One Minute Consult | How Long Can My Patient Use Intranasal Steroid Sprays?
Intranasal steroid sprays are safe for long-term use, and there is little evidence to indicate they cause significant systemic side effects. However, patients with chronic rhinitis who might use them for long periods should be advised to use them only intermittently and at the lowest dose that controls their symptoms. Patients who regularly use steroid sprays should undergo examination of the nasal cavity at least annually to check for damage to the septum. Children using intranasal steroid sprays should be prescribed the newer-generation formulations, use low doses, and have their growth monitored regularly. There is little evidence to indicate significant systemic side effects In 1972, beclomethasone dipropionate was marketed as the first intranasal spray for allergic rhinitis. Its efficacy in the treatment of seasonal, perennial allergic rhinitis and nonallergic rhinitis led to the development of additional formulations and second-generation steroid sprays (TABLE 1).1 Several consensus reports list intranasal steroid sprays as first-line therapy for rhinitis.2-4 These drugs are widely used: an estimated 25% of the US population has allergic rhinitis, and sales of intranasal steroid sprays exceeded $1.6 billion in 2000.5 The usual prescribed dose is one or two squirts in each nostril daily. Some patients are disappointed that there is no immediate decongestant effect-optimal clinical efficacy may not be reached for 1 to 2 weeks. Some patients with chronic allergic and nonallergic rhinitis use intranasal steroid sprays for years. In view of this, studies have been done to determine if these drugs can be taken intermittently on an as-needed basis instead of daily, to reduce exposure to them. Although the studies were short-term (4-6 weeks), dipropionate and fluticasone Continue reading >>
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The Effect Of An Inhaled Corticosteroid On Glucose Control In Type 2 Diabetes
Go to: Abstract Objective: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD). Design: A prospective randomized, double-blind, double-dummy placebo-controlled, crossover investigation of inhaled steroids and oral leukotriene blockers. Setting: A United States Department of Veterans Affairs Health Care System outpatient setting. Participants: Adults with type 2 diabetes and asthma or COPD. Methods: Subjects (n=12) were randomized to receive either inhaled fluticasone propionate (440 μg twice daily) and oral placebo, or inhaled placebo and oral montelukast (10 mg/day). After 6 weeks, subjects were switched to the opposite therapy for 6 weeks. The primary outcome measure was the change in the percentage of glycosylated hemoglobin (%HbA1c) at 6 weeks relative to the baseline value. Results: Ten patients completed the study. The difference between the mean within-subject changes in %HbA1c associated with 6-week periods of fluticasone and the mean changes associated with montelukast therapy was small but statistically significant (mean difference=0.25; P<0.025). Neither fluticasone nor oral montelukast therapy for 6 weeks led to a significantly different mean % HbA1c compared with the relevant baseline (mean differences=0.11 and −0.14, respectively). Conclusion: The absence of a clinically significant within-subject difference in the changes in %HbA1c associated with fluticasone versus oral montelukast therapy, or between either therapy or baseline does not warrant recommending changes in therapy for asthma or diabetes in patients with these co-morbid conditions. However, we suggest that clinicians carefully monitor blood glucose con Continue reading >>
Flonase And Metformin Drug Interactions - Drugs.com
Do not stop taking any medications without consulting your healthcare provider. Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist. Some mixtures of medications can lead to serious and even fatal consequences. Continue reading >>
Sneezes And Wheezes: Seasonal Allergies And Diabetes
Spring is really starting to burst out here in Massachusetts. The tulips are blooming and leaves and buds are popping out on the trees. As pretty and welcoming as this is, many of you (about 50 million!) are probably bracing yourself for all of the pollen that is soon to follow, and suffering through the misery that it can bring. Thanks to the mild winter that we had in the Northeast, plants are pollinating earlier than usual. As if that weren’t bad enough, having seasonal allergies can also affect your blood sugar control. Seasonal allergies: do you have them? Seasonal allergies are sometimes called hay fever or, more technically, seasonal allergic rhinitis. You might be wondering if your symptoms are due to a cold, flu, or allergies. While there can be some overlap, the following symptoms are usually indicative of allergies: • Itchy eyes • Watery eyes • Dark circles under the eyes • Sneezing • Runny nose • Stuffy nose • Sore throat You might also feel a little bit tired. You won’t get a fever from allergies, however. These symptoms can linger for weeks unless they’re treated. Treating allergies There are a number of remedies for seasonal allergies, including oral medications, nasal sprays, and eye drops. It’s important that you not only choose the right one for your symptoms, but that you also are aware of how these medicines might affect your blood sugars. The following types of allergy medicines may affect your blood glucose levels or how you manage them: Antihistamines. These medicines can reduce sneezing, runny nose, and itchy and watery eyes. Common antihistamines include diphenhydramine (Benadryl), loratidine (Alavert, Claritin), cetirizine (Zyrtec Allergy), and fexofenadine (Allegra Allergy). Antihistamines might be combined with a deconge Continue reading >>
Flonase Patient Information Including Side Effects
