Flunisolide nasal spray is used to treat seasonal or perennial (year-round) allergic rhinitis when other therapies are ineffective or are not tolerated. It belongs to a family of medications called corticosteroids, which work by reducing swelling and inflammation.

This medication normally starts to work within a few days but it may take up to 2 weeks to notice a difference. If symptoms have not improved within 3 weeks of starting this medication, contact your doctor.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

Adults: The usual recommended starting dose for adults is 2 sprays into each nostril twice daily, morning and evening. This may be increased to 2 sprays into each nostril 3 times daily. The maximum daily dose should not exceed 6 sprays into each nostril. When using more than one spray in each nostril, ensure that each spray is aimed in a different direction within the nostril so the mist covers more area in the nasal passages.

Children: For children aged 6 to 14 years, the usual recommended starting dose is one spray into each nostril 3 times daily. The maximum daily dose should not exceed 3 sprays into each nostril.

If possible, start this medication before allergic rhinitis symptoms appear. As soon as the symptoms of allergies are brought under control, the lowest possible dose should be used to prevent symptoms from coming back. Some people may need as little as one spray in each nostril daily to keep symptoms under control.

Before using this medication, gently blow your nose to clear your nostrils. Then:

1. Tilt your head forward slightly, close one nostril with a finger, and gently insert the tip of the bottle into the other nostril.
2. Point the atomizer toward back of nostril and pump firmly and sharply to produce a fine mist.
3. Remove the atomizer and tilt your head backwards, allowing the medication to spread over the back of your nose.
4. Repeat in the other nostril.
5. Replace the protective cap when you are finished.

If you are using more than one spray in each nostril, for subsequent sprays the atomizer should be pointed in different directions in order for the mist to cover a wider area of the nasal passages.

To ensure you are using this medication properly, follow the administration instructions provided by your doctor, pharmacist, or other health professional.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is very important to use this medication exactly as prescribed by your doctor. For maximum effectiveness, this medication should be used on a regular basis. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not use this mediction if you:

• are allergic to flunisolide or to any of the ingredients of the medication
• are under the age of 6 years
• have active or inactive tuberculosis
• have untreated fungal, bacterial, or viral infections

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• changes in the sense of smell or taste
• hoarseness
• irritation of the nose
• irritation of throat
• nasal burning or stinging
• nosebleeds
• sore throat

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• nosebleeds (repeated)
• yellow or green-coloured nasal discharge

Stop using the medication and seek immediate medical attention if any of the following occur:

• symptoms of a severe allergic reaction (e.g., swelling of eyes, throat, or face; skin rash; hives; difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Infection: Corticosteroids such as flunisolide can mask the signs of infection. You can also develop other infections such as a fungal throat infection. Talk to your doctor as soon as possible if you develop any new symptoms.

Long-term treatment: If you have been using this medication for long periods of time, your doctor should reassess your condition periodically to determine if continued treatment is necessary.

Medical conditions: If you have asthma, thyroid problems, liver disease, or a history of frequent nosebleeds, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Other corticosteroid medications: If you have been taking oral corticosteroids and are starting flunisolide, your doctor should carefully monitor your condition. Changing from the oral form to the nasal spray can cause symptoms such as tiredness, aches, pains, and depression. Tell your doctor if you have used or are using other corticosteroids. Your doctor will monitor you while you are taking this medication.

Stopping treatment: Treatment with flunisolide should be tapered off gradually as directed by your doctor, not stopped abruptly. Talk with your doctor before stopping this medication.

Wound healing: Flunisolide may increase the time it takes for wounds to heal. If you have recently had nasal surgery or trauma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if flunisolide nasal spray passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 6 years of age.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.