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Although they are the cornerstone of allergy treatment, avoidance measures are not always enough to manage all of the symptoms. When the symptoms of nasal allergies are mild or intermittent, antihistamines with or without decongestants can help. Very often, some relief can be found in taking over-the-counter (OTC) drugs and this is usually the first step an allergy sufferer will take. Self-medication, though, is frequently inadequate since OTC drugs cannot adequately treat the inflammation that develops in the nose. At this stage, anti-inflammatory medications are required, usually in the form of intra- nasal steroid sprays (sprayed into the nose).
The combination of an antihistamine (with or without a decongestant) and a topical nasal steroid spray will usually afford good relief with minimal side effects. The addition of ipratropium bromide nasal spray (Atrovent - an anticholinergic medication) is also very effec...
Flunisolide, the active component of NASAREL nasal spray, is an anti-inflammatory glucocorticosteroid with the chemical name: 6(alpha)-fluoro-11(beta),16(alpha),17,21 tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone, hemihydrate. It has the following chemical structure:

Flunisolide is a white to creamy white crystalline powder with a molecular weight of 443.51 and molecular formula of C 24 H 31 FO 6 . It is soluble in acetone, sparingly soluble in chloroform, slightly soluble in methanol, and practically insoluble in water. It has a melting point of about 245°C. The octanol:water partition coefficient is 2.17 at neutral pH.
NASAREL is a metered dose manual pump spray unit containing 0.025% w/w flunisolide in an aqueous medium containing benzalkonium chloride, butylated hydroxytoluene, citric acid, edetate disodium, polyethylene glycol 400, polysorbate 20, propylene glycol, sodium citrate dihydrate, sorbitol and purified water. Sodium hydroxide and/or hydrochloric acid may be added to adjust the pH to a target of 5.2. Each 25 mL spray bottle contains 6.25 mg of flunisolide.
After initial priming (5 to 6 sprays), each spray of the pump spray unit delivers a metered spray of 100 mg formulation containing 29 mcg of flunisolide. The size of 99.5% of the droplets produced by the unit is greater than 8 microns. The contents of one nasal spray bottle delivers 200 sprays in addition to the priming sprays.
Before using nasal flunisolide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye problems (such as glaucoma, cataracts), infections (including tuberculosis), recent nose problems (such as injury, ulcers, surgery).
Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.
Rarely, using corticosteroid medications for a long time can make it more...
Last reviewed on RxList: 12/8/2004
This monograph has been modified to include the generic and brand name in many instances.
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