Brand Names: Flonase, Veramyst Generic Name: fluticasone nasal (Pronunciation: floo TIK a sone) What is the most important information I should know about fluticasone nasal (Flonase, Veramyst)? What should I discuss with my healthcare provider before using fluticasone nasal (Flonase, Veramyst)? What is fluticasone nasal (Flonase, Veramyst)? Fluticasone is a steroid. It prevents the release of substances in the body that cause inflammation. Fluticasone nasal is used to treat nasal symptoms such as congestion, sneezing, and runny nose caused by seasonal or year-round allergies. Fluticasone nasal is for use in adults and children who are at least 2 years old. Fluticasone nasal may also be used for purposes not listed in this medication guide. What are the possible side effects of fluticasone nasal (Flonase, Veramyst)? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as: severe or ongoing nosebleeds; noisy breathing, runny nose, or crusting around your nostrils; redness, sores, or white patches in your mouth or throat; fever, chills, weakness, nausea, vomiting, flu symptoms; any wound that will not heal; or blurred vision, eye pain, or seeing halos around lights. Less serious side effects may include: headache, back pain; minor nosebleed; menstrual problems, loss of interest in sex; sinus pain, cough, sore throat; or sores or white patches inside or around your nose. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What is the most important information I should know about fluti Continue reading >>
Flonase, Flucatasone And High Bs?
Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Does any body use a Flucatasone or similar nasal spray? If so any thoughts on how it affects your BS? Along with the D I've got hayfever, which is at it's worst in the spring, and asthma which only bothers me if I hang out with furry animals OR I let the springtime hayfever get out of control. Some years back all of that conspired to get me an ambulance ride and Easter weekend in Intensive Care on account of I was turning blue. Since then I've been using the Flucatasone every spring to keep the hayfever down. Flucatasone is a steroid anti inflamatory kind of like prednisone but since it's a nose spray it's not supposed to affect anything other than the nose membranes. This is the first spring I've been really monitoring my BS closely and that I have any way to correct for highs. The last couple of days my BS seems to be rising with out any reason. Steroid medications can often raise blood sugar levels. Yes they often do that along with a whole truckload of other nasty side effects. This stuff is supposed to avoid all of that by applying the medication directly to the location it's needed and nowhere else. My GP who prescribed it and my ex endo both told me this was nothing to worry about. But they both had me on NPH until I ditched them last summer. Can't say that I have a high level of confidence as to their knowlege of pharmaceuticals. That's why I'm hoping somebody here has some experience with this or something like. Continue reading >>
Allergy Tips For People With Diabetes
Aaachoooo! It's that time of year again: spring allergy season. For about 1 in 5 people, warm weather brings not only blooming flowers and trees but also the telltale symptoms of hay fever (seasonal allergies) -- sneezing, coughing, runny or stuffy nose, scratchy throat, and itchy eyes. For those with type 2 diabetes, spring allergies don't directly affect blood sugar, but there are things you need to watch out for, says Gerald Bernstein, MD, FACP. HE's the director of the Diabetes Management Program at the Friedman Diabetes Institute, Beth Israel Medical Center in New York. For relief from itching, sneezing, and runny nose, you might reach for an over-the-counter (OTC) medication such as an antihistamine, which millions have used safely, Bernstein says. "But when you're throwing something like issues around blood sugar into the mix, you need to be a little more aware of the potential things that can occur." One in five people who use antihistamines become drowsy, according to the Asthma and Allergy Foundation of America (AAFA). "So if you take a nap and miss a meal, you can wake up with low blood sugar," Bernstein says. Look for newer antihistamines with less of a sedative effect or talk with a pharmacist about the side effects of various medications. To unclog a stuffy nose, you might choose an OTC or prescription nasal spray, but you might not know that some contain steroids. "Steroids stimulate the liver to make more glucose [blood sugar], so now your liver is beginning to make more sugar," Bernstein says. "And if you're not aware of this, you might be surprised and ask, ‘Why are my numbers high?'" Ask your doctor or pharmacist about nasal sprays without steroids. You have two choices: an OTC decongestant nasal spray or an OTC antihistamine nasal spray. If you cho Continue reading >>
Fluticasone (flonase, Flonase Allergy Relief)
What is fluticasone? How does it work (mechanism of action)? Fluticasone is a man-made corticosteroid. The exact mechanism of action of fluticasone is not known; however, it stimulates glucocorticoid receptors in humans that produces a potent anti-inflammatory response. Fluticasone also works on multiple cells and mediators that are responsible for the inflammatory symptoms of allergic rhinitis (sneezing, runny nose, etc). The FDA approved fluticasone in October 1994. What are the uses for fluticasone? Fluticasone is used for the management of nasal symptoms of seasonal or perennial, allergic and non-allergic rhinitis in adults and children of 4 years of age and older. Safe and effective use of fluticasone has not been established for children under the age of 4. What are the side effects of fluticasone? Side effects of fluticasone include: nasal burning or nasal irritation, Some children may experience growth suppression from use of inhaled steroids. Bad Bugs: Identify Bug Bites From Mosquitos, Spiders and More What else should I know about fluticasone? Fluticasone propionate nasal spray is available as a 16 gm bottle, providing a total of 120 sprays. Each spray contains 50 mcg of fluticasone propionate. Fluticasone propionate should be store between 4 C and 30 C (39 F and 86 F). Brand names for fluticasone propionate are Flonase and Flonase Allergy Relief. Flonase is available by prescription and over-the-counter (OTC). Continue reading >>
Nasal Steroids And Blood Sugar
Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Okay everything I can find <<
Effect Of Intranasal Steroids On Glucose And Hemoglobin A1c Levels In Diabetic Patients.
