Fluticasone Furoate Nitto Special Precautions

Precautions Concerning Dosage and Administration: To achieve an adequate clinical effect with Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray, use the drug continuously.
Important Precautions: In cases where nasal symptoms worsen during treatment with Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray, co-administer an antihistamine or systemic steroid over the short term, and gradually reduce the dose of the co-administered drug in line with improving symptoms.
The dose of the systemic steroid is to be reduced gradually after confirmation that symptoms have stabilized following the start of administration of Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray. The dose reduction is to be performed in accordance with the general dose reduction methods for steroids.
Bronchial asthma and occasionally symptoms such as eczema, urticaria, dizziness, palpitations, malaise, hot flushes of the face, and conjunctivitis may occur or worsen with reduction and withdrawal of systemic steroids. If such symptoms develop, perform appropriate treatment.
In cases where Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray is used over the long term in patients with perennial allergic rhinitis, make efforts towards reducing the dose of the drug when symptomatic improvement is maintained.
Systemic effects (including Cushing's syndrome, Cushingoid features, adrenocortical suppression, growth retardation in children, decreased bone density, cataract, glaucoma, and central serous chorioretinopathy) may develop with administration of nasal steroids, although less probable than with systemic steroids. Particularly in the event of long-term or high-dose administration, perform tests on a regular basis and perform appropriate treatment in cases where the systemic effects are observed.
Precautions Concerning Patients with Specific Backgrounds: Patients with Complication or History of Diseases, etc.: Patients with nose and throat infections (excluding infections for which no effective antibacterial drugs exist, or deep mycoses): Symptoms may be aggravated.
Patients with recurrent epistaxis: Bleeding may be aggravated.
Patients with severe hypertrophic rhinitis or nasal polyps: To ensure the effect of Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray in the nasal cavities, other therapies should be used concomitantly so that the symptoms of these diseases are improved to a certain extent.
Patients on long-term or high-dose systemic steroid therapy: Perform adrenocortical function tests both during reduction and post-withdrawal of systemic steroids, and pay adequate attention to invasion by traumas, surgeries, severe infections, etc. Moreover, temporarily increase the dose of systemic steroids if necessary. Adrenocortical insufficiency may have been occurred in these patients.
Precautions Concerning Use: Precautions concerning the dispensing of the drug: Use solely for the purpose of spraying intranasally.
Shake the container well vertically before using Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray.
When a new spray device is used, prime the device by releasing approximately 10 sprays into the air and confirm that the solution has completely turned into a mist before use.
Other Precautions: Information Based on Clinical Use: It has been reported that nasal congestion occurs as an adverse reaction of antihypertensives such as reserpine and α-methyldopa. In allergic rhinitis patients who are taking such antihypertensives, since the effect of Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray against nasal congestion may be masked, administer the drug while the patients are carefully monitored.
Use in Pregnancy & Lactation: See USE IN PREGNANCY & LACTATION section for further information.
Use in Children: Growth retardation may develop as a result of administration of nasal steroids, particularly in the event of long-term or high-dose administration, although it is less probable comparing to that of a result of administration of systemic steroids. In cases where Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray is administered over the long term in children, monitor the course such as by measuring height, etc., on a regular basis. Moreover, provide proper instructions regarding the methods of use when Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray is used.
No clinical studies have been conducted in low-birth-weight babies, newborns, babies, or infants <2 years old.
Use in the Elderly: Carefully administer Fluticasone Furoate Nitto Nasal Spray 27.5 mcg/spray while the patient's condition is monitored. The physiological functions of geriatric patients are generally decreased.