Dalman Special Precautions

Local infection: Although the presence of infection in the nasal airways does not constitute a specific contraindication for intranasal fluticasone propionate therapy, this infection should be treated appropriately.
Caution should be exercised in patients who discontinue systemic steroid therapy and initiate intranasal fluticasone propionate therapy, especially if there is a reason to think that adrenal function is impaired.
Systemic effects of nasal corticosteroids, especially in high doses and long-term use, have been reported. These effects are much less likely to occur than with oral corticosteroids and may differ between patients and different corticosteroid preparations.
Growth retardation has been reported in children using certain nasal corticosteroids at approved doses. Regular monitoring of the height of children receiving long-term nasal corticosteroid therapy is recommended. In the event of growth retardation, treatment should be reviewed to reduce the nasal corticosteroid dose and, whenever possible, the lowest dose to control symptoms should be used. In addition, referral to a pediatrician should be considered.
During post-marketing use, clinically significant drug interactions have been reported in patients receiving fluticasone propionate and ritonavir; this has led to systemic corticosteroid effects, including Cushing's syndrome and adrenal suppression. Therefore, concomitant use of fluticasone propionate and ritonavir should be avoided unless the potential benefits to the patient outweigh the risk of systemic corticosteroid side effects.
Full benefit may not be achieved unless treatment with Fluticasone Propionate Nasal Spray suspension is continued for several weeks.
Glaucoma and increased intraocular pressure have been reported rarely following intranasal administration of corticosteroids.