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Corticosteroids - topical (skin), nose, and eyes - Management
What are the adverse effects of intranasal corticosteroids?

  • Local adverse effects
    • Approximately 10% of people using intranasal corticosteroids develop local adverse effects (including dryness, irritation, and nosebleed; this may require stopping treatment for a while).
    • Reddening of the skin, rash, itching, headache, and disturbance of smell and taste may also occur.
    • Nasal ulceration has been reported, mostly with preparations containing fluticasone furoate or mometasone furoate.
  • Systemic adverse effects
    • Systemic adverse effects are rare but may occur, especially with high doses prescribed for a long period of time. Adrenal suppression, decreased bone mineral density, increased intra-ocular pressure, cataract, and glaucoma have been reported in people receiving long-term intranasal corticosteroids.
    • Psychological and behavioural effects (such as psychomotor hyperactivity, sleep disorders, anxiety, depression, and aggression [particularly in children]) have also been reported.
    • Growth retardation has been reported in children and adolescents receiving licensed doses. Cushing's syndrome has been reported in children receiving long-term corticosteroid nasal drops.
    • The risk of systemic effects is considered more likely with drops than with sprays, as drops are more likely to be administered incorrectly.

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