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Research · Medication

Nasal corticosteroid sprays

Meta-analyses of placebo-controlled trials found nasal steroid sprays eased allergic nasal symptoms, more than antihistamine pills did. In sinusitis and nasal polyps the gains were smaller, and colds did not improve. Nosebleeds were about 1.5 times as common as on placebo. Children grew slightly slower over weeks, and eye pressure and cataracts did not differ from placebo.

Add to Bio HackChecked 2026-11-14
Status
Sold over the counter in the US, under FDA Drug Facts labels, to relieve hay fever and other upper respiratory allergy symptoms: fluticasone propionate from age 4, fluticasone furoate, triamcinolone and mometasone from age 2, and budesonide from age 6. Prescription labels remain for fluticasone propionate in perennial nonallergic rhinitis, mometasone to prevent seasonal allergy symptoms and treat nasal polyps, and Xhance fluticasone for chronic rhinosinusitis in adults.
Also called
nasal steroid spray, intranasal corticosteroid, INCS, fluticasone propionate, Flonase, Flonase Allergy Relief, Children's Flonase, fluticasone furoate, Flonase Sensimist, Veramyst, triamcinolone acetonide, Nasacort, Nasacort Allergy 24HR, budesonide, Rhinocort, Rhinocort Allergy, Rhinocort Aqua, mometasone furoate, Nasonex, Nasonex 24HR Allergy, Xhance, allergy nasal spray
Taken for
hay fever, allergic rhinitis, stuffy nose, runny nose, sneezing, itchy watery eyes, sinus infection, sinus congestion, chronic sinusitis, nasal polyps, enlarged adenoids, snoring, asthma with allergies, loss of smell after COVID, common cold

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help7

Reported risks8

What people take it for, and what was found

Shown to help7

Strong

Hay fever and other allergic rhinitis

Shown to ease nasal allergy symptoms more than placebo in adults and adolescents with seasonal and year-round allergic rhinitis, with fluticasone among the largest effects.

Compared with placebo [1][2]

The numbers and sources
Effect
Across 151 placebo-controlled trials, most nasal steroids lowered the Total Nasal Symptom Score and improved rhinoconjunctivitis quality of life more than placebo in both seasonal and perennial allergic rhinitis. In seasonal allergic rhinitis, azelastine-fluticasone, fluticasone furoate and fluticasone propionate had the highest probability of moderate or large improvements. Certainty was high in 6 of 46 analyses, moderate in 23 and low or very low in 17 [1]. In 16 trials of fluticasone furoate 110 mcg once daily, the reflective total nasal symptom score fell 1.14 points more than placebo in seasonal allergic rhinitis (95% CI 0.72 to 1.57) and 0.83 points more in perennial allergic rhinitis (95% CI 0.59 to 1.08) [2].
Population
Adults with seasonal or perennial allergic rhinitis in 151 randomized trials [1]; 5,348 adolescents and adults in 16 trials, 7 seasonal and 9 perennial [2].
Sources
[1], [2]
Caveats
Most trials in [1] were in seasonal allergic rhinitis and had unclear or high risk of bias. The abstract of [1] gives no pooled effect sizes. [2] covers one drug of the class, fluticasone furoate.
Moderate

Itchy, watery eyes from allergies

Shown to ease allergic eye symptoms more than placebo with fluticasone furoate, by about half a point on the ocular symptom score in seasonal allergy.

Compared with placebo [2][1]

The numbers and sources
Effect
Fluticasone furoate lowered the reflective total ocular symptom score more than placebo in seasonal allergic rhinitis (WMD -0.54, 95% CI -0.70 to -0.37) and in perennial allergic rhinitis (WMD -0.33) [2]. In the larger review, azelastine-fluticasone had the highest probability of moderate or large improvement in the Total Ocular Symptom Score [1].
Population
5,348 adolescents and adults in 16 trials of fluticasone furoate [2]; adults in 151 placebo-controlled trials [1].
Sources
[2], [1]
Caveats
The pooled number is for fluticasone furoate only [2]. Eye effects for the other sprays are not given in the abstracts.
Strong

Against antihistamine pills for allergic rhinitis

Shown to relieve nasal blockage, sneezing and total nasal symptoms more than antihistamine pills in allergic rhinitis. Eye symptoms did not differ.

