Intranasal corticosteroids (INSs) are the most efficacious medication for the treatment of allergic rhinitis.
This review summarized topical and systemic adverse events associated with the following INS:
- ciclesonide (CIC) (Omnaris in the U.S.)
- fluticasone furoate (FF) (Veramyst in the U.S.)
- mometasone furoate (MF) (Nasonex in the U.S.)
- triamcinolone acetonide
-fluticasone propionate (Flonase and generic in the U.S.)
- budesonide (Rhinocort in the U.S.)
- beclomethasone dipropionate
No significant topical or systemic complications were observed although none of the included studies were longer 1 year in duration.
The newer formulations of topical corticosteroids for allergic rhinitis, such as CIC, FF, and MF, which have lower systemic bioavailability, may be safer for long-term use.
New studies still do not answer the question if these agents are appropriate for long-term use without oversight by a health care professional (such as over-the counter use which is available in New Zealand, for example).
Treatment Options for Allergic Rhinitis and Non-Allergic Rhinitis (click to enlarge the image).
The author of the article is Michael Blaiss, MD, who runs one of the most popular allergist accounts on Twitter @wheezemd
Safety update regarding intranasal corticosteroids for the treatment of allergic rhinitis. Blaiss, Michael S. Allergy Asthma Proc. 2011 Nov-Dec;32(6):413-8.