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Steroid Nasal Sprays

Summary
Types and differences
Conditions treated with steroid nasal sprays
Conditions of concern with steroid nasal sprays
Potential side effects of steroid nasal sprays
Drug or other interactions
Pregnancy use issues
Child use issues
Elderly use issues

Potential side effects of steroid nasal sprays

Side effects of steroid nasal sprays are usually minor, especially when compared to other forms of corticosteroid delivery. Common side effects of steroid nasal sprays include:

Burning sensation in the nose
Unpleasant aftertaste
Dryness in the nasal mucous membranes
Nosebleeds
Yeast infection
Hoarseness
Cough and bronchospasm
Growth suppression
Osteoporosis
Thinning of the skin and increased bruising
Impairment of the adrenal glands
Increased risk of chicken pox or measles
Metabolic changes (causing weight gain and increased blood glucose levels)
Mood changes
Insomnia
Menstrual irregularities

Dryness, hoarseness and related side effects can usually be relieved by gargling and rinsing with water after each inhalation. More serious but much less common side effects include:

Sores in the nose

A hole (perforation) that forms in the wall (septum) that separates the nostrils

Patients must be very careful to use steroid nasal sprays exactly as directed by a physician. Using too much of the drug, or using it too often can cause the body’s adrenal glands to stop making its own steroids, which are needed when the body is under stress from infections, surgery or other conditions.

Tapering off from long–term steroid medicine usage can be a slow process. Patients frequently will feel dizzy, lightheaded, tired or have stomach pain during this process. This should be reported to a physician. Patients should not abruptly stop taking steroid medicines and should consult their physician about the best way to taper off.

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Drug or other interactions

Patients using steroid nasal sprays should consult their physicians before taking any additional prescriptions, over–the–counter medications, nutritional supplements or herbal medications. Some medications may interfere with the body's ability to eliminate steroids from the body. These include:

Ketoconazole. An antifungal medication primarily used for infections of the nails, mouth (thrush), lungs, vagina, and blood. May hamper the elimination of budesonide from the body, leaving high amounts in the bloodstream.

Ephedrine. A powerful bronchodilator that quickly opens breathing passages. May decrease blood levels of some nasal corticosteroids. Patients taking ephedrine may need a higher dosage of steroid nasal sprays.

Phenobarbital. A barbiturate, or sedative, used in the treatment of epilepsy, insomnia and anxiety. May decrease blood levels of some nasal corticosteroids. Patients taking ephedrine may need a higher dosage of steroid nasal sprays.

Rifampin. An antibacterial medication primarily used to treat tuberculosis. May decrease blood levels of some nasal corticosteroids. Patients taking ephedrine may need a higher dosage of steroid nasal sprays.

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