Compared with oral antihistamines [3][4]

The numbers and sources
Effect
Across 16 trials, nasal steroids relieved nasal blockage (SMD -0.63, 95% CI -0.73 to -0.53), discharge (SMD -0.5), sneezing (SMD -0.49), itch (SMD -0.38) and total nasal symptoms (SMD -0.42) more than oral antihistamines. Eye symptoms, nasal discomfort and nasal resistance did not differ [3]. A later review of 5 trials found larger relief of total nasal symptoms (SMD -0.70, 95% CI -0.93 to -0.47) and better quality of life (MD -0.90) on nasal steroids, with no difference in eye symptoms (SMD -0.08, 95% CI -0.23 to 0.08) [4].
Population
2,267 people with allergic rhinitis in 16 randomized trials published 1966 to 1997 [3]; 990 people in 5 randomized trials searched to 2015 [4].
Sources
[3], [4]
Caveats
[3] found significant heterogeneity for sneezing, total nasal symptoms and eye symptoms. The comparison drugs were nonsedating antihistamines in [4].
Moderate

Using the spray only as needed

Shown to ease nasal symptoms when used as needed more than placebo or as-needed antihistamine, though daily use eased them slightly more.

Compared with regular daily nasal steroid, as-needed antihistamine, placebo [5]

The numbers and sources
Effect
Daily use improved total nasal symptom score, disease-specific quality of life, peak nasal inspiratory flow, sneezing and congestion more than as-needed use, with small effect sizes. Eye symptoms, symptom-free days, itch and runny nose did not differ between daily and as-needed use. As-needed use improved total nasal symptom score more than as-needed antihistamine and placebo, with medium effect sizes. Adverse events did not differ in any comparison [5].
Population
882 participants with allergic rhinitis in 8 randomized trials [5].
Sources
[5]
Caveats
The abstract gives no pooled numbers [5]. One review.
ModerateVery common

Acute sinusitis

Shown to raise the share of people whose acute sinusitis symptoms resolved or improved, 73% against 66% on placebo, over 15 to 21 days.

Compared with placebo or no treatment [8]

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
Symptoms resolved or improved in 73% on a nasal steroid and 66.4% on placebo (RR 1.11, 95% CI 1.04 to 1.18, 3 trials). Mometasone 400 mcg had a stronger effect (RR 1.10, 95% CI 1.02 to 1.18) than 200 mcg (RR 1.04, 95% CI 0.98 to 1.11). No significant adverse events were reported, and drop-out and recurrence rates did not differ [8].
Population
1,943 adults and children with acute sinusitis confirmed by imaging or endoscopy in 4 double-blind trials of 15 or 21 days [8].
Sources
[8]
Caveats
Loss to follow-up was 7% to 41% across trials. The authors call the evidence limited [8].
Moderate

Chronic rhinosinusitis and nasal polyps

Shown to ease nasal blockage, runny nose and smell loss slightly more than placebo in chronic rhinosinusitis, mostly in people with nasal polyps.

Compared with placebo or no treatment [9][10]

The numbers and sources
Effect
On a 0 to 3 scale, nasal steroids lowered nasal blockage by 0.40 points more than placebo (95% CI 0.29 to 0.52, 6 studies, 1,702 participants), runny nose by 0.25 and loss of smell by 0.19 (moderate quality). Facial pain did not differ significantly (MD -0.27, 95% CI -0.56 to 0.02). In one study of people with polyps, improvement was more likely on a nasal steroid (RR 2.78, 95% CI 1.76 to 4.40). Disease-specific quality of life was measured in one study of 20 adults, with no difference [9]. Mometasone carries a prescription label for nasal polyps in adults. In a 4-month trial in children 6 to 17 with polyps, it did not show efficacy [10].
Population
2,738 participants in 18 randomized trials of at least 3 months, 14 of them in people with nasal polyps and one in children [9]; 127 children with nasal polyps in one label trial [10].
Sources
[9], [10]
Caveats
Little quality-of-life data. Evidence quality ranged from very low to moderate [9].
ModerateStudied in children

Enlarged adenoids in children

Shown to shrink severe adenoid enlargement and nasal blockage in children more than controls, with fewer children going on to adenoid surgery.

Compared with control groups, placebo or no treatment, the abstract does not separate them [11]

The numbers and sources
Effect
The share of children with severe adenoid enlargement fell 43.5 points on a nasal steroid and 13.3 points in controls. Nasal obstruction scores fell 1.6 against 0.6 and itching 0.7 against 0.2. Adenoidectomy followed in 22.3% of treated children and 98.6% of controls [11].
Population
1,156 children in 16 controlled studies, 636 treated and 520 controls [11].
Sources
[11]
Caveats
The abstract does not say how many studies were randomized or what the control groups received [11].

