Can Fluticasone drops be considered for long-term use?

Question

Hello doctor,

I am 38 years old, female, with a normal BMI, non-smoker, and a past medical history of chronic rhinosinusitis with polyps. I am currently taking Cetirizine, nasal steroids, and Montelukast. My symptoms are present year-round, every day. I have had chronic rhinosinusitis with nasal polyps for the past 14 years. Although I experience allergy-like symptoms such as sneezing, slight facial warmth, and discomfort, all my allergy tests have been negative. I have observed that I can only use the steroid sprays for two weeks before my symptoms worsen. The only treatment that effectively reduces my polyps and inflammation is Fluticasone drops. Cetirizine helps with some of my symptoms, and I have recently added Montelukast, which I am currently trying.

As this is a daily issue for me, I am concerned about the long-term side effects of medication. I am wondering if Fluticasone drops could be used long-term. I recall being advised not to use them for more than six weeks ten years ago, but I am curious if there is any updated evidence regarding this. I am considering using steroid drops to potentially avoid the need for montelukast.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Yes, actually, it is true that steroids cannot be used for longer periods. Steroids are safe for only a few weeks, usually two to three weeks, and then we have to change medications because long-term use of steroids will make the nasal cavity more sensitive and decrease immunity, causing other medications to stop working. That is why we recommend using steroids only for a short period of time. So, please do not use them frequently or regularly; use Montelukast instead. Take proper precautions to avoid allergies: cover your face and nose while going out, and cover your face while cleaning the room. All these things will help prevent allergies and provide relief from symptoms. Avoid cold items completely, as they trigger allergies. There have been no changes in the guidelines for prescribing steroids, so it remains the same.

If you have any further questions, please let me know.

Wishing you excellent health.

Kind regards.

Answer 2

Hello,

Welcome back to icliniq.com.

Fluticasone is a corticosteroid, so it can cause irritation to the nasal mucosa if used for a long period. Therefore, after using it continuously for two weeks, take a break of two to three days, and then resume use. By doing so, we can prevent side effects. You can use it, but if you experience any irritation, try to stop using it for two ti three days before resuming

If anything else please let me know.

Thank you.