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Precautions and Warnings With Azelastine/Fluticasone Nasal Spray

If you have recently had nasal surgery or have sores on the inside of your nose, it may not be safe to use azelastine/fluticasone nasal spray. This product can also increase your risk for certain problems, such as infections, glaucoma, or cataracts. There are also important safety precautions and warnings for pregnant or breastfeeding women to be aware of before using azelastine/fluticasone nasal spray.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to using azelastine/fluticasone nasal spray (Dymista™) if you have:
 
  • Recently had nasal surgery
  • Sores or injury to the inside of your nose
  • Not had chickenpox or the measles (or have not been vaccinated against them)
  • Tuberculosis, herpes, or any other infections
  • Glaucoma or cataracts
  • Any allergies, including to foods, dyes, or preservatives.
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
 
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Azelastine/Fluticasone Nasal Spray Precautions and Warnings

Some warnings and precautions to be aware of prior to using this nasal spray include the following:
 
  • Azelastine/fluticasone nasal spray can cause drowsiness due to the antihistamine component. This could possibly interfere with your ability to drive or operate heavy machinery safely.
 
  • This product contains fluticasone, a steroid that may suppress the immune system. Although this is more likely to occur with oral steroids, it is still possible with nasal steroids. Taking steroids may put you at a higher risk for infections. Certain infections, such as chickenpox or the measles, may be more dangerous if you are using azelastine/fluticasone nasal spray. Let your healthcare provider know right away if you are exposed to chickenpox or the measles if you have not had these infections and have not been vaccinated against them.
 
  • In rare cases, azelastine/fluticasone nasal spray can lead to yeast infections in the nose and throat as a result of suppression of the immune system.
 
  • If you are switching from an oral steroid to azelastine/fluticasone nasal spray, which contains a nasal steroid, your healthcare provider should slowly decrease your dose of the oral steroid. Stopping an oral steroid too quickly can be quite dangerous.
 
  • This medication can suppress the body's ability to make natural steroids. This usually happens when too much azelastine/fluticasone nasal spray is used, or when a drug interaction with azelastine/fluticasone nasal spray occurs, causing the body to be exposed to higher-than-normal levels of fluticasone. In such circumstances, the nasal spray should be stopped gradually to give your body a chance to begin making natural steroids again.
 
  • Like all steroids, azelastine/fluticasone nasal spray may slow down the growth rate of children and teenagers. Contact your child's healthcare provider if you are concerned about a slow growth rate in your child.
 
  • Before starting azelastine/fluticasone nasal spray, tell your healthcare provider if you currently have any type of infection. Also, let him or her know if you have ever had tuberculosis or a herpes infection of the eye; this drug may weaken the immune system, allowing these infections to worsen.
 
  • Corticosteroids, including azelastine/fluticasone nasal spray, can slow healing. Therefore, if you have had recent nasal surgery or nasal sores, you should wait until healing has occurred before using this medicine. Also, corticosteroids can cause nosebleeds and nasal sores or irritation.
 
  • Nasal steroids, including azelastine/fluticasone nasal spray, may increase the risk of glaucoma or cataracts. If you already have glaucoma or cataracts, you may need to be monitored more closely.
 
 
  • Azelastine/fluticasone nasal spray is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are currently unknown (see Dymista and Pregnancy).
 
  • It is unknown if the active ingredients in azelastine/fluticasone nasal spray pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the product (see Dymista and Breastfeeding).
 
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Azelastine/Fluticasone Nasal Spray Information

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