Mixed results4

Moderate

A double dose when a standard dose is not enough

Shown to ease nasal symptoms slightly more than the standard dose in adults. In children a double dose did not differ from the standard dose.

Compared with the standard dose of the same spray [6]

The numbers and sources
Effect
In adults, double-dose nasal steroid lowered total nasal symptom score more than the standard dose (SMD -0.25, 95% CI -0.41 to -0.08, 4 studies, 568 patients) and total ocular symptom score in one study (SMD -0.27). In children, total nasal symptom score did not differ (SMD -0.16, 95% CI -0.40 to 0.07, 3 studies, 801 patients). Adverse events did not differ [6].
Population
4,166 patients in 12 randomized trials, 5 pediatric, 5 adult and 2 mixed [6].
Sources
[6]
Caveats
The ocular result rests on one study [6].
Moderate

Adding an antihistamine to the spray

Shown to ease nasal and eye symptoms slightly more when an antihistamine nasal spray was added. Adding an antihistamine pill gave no added benefit.

Compared with a nasal steroid alone [7]

The numbers and sources
Effect
Adding an antihistamine lowered total nasal symptom score (SMD -0.13, 95% CI -0.19 to -0.06, 10 trials, 3,348 patients) and total ocular symptom score (SMD -0.12) against a nasal steroid alone. The benefit was seen with antihistamine nasal sprays (SMD -0.18, 95% CI -0.27 to -0.09) but not with antihistamine pills. Quality of life, nasal airflow and adverse events did not differ [7].
Population
4,026 patients with allergic rhinitis in 16 randomized trials [7].
Sources
[7]
Caveats
The effect sizes are small [7].
Moderate

Asthma in people who also have allergic rhinitis

Shown to improve lung function, asthma symptoms and rescue inhaler use slightly against placebo in people with both conditions, but not when added to an asthma inhaler.

Compared with placebo [12]; an inhaled asthma steroid alone [12]

The numbers and sources
Effect
Against placebo, nasal steroid sprays improved FEV1 (SMD 0.31, 95% CI 0.04 to 0.58), bronchial challenge (SMD 0.46), asthma symptom scores (SMD -0.42, 95% CI -0.53 to -0.30) and rescue medication use (SMD -0.29). Added to an orally inhaled corticosteroid, the spray did not change asthma outcomes [12].
Population
2,162 patients with allergic rhinitis and asthma in 18 randomized trials [12].
Sources
[12]
Caveats
One review. The effects were largest in people not already using an asthma steroid inhaler [12].
Moderate

Loss of smell after COVID-19

Mixed results: smell test scores improved more than in controls, but full recovery of smell and recovery time did not differ.

Compared with placebo or no treatment [13][14]

The numbers and sources
Effect
Olfactory scores improved more than in controls at 2 weeks (SMD 0.73, 95% CI 0.39 to 1.07) and 4 weeks (SMD 1.04), but full recovery from smell loss did not differ (OR 1.43, 95% CI 0.95 to 2.16) [13]. A second review found olfactory scores 1.40 higher (95% CI 0.34 to 2.47), with no difference in cure rate (RR 1.18, 95% CI 0.89 to 1.69) or recovery time [14].
Population
People with smell loss after COVID-19 in cohort studies and trials searched to September 2021 [13]; 930 patients in 7 studies [14].
Sources
[13], [14]
Caveats
[13] pooled randomized and nonrandomized studies, with heterogeneity of 45% to 62%. The two reviews overlap in their trials.

Not shown to help2

Limited

The common cold

Small trials found nasal steroid sprays did not shorten colds or ease cold symptoms against placebo.

Compared with placebo [15]; usual care [15]

The numbers and sources
Effect
In two placebo-controlled trials, duration and severity of symptoms did not differ. In one of 54 people, symptomatic days averaged 10.3 on placebo and 10.7 on the spray. A trial of 199 people found no difference in duration. A third trial in children also on amoxicillin reported lower severity scores but was at high risk of bias. Data could not be pooled [15].
Population
353 participants in 3 trials [15].
Sources
[15]
Caveats
Limited statistical power and only three trials [15]. The OTC labels state the sprays are not for the common cold [19][21].
Limited

Differences between sprays

Small trials found no difference between one nasal steroid and another in chronic rhinosinusitis. Higher doses gave similar relief with more nosebleeds.

