flunisolide (nasal)

Contraindicated in:

Hypersensitivity (product contains propylene glycol and polyethylene glycol).

Use Cautiously in:

Active untreated infections;
Diabetes;
Glaucoma;
Underlying immunosuppression;
Systemic corticosteroid therapy (should not be abruptly discontinued when intranasal therapy is started);
Recent nasal trauma, septal ulcers, or surgery (wound healing may be impaired);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Children <6 yr (safety and effectiveness not established).

Adv. Reactions/Side Effects ⬆ ⬇

EENT: nasal burning, epistaxis, nasal dryness, nasal irritation, nasopharyngeal fungal infection, pharyngitis

Endo: ↓growth (children), adrenal suppression (with ↑ dose or long-term therapy)

GI: after taste, nausea

Resp: cough

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

(Generic available)

Nasal spray: 25 mcg/metered spray in 25-mL bottle (200 metered sprays)

Route/Dosage ⬆ ⬇

Intranasal (Adults and Children >14 yr): 2 sprays in each nostril twice daily; may ↑ to 2 sprays in each nostril 3 times daily if greater effect needed after 4–7 days (not to exceed 8 sprays in each nostril/day).
Intranasal (Children 6–14 yr): 1 spray in each nostril 3 times daily or 2 sprays in each nostril twice daily (not to exceed 4 sprays in each nostril/day).

Action ⬆ ⬇

Potent, locally acting anti-inflammatory and immune modifier.

Therapeutic effects:

Decrease in symptoms of allergic rhinitis.

Classifications ⬆ ⬇

Therapeutic Classification: corticosteroids

Pharmacologic Classification: corticosteroids

Pharmacokinetics ⬆ ⬇

Absorption: 50%; action is primarily local following nasal use.

Distribution: Unknown.

Metabolism/Excretion: Rapidly and extensively metabolized by the liver; 50% excreted in urine; 50% excreted in feces.

Half-Life: 1–2 hr.

Time/Action Profile ⬆ ⬇

(improvement in symptoms)

ROUTE	ONSET	PEAK	DURATION
Intranasal	few days	up to 3 wk	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Instruct patient in correct technique for administering nasal spray (see Medication Administration Techniques). Shake well before use. Before 1st-time use, prime unit by spraying 5–6 times or until fine mist appears. If not used for ≥5 days or if unit has been disassembled, reprime unit. Warn patient that temporary nasal stinging may occur.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Instruct patient to notify health care professional if symptoms do not improve within 3 wk, if symptoms worsen, or if sneezing or nasal irritation persists.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

24208- Bausch & Lomb Incorporated
- 24208-344- Flunisolide
  - 24208-344-25- 1 BOTTLE, PUMP in 1 CARTON (24208-344-25) / 25 mL in 1 BOTTLE, PUMP

46439- Farmabios S.p.A.
- 46439-8740-
  - 46439-8740-1- 2000 g in 1 DRUM (46439-8740-1)

50742- Ingenus Pharmaceuticals, LLC
- 50742-317- Flunisolide
  - 50742-317-25- 1 BOTTLE, PUMP in 1 CARTON (50742-317-25) / 25 mL in 1 BOTTLE, PUMP

68682- Oceanside Pharmaceuticals
- 68682-344- Flunisolide
  - 68682-344-25- 1 BOTTLE, PUMP in 1 CARTON (68682-344-25) / 25 mL in 1 BOTTLE, PUMP

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Indications ⬇

Contraind./Precautions ⬆ ⬇