Discontinue treatment if localised fungal infection of nose or pharynx develops; persistent nasopharyngeal irritation. Not recommended in case of nasal septum perforation. Active or quiescent tuberculous infections of resp tract, or in untreated fungal, bacterial, or systemic viral infections. Systemic effects at high doses for prolonged periods eg, Cushing's syndrome, Cushingoid features, adrenal suppression, growth retardation in childn & adolescents, cataract, glaucoma, psychological behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression (particularly in childn). Increased IOP. Adrenal insufficiency in w/drawal. May unmask pre-existing allergic conditions eg, allergic conjunctivitis & eczema. Potentially immunosuppressed patients. Patients who are transferred from long-term systemic active corticosteroids. Contains benzalkonium Cl which may cause irritation or swelling inside the nose, especially in prolonged use. Periodically examine patients on therapy over several mth or longer for possible changes in nasal mucosa. Refer ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases eg, central serous chorioretinopathy in patients w/ blurred vision or other visual disturbances. Further evaluate for unilateral polyps (unusual or irregular in appearance), especially if ulcerating or bleeding. Not to be used during pregnancy. Lactation. Regularly monitor height of childn receiving prolonged treatment. Observe infants born of mothers who received corticosteroids during pregnancy for hypoadrenalism. Seasonal allergic or perennial rhinitis: Childn <3 yr. Nasal polyposis: Childn & adolescents <18 yr.
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