Compared with another nasal steroid, or a lower dose of the same one [16]

The numbers and sources
Effect
Fluticasone propionate against beclomethasone (2 studies, 56 people) and fluticasone propionate against mometasone (1 study, 100 people) showed no reported difference in disease severity, on very low quality evidence. In 5 studies of 663 people with polyps, high and low doses gave similar severity and polyp size, while nosebleeds were more common on high doses (RR 2.06, 95% CI 1.20 to 3.54) [16]. In allergic rhinitis, the large placebo-anchored review ranked fluticasone furoate and fluticasone propionate highest for nasal symptoms, without direct head-to-head trials [1].
Population
911 people with chronic rhinosinusitis in 9 randomized trials [16]; 151 placebo-controlled allergic rhinitis trials [1].
Sources
[16], [1]
Caveats
Head-to-head trials are few and small. Rankings in [1] are indirect.

Doses studied

The over-the-counter labels direct, for adults and children 12 and older, once daily: fluticasone propionate 50 mcg per spray, 2 sprays in each nostril in week 1, then 1 or 2 [18]. Fluticasone furoate 27.5 mcg per spray on the same schedule [22]. Triamcinolone 55 mcg per spray and budesonide 32 mcg per spray, 2 sprays in each nostril, reduced to 1 once symptoms improve [19][21]. Mometasone 50 mcg per spray, 2 sprays in each nostril [20]. Children use 1 spray in each nostril, and the labels say to talk to a doctor if a child needs the spray more than two months a year [18][19][20][21][22]. The fluticasone furoate placebo review pooled trials of 110 mcg once daily [2]. The fluticasone propionate prescription trials used 200 mcg once daily, or 100 mcg in children [17]. The prescription mometasone label uses 200 mcg a day for allergy and 200 or 400 mcg a day for nasal polyps [10]. The acute sinusitis trials compared mometasone 200 and 400 mcg [8].

Risks

Reported risks6

ModerateVery common

Headache and sore throat

The labels report headache and sore throat a little more often than on placebo, headache in 26% on mometasone against 22% on placebo.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
On mometasone 200 mcg, headache occurred in 26% against 22% on placebo, viral infection 14% against 11%, pharyngitis 12% against 10% and cough 7% against 6% [10]. On fluticasone propionate 200 mcg, headache occurred in 16.1% against 14.6% on placebo and pharyngitis in 7.8% against 7.2%. Fewer than 2% stopped for adverse reactions, a rate similar to placebo [17].
Population
2,103 people 12 and older on mometasone and 1,671 on placebo [10]; 782 people 4 and older on fluticasone propionate 200 mcg and 758 on placebo [17].
Sources
[10], [17]
Caveats
The tables list all adverse events regardless of cause, and the gaps from placebo are small.
StrongVery common

Nosebleeds

Shown to raise nosebleeds about 1.5 times against placebo in allergic rhinitis, and about 2.7 times in chronic rhinosinusitis. Most were streaks of blood.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
Across 72 trials in allergic rhinitis, the relative risk of nosebleed on a nasal steroid was 1.48 (95% CI 1.32 to 1.67) against placebo [23]. In chronic rhinosinusitis the relative risk was 2.74 (95% CI 1.88 to 4.00, 13 studies, 2,508 participants, high quality) [9]. On the labels, epistaxis or blood-tinged mucus occurred in 11% on mometasone against 6% on placebo [10], and 6.9% on fluticasone propionate against 5.4% on placebo [17]. In nasal polyps, nosebleeds occurred in 9% on mometasone once daily, 13% twice daily and 5% on placebo [10].
Population
72 randomized trials in allergic rhinitis [23]; 2,508 participants with chronic rhinosinusitis [9]; label trial populations [10][17].
Sources
[23], [9], [10], [17]
Caveats
Most trials counted any bleeding, including flecks in mucus [9]. Differences between sprays were not clearly shown [23].
ModerateUncommon

Adrenal suppression

Linked to adrenal insufficiency in about 0.7% of people using nasal steroids, rising to about 1.7% with use beyond a year.

