching Standard Operating Procedure for nurses that describes how to make and how to use a nasal douche.

BECLOMETASONE DIPROPIONATE - (First line)

Therapy notes

Formulation and dosage details

Formulation:

Nasal sprayOTC 50 micrograms/metered spray

Dosage:

Apply 100 micrograms (2 sprays) into each nostril twice daily or 50 micrograms (1 spray) into each nostril 3 to 4 times daily; maximum total 400 micrograms (8 sprays) daily; when symptoms controlled, reduce dose to 50 micrograms (1 spray) into each nostril twice daily.

MOMETASONE

Therapy notes

Formulation and dosage details

Formulation:

Nasal spray 50 micrograms/metered spray

Dosage:

Apply 100 micrograms (2 sprays) into each nostril once daily, increased if necessary to maximum 200 micrograms (4 sprays) into each nostril once daily; when control achieved reduce to 50 micrograms (1 spray) into each nostril once daily.

FLUTICASONE FUROATE

Therapy notes

Formulation and dosage details

Formulation:

Nasal spray (Avamys®) 27·5 micrograms/metered spray

Dosage:

Apply 55 micrograms (2 sprays) into each nostril once daily; when control achieved reduce to 27·5 micrograms (1 spray) into each nostril once daily.

FLUTICASONE WITH AZELASTINE

Therapy notes

Formulation and dosage details

Formulation:

Nasal spray (fluticasone propionate 50 micrograms, azelastine 137 micrograms/metered spray) (Dymista®)

Dosage:

Moderate to severe seasonal and perennial allergic rhinitis if monotherapy with antihistamine or corticosteroid is insufficient, 1 spray into each nostril twice daily. Discontinue after 2 months if no benefit.

Editorial Information

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