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12.2.1 Drugs used in nasal allergy

Allergic rhinitis and nasal congestion can be relieved by topical corticosteroids.  
Topical antihistamines are probably less effective.
GREEN      Azelastine aqueous nasal spray 140 microgram/metered spray     
Twice daily preparations 
GREEN      Beclometasone nasal aerosol 50 micrograms/metered spray 

Once daily preparations  
First line  (licensed for use in children 3 years and over)
GREEN      Mometasone furoate nasal spray 50 micrograms 
                  Preferred product for nasal polyps
(licensed for use in adults and children  6 years)   
GREEN      Triamcinolone aqueous nasal spray 55microgram/metered spray 
Alternative (additionally licensed for children  4 years) 
GREEN      Fluticasone aqueous nasal spray 50 microgram/met spray   
 Severe allergic rhinitis is paediatric patients who have had other failed treatment options.
 Only on approval of paediatric asthma consultant following initiation in tertiary care.
 RED          Fluticasone with azelastine nasal spray (Dymista®)

12.2.2 Topical nasal decongestants

For use only by anaesthetists for nasal intubation. Not recommended for general use. 
RED           Xylometazoline nasal spray 0.1%  
For use only by ophthalmologists to treat peri-orbital cellulitis in children. 
RED           Xylometazoline nasal drops 0.05%      
For non-allergic watery rhinorrhoea 
GREEN      Ipratropium bromide nasal spray 0.03% 

12.2.3 Nasal preparations for infection

RED           B.I.P.P. on gauze 
Nasal staphylococci 
Elimination of organisms from the nasal vestibule can be achieved but re-colonisation frequently occurs. 
GREEN      Naseptin® cream (as part of MRSA eradication) 
GREEN      Naseptin® cream (as part of MRSA eradication)