Abstract BACKGROUND: Intranasal steroids are widely used for the treatment of inflammatory diseases of the nose and sinuses such as rhinosinusitis, allergic rhinitis, and nonallergic rhinitis. Along with the general otherwise healthy population, many diabetic patients use intranasal steroids as well. This study was designed to evaluate the adverse effects of long-term treatment with intranasal corticosteroid preparations in diabetic patients. METHODS: The study group included all diabetic patients treated with intranasal steroids for at least 3 months at primary care clinics in Clalit Health Services Central District in Israel in 2002-2007. The central database had been reviewed for demographic data, medical history, medications, and laboratory test results. RESULTS: A total of 1768 diabetic patients were treated with topical nasal steroid sprays during the study period. Data on hemoglobin A1c (HbA1c) levels both before and during steroid treatment was available for 245 patients, and data on fasting serum glucose levels at both time points was available for 163 patients. On statistical analysis, there was no change in either measure from baseline to 3 months after starting treatment (p = 0.104 and p = 0.101, respectively). Treatment with triamcinolone acetonide was associated with a significantly greater increase in fasting serum glucose levels than other preparations (p = 0.006). CONCLUSION: Intranasal corticosteroids seem to have no adverse effects on HbA1c and serum glucose levels in diabetic patients. Their long-term use appears to be safe, provided that the patients are carefully monitored, especially those receiving triamcinolone acetonide. Continue reading >>
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- Hemoglobin A1c (HbA1c) Test for Diabetes
Flonase And Higher Sugars?
Anyone have any thoughts on the possibility of inhaled steroids (like Flonase) affecting blood sugars? Since starting it a few weeks ago, my blood sugars seem to be spiking much higher after rather modest carb meals. Just wondered if there was a correlation. I might add, Ive been fighting an upper respiratory virus for about a month (and gave it to my wife as well) - not sure how viruses affect blood sugar. Inhaled steroids arent supposed to cause high BG like oral steroids, but they can. Do you have a choice of using a non-steroidal inhaler instead? Viruses effect my BG, any type of illness does. Ditch the flonase and get some safeway non steroid nose spray in the 30 ml spray bottle more efective than the smaller one. No efect on BG. I should add that if I restrict my carbs severely - in other words, letting no grains pass my lips and eating large salads,chicken,fish,eggs,nuts etc, that my blood sugar will go back down to around 100-105 (Im not on any meds). I had a spike from 112 up to 165 after 2 hours (I can imagine it was probably 200 after an hour) after eating a small 250 calorie Lean cuisine meal of chicken and noodles - net carbs about 25. I knew the noodles were bad, but I wouldnt have expected that big of a jump from that few carbs. A few days ago, I had a small 15-20 net carb bowl of oatmeal with pecans - my bs was 134 before eating that and 250 two hours later! I double checked that reading with another meter. Is my pancreas finally just giving up? (Ive had diabetes about 12 years). Or could it be virus or flonase related? If it were related to those, I wouldnt think it would return to the 100 level eating only salads,meat,nuts,etc. Seems like it would remain elevated. (my last hba1c was 7.3 - which prompted me to start being very strict with my diet again Continue reading >>
Flonase Nasal Spray
What is Flonase? Flonase is a nasal spray containing fluticasone propionate. Fluticasone propionate is a corticosteroid that prevents the release of substances in the body that cause inflammation. Flonase Nasal Spray is used to treat nasal congestion, sneezing, runny nose, and itchy or watery eyes caused by seasonal or year-round allergies. Flonase is for use in adults and children who are at least 4 years old and is available without a prescription. Important information Before using Flonase Nasal Spray, tell your doctor if you have glaucoma or cataracts, liver disease, diabetes, herpes simplex virus of your eyes, tuberculosis or any other infection, sores or ulcers inside your nose, or if you have recently had injury of or surgery on your nose. It may take up to several days of using Flonase nasal spray before your symptoms improve. Tell your doctor if your symptoms do not improve after a week of treatment. Flonase can lower blood cells that help your body fight infections. Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using fluticasone. Do not administer Flonase Nasal Spray to a child younger than 4 years old without medical advice. Corticosteroid medication can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medicine. Before taking this medicine You should not use Flonase Nasal Spray if you are allergic to fluticasone. Fluticasone can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or recently had. Tell your doctor about any illness or infection you have had within th Continue reading >>
