Nasoflo Special Precautions

Intranasal corticosteroids may cause reduction in growth velocity when administered to children.
Avoid higher than recommended doses of fluticasone propionate nasal spray since hypercorticism and suppression of the hypothalamic-pituitary-adrenal (HPA) axis function may occur.
Patients who have received systemic corticosteroids for prolonged periods and transferred to topical corticosteroids should be monitored carefully since corticosteroid withdrawal symptoms (e.g., joint pain, muscular pain, lassitude, depression), acute adrenal insufficiency, or severe symptomatic exacerbation of asthma or other clinical conditions may occur.
Concomitant use of intranasal corticosteroids with other inhaled steroids may increase the risk of manifestations of hypercorticism and/or suppression of HPA axis function.
Although there have been no reports of manifestations of Cushing's syndrome (e.g., hypertension, glucose intolerance, cushingoid features) associated with intranasal fluticasone propionate therapy, the possibility of their occurrence should be considered in patients who are sensitive to corticosteroid effects or when the usual doses of the drug are exceeded.
Patients with severe allergies should be instructed to avoid exposure to allergens during treatment with intranasal fluticasone propionate to prevent occurrence of severe allergic symptoms in the eyes and/or lower respiratory tract.
Use with caution in patients with clinical tuberculosis or asymptomatic Mycobacterium tuberculosis infections of the respiratory tract, untreated fungal or bacterial infections, ocular herpes simplex, or untreated, systemic viral infections.
Nasal passages should be examined periodically for mucosal changes and for signs of candidiasis during long-term therapy with fluticasone propionate. If such infections occur, appropriate local treatment of the infection may be necessary and/or discontinuance of intranasal fluticasone propionate therapy may be required.
Patients who are taking immunosuppressant drugs while receiving corticosteroids have increased susceptibility to infections (e.g., chickenpox, measles) compared with healthy individuals. If exposure to varicella or measles occurs, administration of varicella zoster immune globulin (VZIG) or intramuscular immunoglobulin (IG), respectively, may be indicated. If varicella develops, treatment with an antiviral agent (e.g., Acyclovir) may be considered.
Use in Children: The safety and efficacy of fluticasone propionate in children younger than 4 years old have not been established.
Use in Elderly: Adverse effects reported in elderly patients were similar to those reported by younger patients.