Intranasal corticosteroid + antihistamine
Fluticasone with azelastine
Brand names: Dymista
Adult dose
Dose: 1 spray each nostril BD
Route: Intranasal
Frequency: BD
Clinical pearls
- Moderate-severe allergic rhinitis where mono-therapy inadequate
- Onset within hours; faster than INCS alone
Contraindications
- Hypersensitivity
Side effects
- Epistaxis
- Bitter taste
- Headache
- Nasal irritation
Interactions
- Strong CYP3A4 inhibitors
Reference: BNF; BSACI rhinitis guideline; https://bnf.nice.org.uk/drugs/fluticasone-with-azelastine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Adult Upper Airway Obstruction (Stridor) · DAS 2015 unanticipated difficult airway; RCEM
- Epistaxis Management · ENT-UK / NICE
- Acute Otitis Media · NICE NG91 2018
- Tonsillitis and Sore Throat · NICE NG84 2018
- Benign Paroxysmal Positional Vertigo · NICE CG124 / AAO-HNS Guidelines
- Acute Rhinosinusitis · NICE NG79 2017 / EPOS 2020