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Intranasal glucocorticoids (INGC’s) I-III Gen.
- First generation
- Beclomethasone (Beconase)
- Flunisolide (Nasarel)
- Second generation
- Budesonide (Rhinocort)
- Third generation
- Fluticasone (Flonase, Veramyst)
- Mometasone furoate (Nasonex)
- Ciclesonide (Omnaris)
First line therapy for nasal congestion, allergic rhinitis
Down regulate inflammatory response in the nose.
Onset of action
- First generation- 1-4wks
- Second generation- 2-8days, peak 2 weeks
- Third generation- rapid, peak 2-3 days.
- Nasal mucosal drying, burning, irritation, epistaxis, rare nasal septal perforation
- No significant mucosal atrophy, or hypothalamic-pituitaryadrenal suppression
- Overall, quite safe
Contra & Drug Interactions
- No specific contraindications
- Drug interactions
- CYP3A4 inhibitors increase effect, azole antifungals, protease inhibitors, avoid ritonavir.