Otc Steroid Nasal Sprays
I took these back when they were by prescription and before I was diabetic. Discontinued them as they caused nose bleeds. This season my allergies are acting up enough for me to reconsider them. But I see the adverse reports associated with steroids and BG. Do these sprays raise one's blood sugar? A1c 7.0 (7/14) 6.3 (4/15) 6.2 (7/15) 5.9 (10/15) 6.1 (1/16) 6.1 (4/16) Cardio and weight training 4-5 times a week Moderate low carb (40-60 grams a day). Amplodipine (10mg 1x), Metformin (1000mg 2x), Atorvastatin (80mg 1x) Moderator T2 insulin resistant Using Basal/Bolus Therapy Most all nasal sprays I have seen caution you to not use if you are diabetic or have one of several medical conditions listed on their packaging. Consult your doctor because it might be just enough to cause you a problem. I feel that even relating my personal experience could be too dangerous for some one else to try. Wish I could be of better help to you. It seems to indicate that Flonase can increase A1c (by about .025%) when used at high doses; that difference is detectable but not clinically relevant (as stated in the study). The doses used were much higher than those typically used by a seasonal allergy user and so I will continue to use Flonase during allergy season. I believe that anybody concerned should monitor their bg closely. Personally, I do not see an increase in bg by using a single spray in each nostril in the morning and another at night as prescribed by my internist. D.D. Family Getting much harder to control I would say a spray could raise numbers, depending on how bad you need it might have to out way the use of same. It may or may not raise your BG depending on (a) how often and long you use it and (b) how sensitive you are to small amounts of steroids and (c) if you use other med Continue reading >>
Flonase Side Effects
Flonase is the brand name for fluticasone nasal spray, a prescription drug used to prevent and reduce nasal inflammation. Doctors prescribe Flonase to treat symptoms of seasonal and year-round allergies. Flonase is a corticosteroid, a class of drugs (also referred to as steroids) that's used to reduce inflammation in the nasal passages, lungs, and skin, and is sometimes given orally for more severe conditions. In 2006, the Food and Drug Administration (FDA) approved the sale of fluticasone propionate nasal spray (the generic form of Flonase). Flonase works by reducing inflammation and swelling in the nose, which can lead to a number of allergy symptoms, including: Sneezing Congested or stuffy nose Runny nose Itchy nose Other nasal steroids are available over-the-counter, such as Rhinocort (budesonide). Veramyst (fluticasone furoate) is a prescription steroid that's ideal for people who benefit from fluticasone yet do not tolerate the occasional dripping into the throat linked to Flonase. Other Uses for Fluticasone Fluticasone is also available (under other brand names) as an aerosol inhaled by mouth, and as a topical cream or ointment applied to the skin. Flovent (fluticasone oral inhalation) helps people with asthma breathe more easily and reduces tightness in the chest. It can also treat asthma-related wheezing and coughing. There is research suggesting that inhaled steroids such as fluticasone may benefit people with stable chronic obstructive pulmonary disease (COPD). A study published in the International Journal of Chronic Obstructive Pulmonary Disease in 2014 found that a once-daily dry powder inhaler combination therapy could improve people's adherence to long-term inhaled therapy as well as their prognosis. In the United States, GlaxoSmithKline markets fluticas Continue reading >>
How does this medication work? What will it do for me? Fluticasone propionate belongs to the class of medications called corticosteroids. It is used to treat seasonal allergic rhinitis, including hay fever, and perennial rhinitis. It can be used to manage symptoms such as sinus pain and pressure associated with allergic rhinitis. It may take 2 to 3 days for the medication to reach its full effect. For some people the full effect will not be reached for a long as 2 weeks. This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it. What form(s) does this medication come in? Each 100 mg of spray (1 spray) delivered by the nasal adaptor contains 50 µg of fluticasone. Nonmedicinal ingredients: benzalkonium chloride, dextrose, microcrystalline cellulose and carboxymethylcellulose sodium, phenylethyl alcohol, polysorbate 80, and purified water. How should I use this medication? For adults and children 12 years and older, the recommended dose is 2 sprays in each nostril once a day. Some people with severe rhinitis may benefi Continue reading >>