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Nasal azelastine/fluticasone is a nasal spray with two medicines in it that is used to treat symptoms of seasonal allergic rhinitis, such as a stuffy nose, runny nose, and sneezing. Common side effects include changes in how things taste, nosebleeds, and headache. Serious side effects are less common but can include nasal problems, eye problems such as cataracts and glaucoma, or infections. Contact your health care provider right away if you notice any vision changes, easy bleeding or bruising, or think you have an infection while using nasal azelastine/fluticasone.

Uses

What is nasal azelastine/fluticasone used for?

Nasal azelastine/fluticasone is commonly used to treat symptoms of seasonal allergic rhinitis, such as a stuffy nose, runny nose, and sneezing.

Nasal azelastine/fluticasone may also be used for other conditions as determined by your health care provider.

How does nasal azelastine/fluticasone work (mechanism of action)?

Nasal azelastine/fluticasone contains two medicines. Azelastine is an antihistamine, which is a medicine that reduces allergy symptoms by blocking a substance called histamine. Fluticasone is a corticosteroid. It reduces inflammation in your nasal passages, which may help with allergy symptoms.

How is nasal azelastine/fluticasone supplied (dosage forms)?

Brands and other names

  • Dymista

Dosage forms and strengths

  • 137 mcg/50 mcg per nasal spray 

How should I store nasal azelastine/fluticasone?

Nasal azelastine/fluticasone should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store it upright in a cool, dry place. Do not put it in the refrigerator or freezer.

Side Effects

What are the most common side effects of nasal azelastine/fluticasone?

The most common side effects of nasal azelastine/fluticasone are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Change in how things taste
  • Nosebleeds
  • Headaches

There may be other side effects of nasal azelastine/fluticasone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of nasal azelastine/fluticasone?

While less common, the most serious side effects of nasal azelastine/fluticasone are described below, along with what to do if they happen.

Severe Allergic Reactions. Nasal azelastine/fluticasone may cause allergic reactions, which can be serious. Stop using nasal azelastine/fluticasone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Dizziness and Sleepiness. Nasal azelastine/fluticasone can make you dizzy or sleepy. Do not drive or do other activities that require alertness or coordination until you know how nasal azelastine/fluticasone affects you.

Nasal Problems. Nasal azelastine/fluticasone may cause severe problems with your nasal passages, such as sores in your nose (nasal ulceration) and nasal septal perforation, which is a hole in the cartilage that separates your nose. Tell your health care provider right away if you have any of the following symptoms of nasal problems.

  • Crusting in your nose
  • Nosebleeds
  • Runny nose
  • Whistling sound when you breathe

Eye Problems. Nasal azelastine/fluticasone may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. It can also cause cataracts (clouding of the eye lens). It is important to have regular eye exams while using nasal azelastine/fluticasone. Tell your health care provider right away if you have any of the following symptoms of glaucoma or cataracts.

  • Loss of vision or vision changes
  • Eye pain or redness
  • Severe headache or vomiting
  • Vision that is cloudy, blurry, foggy, or filmy
  • Seeing bright, colorful circles around lights (vision halos)

Infections. Nasal azelastine/fluticasone can increase your risk of infections, including serious infections. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Burning or stinging when you pee 
  • A cough or coughing up blood
  • Fever, sweats, chills, or muscle aches
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss
  • White patches or redness in your nose or throat

Increased Stress Hormone (Hypercorticism). Long-term use of nasal azelastine/fluticasone can lead to hypercorticism, a condition when your body has too much stress hormone, also called cortisol. Call your health care provider if you have any of the following symptoms of increased stress hormone.

  • Acne
  • Easy or frequent bruising
  • More or thicker hair on your body and face
  • Rounded or moon-like face 
  • Ankle swelling
  • Hump or a fatty pad between your shoulders 
  • Stretch marks on your stomach, thighs, breasts, or arms

Reduced Adrenal Function. Long-term use of nasal azelastine/fluticasone can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. This is especially a concern if you have been taking a corticosteroid by mouth, such as prednisone, and you stop it and switch to nasal azelastine/fluticasone. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

  • Nausea and vomiting
  • Weakness, tiredness, or lack of energy
  • Low blood pressure

Slowed Growth in Children. Nasal azelastine/fluticasone may slow down growth in children and adolescents who are still growing. Talk with their health care provider if you have any concerns about how your child is growing.

Warnings & Precautions

Who should not use nasal azelastine/fluticasone?

Allergies to Ingredients. People who are allergic to any of the following should not use nasal azelastine/fluticasone.

  • Azelastine
  • Fluticasone
  • Dymista
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific nasal azelastine/fluticasone products they stock.

What should I know about nasal azelastine/fluticasone before using it?

Do not use nasal azelastine/fluticasone unless it has been prescribed to you by a health care provider. Use it as prescribed. Ask your pharmacist or other health care provider to show you how to correctly use, prime, and clean nasal azelastine/fluticasone. Follow the “Instructions for Use” that come with it.

Do not share nasal azelastine/fluticasone with other people, even if they have the same condition as you. Sharing a nasal spray can spread germs and may cause harm.

Keep nasal azelastine/fluticasone out of the reach of children.

Nasal azelastine/fluticasone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how nasal azelastine/fluticasone affects you.

If a young child is prescribed nasal azelastine/fluticasone, an adult should help them use it. 

Nasal azelastine/fluticasone is only for use in your nose. Do not spray it into your eyes or mouth.

Gently shake nasal azelastine/fluticasone before each use. This helps to make sure you get the right amount of medicine each time.

Tilt your head down when using nasal azelastine/fluticasone. This may make you less likely to have a bitter taste in your mouth after using it. Try not to tilt your head back right after using it. This will help keep the medicine from running down the back of your throat.

What should I tell my health care provider before using nasal azelastine/fluticasone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if nasal azelastine/fluticasone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Nose sores (nasal ulcers), nasal surgery, or an injury to your nose
  • Eye problems, such as blurry vision, cataracts, or glaucoma
  • Have been near someone who has chickenpox or measles
  • Tuberculosis
  • Current infections that have not been treated, including a herpes eye infection
  • Feel like you may be coming down with an infection or not feeling well

Other Medicines and Supplements. Nasal azelastine/fluticasone may interact with other medicines and supplements. Before using nasal azelastine/fluticasone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how nasal azelastine/fluticasone could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if nasal azelastine/fluticasone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use nasal azelastine/fluticasone while breastfeeding.

Interactions

Does nasal azelastine/fluticasone interact with foods or drinks?

There are no known interactions between nasal azelastine/fluticasone and foods or drinks.

Do not drink alcohol while using nasal azelastine/fluticasone. The risk of dizziness and sleepiness may be increased if you drink alcohol while using it.

Does nasal azelastine/fluticasone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking nasal azelastine/fluticasone.

  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Ketoconazole, which is a medicine used for fungal infections

Some other medicines may alter the blood levels of nasal azelastine/fluticasone. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with nasal azelastine/fluticasone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much nasal azelastine/fluticasone?

If you or someone else has used too much nasal azelastine/fluticasone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of nasal azelastine/fluticasone?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.