Flunisolide (marketed as AeroBid among others) is a
corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involv ...
often prescribed as treatment for
allergic rhinitis
Allergic rhinitis, of which the seasonal type is called hay fever, is a type of inflammation in the nose that occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, i ...
. Intranasal corticosteroids are the most effective medication for controlling symptoms.
The principal mechanism of action of flunisolide is to activate
glucocorticoid
Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebr ...
receptors, meaning it has an
anti-inflammatory
Anti-inflammatory is the property of a substance or treatment that reduces inflammation or swelling. Anti-inflammatory drugs, also called anti-inflammatories, make up about half of analgesics. These drugs remedy pain by reducing inflammation as o ...
action. The effects of topical corticosteroids is not immediate and requires regular use and at least a few days to start experiencing noticeable symptom relief. As-needed use has been shown to be not as effective as regular recommended use.
Flunisolide should not be used in the presence of nasal infection. It should not be continued if there is no relief of symptoms after regular use over two to three weeks.
It was patented in 1958 and approved for medical use in 1978.
It is on the
World Health Organization's List of Essential Medicines
The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health ...
.
Side effects
Temporary nose and throat dryness, irritation, bleeding or unpleasant taste or smell may occur.
Nasal septum perforation
A nasal septum perforation is a medical condition in which the nasal septum, the cartilage, bony/cartilaginous wall dividing the nostrils, nasal cavities, develops a hole or fissure.
This may be brought on directly, as in the case of nasal body ...
is rarely reported.
Rare, but localized infections of the nose and pharynx with ''
Candida albicans
''Candida albicans'' is an opportunistic pathogenic yeast that is a common member of the human gut flora. It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is us ...
'' have been reported and long-term use may raise the chance of cataracts or glaucoma.
Flunisolide nasal spray is absorbed into the
circulatory system
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
(blood).
Corticosteroid nasal sprays may affect the
hypothalamic-pituitary-adrenal axis function in humans.
After the desired clinical effect is obtained, the
maintenance dose
In pharmacokinetics, a maintenance dose is the maintenance rate g/hof drug administration equal to the rate of elimination at steady state. This is not to be confused with dose regimen, which is a type of drug therapy in which the dose gof ...
should be reduced to the smallest amount necessary to control symptoms, which can be as low as 1 spray in each nostril a day. Utilizing the
minimum effective dose will reduce possibility of side effects.
Recommended amounts of intranasal corticosteroids are generally not associated with
systemic
Systemic fundamental to a predominant social, economic, or political practice. This refers to:
In medicine
In medicine, ''systemic'' means affecting the whole body, or at least multiple organ systems. It is in contrast with ''topical'' or ''loc ...
side effects.
Corticosteroids inhibit wound healing. Therefore, use of corticosteroid nasal sprays in patients who have experienced recent nasal septal ulcers, recurrent
epistaxis
A nosebleed, also known as epistaxis, is bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significant that low bloo ...
, nasal surgery or trauma, a nasal corticosteroid should be used with caution until healing has occurred.
In pregnancy, recommended doses of intranasal corticosteroids are safe and effective.
References
{{Glucocorticoidics
Acetonides
Corticosteroid cyclic ketals
Diketones
Diols
Fluoroarenes
Glucocorticoids