3.4.1.1. Intranasal Corticosteroids


Choice	Drug
1st choice	Mometasone 50 micrograms/dose nasal spray (140 dose)
2nd choice	Fluticasone furoate 27.5 micrograms/dose nasal spray (120 dose)

Many intranasal corticosteroids including mometasone and fluticasone propionate can be purchased over the counter (OTC).
- Encourage self-care and OTC purchase for seasonal allergic rhinitis.
- Treatments may be prescribed for long-term conditions (such as perennial rhinitis)
Intranasal corticosteroids are the treatment of choice for moderate-to-severe or persistent symptoms of allergic rhinitis, or where treatment with an antihistamine is ineffective. They can relieve all symptoms including nasal congestion and should be used regularly during periods of allergen exposure. Aim to start treatment 2 weeks before symptoms are likely to begin. Refer to NICE CKS Allergic Rhinitis for further information.
Reduce to maintenance dose once symptoms have been controlled.
Check compliance and ensure correct technique is used – how to use a nasal spray.