Avamys Nasal Spray (fluticasone)

How do I use Avamys nasal spray?

• Avamys won't relieve the symptoms of nasal allergies straight away, and it can take three to four days to have its full effect. It's most effective to start using it a few days before you expect to get symptoms, for example before the start of the pollen season, or if you know you're going to be in contact with pets that give you the allergy. For maximum benefit, the spray should be used regularly while you're still being exposed to the allergen.
• Follow the instructions provided with the nasal spray. Be careful not to get the spray in your eyes.
• Shake the bottle vigorously with the cap on for about 10 seconds before use. This is important because Avamys is a thick suspension that becomes liquid when you shake it. It won't spray unless it's liquid.
• Before you use the nasal spray for the first time it needs to be prepared. After shaking, take the cap off and then press the mist release button all the way in at least six times until a fine mist is released through the nozzle. Hold the bottle upright and away from you while you're doing this. If the nasal spray hasn't been used for 30 days or more, or the cap has been left off for five days or more, you should prepare the spray in this way before using it again.
• Adults and children aged 12 years and over should use two sprays into each nostril once a day, at the same time of day. Once your symptoms are under control you should reduce your dose to one spray in each nostril once a day. Always use the lowest dose necessary to relieve your symptoms. Do not use more than your doctor has prescribed.
• Children aged 6 to 11 years should use one spray in each nostril once a day, at the same time of day. If your child's symptoms are not controlled with this dose your doctor may ask you to use two sprays in each nostril once a day, and then reduce to one spray once the symptoms have improved. Follow the instructions given by your doctor. You should always use the lowest dose necessary to relieve your child's symptoms. Do not use more than your doctor has prescribed.
• If you forget to use your nasal spray just leave out the forgotten dose. Don't use a double dose to make up for a missed dose.
• Any remaining spray must be discarded two months after you first open the bottle, because it may be contaminated with dirt or bacteria. You may find it helpful to write the date of first opening on the bottle so you know when to throw it away. Dispose of carefully, preferably by returning it to a pharmacy.

Who shouldn't use Avamys nasal spray?

• People who are allergic to any of its ingredients. Check the ingredients in the leaflet provided with the medicine if you know you have specific allergies.
• Avamys is not recommended for children under six years of age, as its safety and effectiveness have not been established in this age group.

Who might need extra monitoring when using Avamys nasal spray?

• People with an infection in the nasal passages or sinuses (the infection should be treated).
• People who have had recent nasal surgery or injury (only use when the nose has healed).
• People with tuberculosis affecting the lungs.

Can I use Avamys nasal spray while pregnant or breastfeeding?

• The safety of Avamys for use during pregnancy has not been established. Only minimal amounts of the medicine pass into the bloodstream after using the nasal spray, but it should be only be used during pregnancy if the expected benefit to the mother is greater than any possible risk to the developing baby. Ask your doctor for further information.
• It's unlikely that this medicine will pass into breast milk after using it in the nose. However, it should be used with caution by mothers who are breastfeeding, and only if the benefits to the mother outweigh any possible risks to the nursing infant. Ask your doctor for more advice.

What are the possible side effects of Avamys nasal spray?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects known to be associated with Avamys. Just because a side effect is stated here doesn't mean that all people using this medicine will experience that or any side effect.

Very common

• Nosebleeds.

Common

• Headache.
• Ulceration in the nose.

Uncommon

• Pain, irritation, burning, soreness or discomfort in the nose.
• Dryness in the nose.

Rare

• Allergic reactions such as narrowing of the airways (bronchospasm), swelling of the lips, throat and tongue (angioedema), itchy blistering rash or anaphylactic shock. Stop using Avamys and get immediate medical advice if you think you've had an allergic reaction to it.

Very rare or unknown frequency

• Perforation of the nasal septum.
• Raised pressure in the eye or glaucoma.
• Cataract. Tell your doctor if you notice any changes in your vision while using Avamys.
• Slowed growth in children. Your doctor may want to monitor your child's height if they need to use this nasal spray for long periods of time.

Side effects similar to those associated with corticosteroids taken by mouth (for example Cushing's syndrome, adrenal suppression or mental health problems) are possible if enough of this medicine is absorbed into the bloodstream. The risk of these side effects when using a steroid nasal spray is very low, but is more likely if you use the spray at high doses for prolonged periods of time, which is why you must not exceed the prescribed dose. For more information talk to your doctor or pharmacist.

Can I use Avamys nasal spray with other medicines?

This medicine is only absorbed into the bloodstream in very small amounts after application into the nose so it's unlikely to significantly affect other medicines that you're taking. However, if you are taking any other medicines, including those bought without a prescription and herbal medicines, you should tell your doctor or pharmacist before you start using Avamys.

This is particularly important if you are or have recently been using any other medicines that contain corticosteroids, for example tablets, injections, eye or nose drops, creams, asthma inhalers, or other similar nasal sprays. There may be a higher risk of side effects if you're using more than one type of steroid medication - you may need to be monitored by your doctor.

It's fine to use Avamys nasal spray alongside antihistamine tablets or decongestant nasal sprays if you need to, and it's also fine to take non-prescription painkillers such as paracetamol, ibuprofen or co-codamol while you're using it, assuming all these are appropriate for you.

The following medicines may slow the breakdown of any fluticasone that's absorbed into your bloodstream from your nose and so may increase the risk of side effects on the rest of the body:

• protease inhibitors such as ritonavir for HIV infection (Avamys nasal spray is not recommended for people who are taking ritonavir)
• telaprevir for hepatitis C
• the antifungals ketoconazole and itraconazole (long courses of treatment with these antifungals should be avoided).

References:

https://ca.gsk.com/media/588633/avamys.pdf

http://www.netdoctor.co.uk/medicines/allergy-and-asthma/a8131/avamys-nasal-spray-fluticasone/

http://www.medicines.ie/medicine/12889/SPC/AVAMYS+27.5+micrograms+spray+nasal+spray+suspension/

http://www.medbroadcast.com/drug/getdrug/avamys

http://www.dokteronline.com/en/avamys/

http://chealth.canoe.com/drug/getdrug/avamys

http://www.mydr.com.au/medicines/cmis/avamys-nasal-spray