Triamcinolone Acetonide 55 micrograms/actuation Nasal Spray (Nasacort)

How it works

Triamcinolone acetonide is a potent topical glucocorticoid that, applied to the nasal mucosa, suppresses local inflammatory mediators and reduces the cellular inflammatory response underlying allergic rhinitis.

Prescribing in practice

• Regular daily use is needed for full benefit, as effect builds over days rather than providing immediate relief.
• Local effects such as nasal dryness, irritation, crusting and epistaxis can occur, and incorrect aiming at the septum increases the risk of bleeding and, rarely, perforation.
• With prolonged or high-dose use, and particularly when combined with inhaled or other corticosteroids, the small potential for systemic effects should be considered.

Monitoring

Monitor symptom control and the nasal mucosa for irritation or bleeding; with long-term use in children consider periodic review of growth.

Counselling the patient

• Use it every day for ongoing control, not just when symptoms are bad.
• Aim the spray slightly away from the central wall of the nose, towards the outer side.
• Tell your prescriber if you get persistent nosebleeds or crusting.

Evidence & guidelines

Intranasal corticosteroids are recommended by NICE as the most effective treatment class for moderate-to-severe and persistent allergic rhinitis.