The numbers and sources
How common
Uncommon: between 1 in 1,000 and 1 in 100 people.
Effect
The pooled rate of adrenal insufficiency on nasal steroids was 0.70% (95% CI 0.29 to 1.12%). It was 0.48% with use under 1 month, 1.13% with 1 to 12 months and 1.67% with more than 12 months [27]. In a 4-week label study, fluticasone propionate 200 or 800 mcg a day did not change the adrenal response to cosyntropin, while oral prednisone did [17].
Population
1,678 patients in 39 studies [27]; label pharmacology studies [17].
Sources
[27], [17]
Caveats
Adrenal insufficiency was defined by cortisol cut-offs, with or without stimulation tests [27]. Most included studies had no control group.
LimitedHow often is not known

Nasal sores, septal perforation and thrush

The labels warn of nasal ulcers, holes in the nasal septum, Candida infection and slow wound healing, from post-marketing reports with no rate.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The prescription labels warn of epistaxis, nasal ulceration, Candida albicans infection, nasal septal perforation and impaired wound healing, and list nasal septal perforation and ulceration from post-marketing reports [17][10]. Nasal ulcers and nasal and oral candidiasis were reported in mometasone trials, mainly after more than 4 weeks of use [10]. The OTC label says to stop and ask a doctor if a constant whistling sound comes from the nose, which it calls a possible sign of damage [18].
Population
Post-marketing reports and trial participants summarized in labeling [17][10].
Sources
[17], [10], [18]
Caveats
Post-marketing reports cannot give a rate [17].
LimitedHow often is not known

Interactions with ritonavir and other strong CYP3A4 inhibitors

The label warns that ritonavir and other strong CYP3A4 inhibitors raise fluticasone levels. Post-marketing reports describe Cushing's syndrome and adrenal suppression.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In 18 healthy adults, ritonavir 100 mg twice daily raised peak plasma fluticasone propionate from about 11.9 to 318 pg/mL and lowered serum cortisol AUC by 86%. The label lists ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, ketoconazole, telithromycin, conivaptan, lopinavir and voriconazole, and states that use with them "is not recommended". Post-marketing reports with ritonavir include Cushing's syndrome and adrenal suppression [17]. The OTC label says to ask a doctor or pharmacist before use with HIV medicine such as ritonavir, ketoconazole pills, or another steroid medicine [18].
Population
18 healthy adults in a crossover study, plus post-marketing reports [17].
Sources
[17], [18]
Caveats
The interaction study is for fluticasone propionate. Post-marketing reports give no rate.
LimitedHow often is not known

Infections such as chickenpox and measles

The labels warn that people on corticosteroids who have not had chickenpox or measles may have a more serious course if exposed. They give no rate for nasal sprays.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The mometasone label states chickenpox and measles can have a more serious or even fatal course in nonimmune people on corticosteroids, and that how dose, route and duration affect this risk is not known [10]. The OTC label says to stop and ask a doctor after contact with chickenpox, measles or tuberculosis [18].
Population
Labeling statement for corticosteroids in general [10].
Sources
[10], [18]
Caveats
The warning is drawn from corticosteroids by any route, not from nasal spray trials [10].

Mixed results2

ModerateStudied in childrenHow often is not known

Slower growth in children

Shown to slow lower-leg growth slightly over 2 to 4 weeks in children against placebo. Over 12 months, height growth did not differ.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Across short knemometry trials, lower-leg growth was 0.22 mm a week lower on a nasal steroid than placebo (95% CI 0.02 to 0.43). Across 12-month stadiometry trials, growth did not differ (-0.053 cm a year, 95% CI -0.49 to 0.39) [24]. In a 1-year label trial in children 3 to 9, growth on fluticasone propionate 200 mcg was 0.14 cm a year lower than placebo, not significant [17]. The labels warn that intranasal corticosteroids may reduce growth velocity in children and that the effect on final adult height is unknown [17]. The OTC labels state that the growth rate of some children may be slower [18][19].
Population
755 children aged 3 to 12 in 8 randomized trials [24]; 108 children in the 1-year analysis [17].
Sources
[24], [17], [18], [19]
Caveats
The trials cannot show catch-up growth or effects on adult height [24][17].
LimitedStudied in pregnancyHow often is not known

Pregnancy

The fluticasone label states human data are too few to show a risk. A review found no malformation link for most sprays, and a respiratory defect link for triamcinolone.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The fluticasone propionate label states there are insufficient data in pregnant women to inform a drug-associated risk, and that injected doses caused birth defects in rats, mice and rabbits [17]. A review of the published studies found no significant association with congenital malformations for intranasal beclomethasone, budesonide, fluticasone propionate, fluticasone furoate or mometasone, and an association with respiratory tract defects for intranasal triamcinolone [28]. The OTC labels say to ask a health professional before use in pregnancy [18].
Population
Three studies of pregnant women reviewed in [28]; animal studies summarized in labeling [17].
Sources
[17], [28], [18]
Caveats
Only three studies met the review's criteria [28]. The label notes rodents are more prone than humans to steroid birth effects [17].

