12.2 DRUGS ACTING ON THE NOSE

12.2 Drugs acting on the nose

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.

Antihistamines

GREEN Azelastine aqueous nasal spray 140 microgram/metered spray

Corticosteroids:

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

Alternative product for the regular treatment of nasal polyps and associated symptoms of nasal obstruction

GREEN Betamethasone 0.1% nasal drops

(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

Epistaxis

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)

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