The intranasal
corticosteroid fluticasone propionate is an effective agent for the treatment of
rhinitis, demonstrating potent local anti-inflammatory activity and little, if any, systemic activity. Intranasal
fluticasone propionate has shown clinical efficacy similar to that of other intranasal
corticosteroids, including
beclomethasone (administered at up to a 2-fold higher dosage than
fluticasone),
budesonide,
flunisolide and
triamcinolone acetonide, and provides greater relief from nasal symptoms (including
nasal blockage) than
antihistamine agents and intranasal
sodium cromoglycate. Its efficacy in the treatment of
seasonal allergic rhinitis and perennial allergic and nonallergic
rhinitis has been demonstrated in large well-controlled studies in which the
drug maintained adequate control of symptoms when administered in a once daily dose of 200 micrograms. In addition,
fluticasone propionate has shown similar efficacy to that of
beclomethasone in the treatment of
nasal polyps; however, its use in the postoperative setting requires further investigation. Intranasal
fluticasone propionate is well tolerated in the majority of patients, the incidence of adverse events being similar to that seen with placebo. Pharmacoeconomic analyses indicate that intranasal
fluticasone propionate is significantly more cost-effective than the
antihistamines terfenadine and
loratadine. Overall quality of life was improved to a similar extent by
fluticasone propionate and
beclomethasone. In conclusion, recent clinical experience has confirmed that intranasal
fluticasone propionate is a convenient, effective and well tolerated alternative to other intranasal
corticosteroids and
antihistamines for the treatment of
rhinitis when administered once daily.