Checked, no increase found1

Strong

Eye pressure, glaucoma and cataracts

Not shown to raise eye pressure, glaucoma or cataracts against placebo in adults with rhinitis.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Across 10 trials, the relative risk of raised eye pressure was 2.24 (95% CI 0.68 to 7.34), an absolute rise of 0.8% (95% CI 0 to 1.6%). There were no cases of glaucoma in either group at 12 months, and posterior subcapsular cataract rose by 0.02% (95% CI -0.3 to 0.4%) [25]. A second review found none of 10 controlled trials showed a change in eye pressure, and none of 6 showed a change in lens opacity or cataract [26]. The OTC label says to ask a doctor before use with glaucoma or cataracts [18].
Population
2,226 adults in 10 randomized trials [25]; 19 studies, 10 of them randomized trials [26].
Sources
[25], [26], [18]
Caveats
Trials used eye pressure as a stand-in for glaucoma and did not formally look for glaucoma [25].

Claims tested and not found

  1. That a nasal steroid spray helps the common cold. In two placebo-controlled trials, duration and severity of cold symptoms did not differ, 10.7 symptomatic days on the spray against 10.3 on placebo in one [15].
  2. That a nasal steroid spray restores the sense of smell after COVID-19. Two meta-analyses found smell scores rose but full recovery did not differ from control (OR 1.43, 95% CI 0.95 to 2.16, and RR 1.18, 95% CI 0.89 to 1.69) [13][14].
  3. That adding an antihistamine pill to a nasal steroid adds relief. Across trials, the pill combination gave no benefit over the nasal steroid alone [7].
  4. That nasal steroid sprays cause glaucoma or cataracts. In 10 trials, glaucoma did not occur in either group and cataract rose by 0.02%, not significant [25].

