A number of steroid nasal sprays are available by prescription, including fluticasone propionate, beclomethasone dipropionate monohydrate, mometasone furoate monohydrate, triamcinolone acetonide, flunisolide, budesonide and fluticasone furoate. While according to the Mayo Clinic steroid nasal sprays are safe for long-term use and do not cause the rebound effect of other nasal decongestant sprays, they may still cause bothersome side effects for some people.
General Side Effects
According to the Mayo Clinic, all steroid nasal sprays can cause side effects. Irritation, itching, burning or dryness inside the nose or throat may commonly occur. Headaches, sneezing, runny nose, upset stomach or nosebleeds are also possible. According to RX List, other symptoms reported in more than three percent of clinical trial participants include nausea, vomiting, lightheadedness, tearing eyes, nasal stuffiness, cough, aftertaste, asthma symptoms, throat inflammation, viral or upper respiratory tract infection and dysmenorrhea (severe uterine pain during menstruation).
If these symptoms worsen or do not go away, contact your doctor.
Serious Side Effects
All steroid nasal sprays can suppress the functioning of the immune system, increasing the likelihood of developing other infections, according to RX List. Those exposed to chicken pox or measles while using these medications should notify their doctor. Intranasal corticosteroids may also have serious adverse effects on the eyes, including dryness and irritation, blurred vision, cataracts, glaucoma, increased intraocular pressure and conjunctivitis, according to RX List. Rarely, ulcers or nasal polyps have been reported by those taking mometasone furoate monohydrate and beclomethasone dipropionate monohydrate.
During clinical trials of triamcinolone acetonide, one patient reported nasal septum perforation (a hole in the septum or inner wall of the nose), according to RX List. This side effect has also been reported by some people taking budesonide. This condition can cause crusting or bleeding inside the nose, nasal discharge and whistling during breathing. Surgery may be required to repair the hole.
Allergic reactions have also been reported, including symptoms such as unexplained rash, hives, itching, swelling, angioedema (swelling under the skin) and anaphylaxis (a life-threatening allergic reaction affecting the whole body). If you experience any of these symptoms, seek emergency medical care.
Adrenal Suppression and Hypercorticism
Some research suggests that prolonged or excessive use of certain intranasal steroids can interfere with the functioning of the adrenal glands. The adrenal glands produce important hormones (cortisol) that are vital to regulating the body's stress response, sexual function, metabolism, balance of salt and water and blood glucose levels. According to RX List, certain steroid nasal sprays such as budesonide, flunisolide and fluticasone furoate carry some risk of causing adrenal suppression and slowed growth or hypercorticism (increased production of cortisol), which can cause Cushing's disease-like symptoms such as weight gain in the upper back, abdomen, face and neck. A review published in a 2009 issue of "Neuroimmunomodulation" finds one study of confirmed adrenal suppression among adults treated with budesonide or fluticasone propionate, and another study showing decreased cortisol in urine output among adults taking beclomethasone dipropionate. Studies of fluticasone furoate and of budesonide or fluticasone propionate in children show no significant adrenal effects. The study concludes that there is no evidence to suggest doctors need to routinely monitor healthy children treated with steroid nasal sprays. Adults who use intranasal corticosteroids long-term should consult with their doctors to determine whether adrenal testing is indicated.
- Mayo Clinic: Can Nasal Steroid Sprays Be Used Long-Term?
- "Neuroimmunomodulation;" Intranasal Corticosteroids and adrenal suppression; Bruni FM et al; 2009
- RX List: Fluticasone Propionate