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The following information outlines important safety warnings and precautions for the use of fluticasone nasal spray. It is crucial to understand these risks and discuss any concerns with your healthcare provider.

• Nasal Issues: Fluticasone nasal spray may lead to nosebleeds or sores within the nasal cavity, which in rare cases, can result in perforations in the nasal septum. If you experience nasal discomfort, frequent nosebleeds, or painful sores, consult your healthcare provider. Increased risk factors include recent nasal surgery or injury and prolonged use of the spray.

• Growth Concerns in Children: This medication can potentially slow down growth in children. It is important for healthcare providers to monitor growth regularly. Use the lowest effective dose for managing symptoms and restrict use to the shortest duration necessary. Avoid using over-the-counter fluticasone nasal spray for more than two months annually unless directed by a healthcare provider. Risk factors include children under 12 years, exceeding the recommended dose, and extended use beyond two months.

• Eye Health: Fluticasone nasal spray can increase intraocular pressure, potentially worsening conditions such as glaucoma or cataracts. If you notice any changes in vision, seek medical advice promptly. Individuals with a history of eye issues or those using the spray long-term should have their vision monitored closely by a healthcare professional.

• Infection Risks: This medication can compromise your immune system, making you more susceptible to infections. Avoid contact with individuals who have chickenpox or measles and inform your provider if exposure occurs. Prior to use, discuss with your provider if you have any ongoing infections or a history of tuberculosis. Risk factors include incomplete vaccinations, concurrent use of immune-suppressing drugs, and prolonged use of the nasal spray.

• Hormonal Imbalance (Adrenal Gland Issues): Extended use or high doses of fluticasone nasal spray can disrupt stress hormone balance, possibly causing symptoms like depression, weight gain, or muscle weakness. If you experience these symptoms, consult with your healthcare provider to safely taper off the medication. Risk factors include concurrent corticosteroid use and prolonged or excessive dosing of the nasal spray.

• Severe Allergic Reactions: Although rare, there have been instances of severe allergic reactions. Discontinue use immediately and seek emergency medical assistance if you develop a rash, hives, facial or tongue swelling, throat tightness, or difficulty breathing.

For any concerns or unusual symptoms while using fluticasone nasal spray, please contact your healthcare provider promptly.

Common side effects:

• headache
• sore throat
• nosebleeds

Less common but important to monitor:

• nasal burning
• irritation
• nausea
• vomiting
• cough
• changes in smell or taste

Serious side effects:

• difficulty breathing
• hives
• swelling of the face, lips, tongue, or throat
• unusual tiredness
• weight loss
• headaches
• swelling in the ankles or feet
• increased thirst or urination
• vision problems

Fluticasone, a corticosteroid used to manage conditions like asthma and allergic rhinitis, can interact with certain medications, potentially leading to increased side effects. It's important to be aware of these interactions to ensure safe and effective use.

Interactions with CYP3A4 Inhibitors:

Fluticasone is metabolized in the liver by an enzyme called CYP3A4. Medications that strongly inhibit this enzyme can elevate fluticasone levels in the body, increasing the risk of systemic corticosteroid side effects such as Cushing's syndrome and adrenal suppression. Notable CYP3A4 inhibitors include:

• Ritonavir: Commonly used in HIV treatment, ritonavir can significantly raise fluticasone concentrations, leading to systemic corticosteroid effects.

• Ketoconazole: An antifungal agent that can increase fluticasone levels, potentially resulting in heightened side effects.

• Clarithromycin: An antibiotic that may elevate fluticasone concentrations, increasing the likelihood of adverse effects.

Other Notable Interactions:

• Beta-Blockers: Non-selective beta-blockers can potentially worsen bronchospasm in patients with asthma.

• Grapefruit Juice: Consuming grapefruit juice can inhibit CYP3A4, leading to increased fluticasone levels and a higher risk of side effects.

Recommendations:

To minimize the risk of interactions:

• Inform Your Healthcare Provider: Always disclose all medications, including over-the-counter drugs and supplements, to your doctor before starting fluticasone.

• Monitor for Side Effects: Be vigilant for symptoms like unusual weight gain, fatigue, or signs of adrenal suppression, and report them promptly.

• Avoid Certain Substances: Limit or avoid the intake of grapefruit juice while using fluticasone.

By being aware of these potential interactions and taking appropriate precautions, you can use fluticasone safely and effectively.