Related

Inhaled corticosteroidsAntihistaminesDecongestant nasal sprays

Sources

  1. Sousa-Pinto B, Vieira RJ, Brozek J, et al. Intranasal antihistamines and corticosteroids in allergic rhinitis: A systematic review and meta-analysis. Journal of Allergy and Clinical Immunology. 2024. https://doi.org/10.1016/j.jaci.2024.04.016
  2. Rodrigo GJ, Neffen H. Efficacy of fluticasone furoate nasal spray vs. placebo for the treatment of ocular and nasal symptoms of allergic rhinitis: a systematic review. Clinical & Experimental Allergy. 2011. https://doi.org/10.1111/j.1365-2222.2010.03654.x
  3. Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ. 1998. https://doi.org/10.1136/bmj.317.7173.1624
  4. Juel-Berg N, Darling P, Bolvig J, et al. Intranasal Corticosteroids Compared with Oral Antihistamines in Allergic Rhinitis: A Systematic Review and Meta-Analysis. American Journal of Rhinology & Allergy. 2017. https://doi.org/10.2500/ajra.2016.30.4397
  5. Hoang MP, Chitsuthipakorn W, Seresirikachorn K, Snidvongs K. As-needed intranasal corticosteroid spray for allergic rhinitis: a systematic review and meta-analysis. Rhinology. 2022. https://doi.org/10.4193/rhin21.355
  6. Khattiyawittayakun L, Seresirikachorn K, Chitsuthipakorn W, et al. Effects of double-dose intranasal corticosteroid for allergic rhinitis: a systematic review and meta-analysis. International Forum of Allergy & Rhinology. 2019. https://doi.org/10.1002/alr.22204
  7. Seresirikachorn K, Chitsuthipakorn W, Kanjanawasee D, et al. Effects of H1 antihistamine addition to intranasal corticosteroid for allergic rhinitis: a systematic review and meta-analysis. International Forum of Allergy & Rhinology. 2018. https://doi.org/10.1002/alr.22166
  8. Zalmanovici Trestioreanu A, Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database of Systematic Reviews. 2013. https://doi.org/10.1002/14651858.cd005149.pub4
  9. Chong LY, Head K, Hopkins C, et al. Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.cd011996.pub2
  10. U.S. Food and Drug Administration. Mometasone furoate nasal spray (Apotex), prescribing information. 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=48f7ba0d-33e0-163b-2fa0-f85062768fd5
  11. Ripp AT, Kallenberger EM, Nguyen SA, et al. Topical nasal steroids for adenoid hypertrophy in children: A systematic review and meta-analysis. International Journal of Pediatric Otorhinolaryngology. 2025. https://doi.org/10.1016/j.ijporl.2025.112580
  12. Lohia S, Schlosser RJ, Soler ZM. Impact of intranasal corticosteroids on asthma outcomes in allergic rhinitis: a meta-analysis. Allergy. 2013. https://doi.org/10.1111/all.12124
  13. Kim DH, Kim SW, Kang M, Hwang SH. Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID-19: A systematic review and meta-analysis. Clinical Otolaryngology. 2022. https://doi.org/10.1111/coa.13933
  14. Chen RD, Yang CW, Chen XB, et al. Therapeutic Efficacy of Nasal Corticosteroids in COVID-19-Related Olfactory Dysfunction: A Comprehensive Systematic Review and Meta-analysis. Otolaryngology-Head and Neck Surgery. 2024. https://doi.org/10.1002/ohn.621
  15. Hayward G, Thompson MJ, Perera R, et al. Corticosteroids for the common cold. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.cd008116.pub3
  16. Chong LY, Head K, Hopkins C, et al. Different types of intranasal steroids for chronic rhinosinusitis. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.cd011993.pub2
  17. U.S. Food and Drug Administration. Fluticasone propionate nasal spray (Hikma), prescribing information. 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0d9a521b-8314-437c-8c9f-f6188f1134fe
  18. U.S. Food and Drug Administration. FLONASE ALLERGY RELIEF (fluticasone propionate) nasal spray, drug facts label. 2024. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b6134ba0-b70a-4eac-9a82-cef64b242c1d
  19. U.S. Food and Drug Administration. NASACORT ALLERGY 24HR (triamcinolone acetonide) nasal spray, drug facts label. 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4bff57a5-cce0-401c-a0fe-23c65c1b7ddc
  20. U.S. Food and Drug Administration. NASONEX 24HR ALLERGY (mometasone furoate) nasal spray, drug facts label. 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13696a8b-366a-4a5e-adea-d5b7bff9e46f
  21. U.S. Food and Drug Administration. Budesonide nasal spray 32 mcg (CVS Pharmacy), drug facts label. 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b2650d29-c011-48f1-a7f4-040011d4563d
  22. U.S. Food and Drug Administration. FLONASE SENSIMIST ALLERGY RELIEF (fluticasone furoate) nasal spray, drug facts label. 2024. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=107100af-7ca2-44e8-b067-c0ab0a19a6dc
  23. Wu EL, Harris WC, Babcock CM, et al. Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta-analysis. Otolaryngology-Head and Neck Surgery. 2019. https://doi.org/10.1177/0194599819832277
  24. Mener DJ, Shargorodsky J, Varadhan R, Lin SY. Topical intranasal corticosteroids and growth velocity in children: a meta-analysis. International Forum of Allergy & Rhinology. 2015. https://doi.org/10.1002/alr.21430
  25. Valenzuela CV, Liu JC, Vila PM, et al. Intranasal Corticosteroids Do Not Lead to Ocular Changes: A Systematic Review and Meta-analysis. The Laryngoscope. 2019. https://doi.org/10.1002/lary.27209
  26. Ahmadi N, Snidvongs K, Kalish L, et al. Intranasal corticosteroids do not affect intraocular pressure or lens opacity: a systematic review of controlled trials. Rhinology. 2015. https://doi.org/10.4193/rhino15.020
  27. Sampieri G, Namavarian A, Lee JJW, et al. Hypothalamic-pituitary-adrenal axis suppression and intranasal corticosteroid use: A systematic review and meta-analysis. International Forum of Allergy & Rhinology. 2022. https://doi.org/10.1002/alr.22863
  28. Alhussien AH, Alhedaithy RA, Alsaleh SA. Safety of intranasal corticosteroid sprays during pregnancy: an updated review. European Archives of Oto-Rhino-Laryngology. 2018. https://doi.org/10.1007/s00405-017-4785-3

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