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This document provides crucial safety and warning information regarding the use of Dymista (azelastine/fluticasone). It is essential to review these warnings and discuss any concerns with your healthcare provider.

• Drowsiness: Dymista can cause drowsiness. Refrain from driving or engaging in activities that require full attention until you understand how the medication affects you. Alcohol may intensify this effect, so it is advised to avoid it while using Dymista.

• Nasal Issues: Some users may experience nosebleeds or damage to the nasal tissues, potentially leading to serious injury to the nasal septum. Healing of nasal injuries may be impaired. Those with recent nasal surgery, existing nasal injuries, or ulcers should exercise caution.

• Infection Risk: Corticosteroids like fluticasone in Dymista can increase the risk of infections, including fungal infections in the nose or throat, and viral infections such as chickenpox. The risk is higher with prolonged use or when taking other immune-suppressing medications.

• Hormonal Effects: Long-term or excessive use of Dymista can lead to increased absorption of the medication, impacting stress hormone levels due to its similarity to cortisol. Use the medication as prescribed to minimize this risk.

• Growth Concerns in Children: Fluticasone may slow growth in children. To mitigate this, use the lowest effective dose for the shortest duration. Consult a pediatrician to ensure appropriate use for your child.

• Allergic Reactions: Potential allergic reactions to Dymista may include severe facial swelling, shock, and anaphylaxis. Seek immediate medical help if you experience hives, rash, swelling, or breathing difficulties.

• Eye Health: Though rare, Dymista may increase eye pressure, leading to vision issues such as glaucoma or cataracts. If you have a history of eye pressure problems, discuss with your eye specialist before using this medication and report any vision changes promptly.

In case of an overdose or severe reactions, seek emergency medical attention immediately. Always use Dymista as directed by your healthcare provider and report any unusual symptoms promptly.

Common side effects:

• Drowsiness
• Nasal dryness or irritation
• Mild nosebleeds
• Changes in taste

Less common but important to monitor:

• Severe nosebleeds
• Pain in the nose
• A whistling sound when breathing
• Eye pain
• Persistent sore throat
• White patches in the nose or back of the throat
• Fever
• Chills

Serious side effects:

• Unusual tiredness
• Weight loss
• Headaches
• Swelling of the ankles or feet
• Increased thirst or urination
• Vision problems
• Very serious allergic reaction (rash, severe dizziness, itching, swelling of the face, tongue, or throat, trouble breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• lopinavir
• Ritonavir

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• opioid pain or cough medications (such as codeine, hydrocodone)
• alcohol
• marijuana (cannabis)
• sleep or anxiety medications (such as Alprazolam, Lorazepam, Zolpidem)
• muscle relaxants (such as Carisoprodol, Cyclobenzaprine)
• other antihistamines (such as Cetirizine, diphenhydramine)