Intranasal corticosteroid Pregnancy: Clinical experience in pregnant women is limited and corticosteroids have induced teratogenic effects in animal studies; triamcinolone acetonide may pass into human breast milk. It should NOT be administered during pregnancy or lactation unless the therapeutic benefit to the mother is considered to outweigh the potential risk to the foetus/baby.

Triamcinolone Acetonide 55 micrograms/actuation Nasal Spray (Nasacort)

Brand names: Nasacort

Triamcinolone acetonide nasal spray (Nasacort) is an intranasal corticosteroid used to relieve and prevent the symptoms of allergic rhinitis, including nasal congestion, rhinorrhoea, sneezing and itch.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Starting dose 220 micrograms (2 sprays into each nostril); once symptoms are controlled, maintain on 110 micrograms (1 spray into each nostril)

Route: Nasal use only — shake the bottle gently before each use; each actuation delivers 55 micrograms triamcinolone acetonide after an initial priming of 5 sprays until a fine mist is achieved

Frequency: Once daily

Adults: recommended starting dose 220 micrograms as 2 sprays in each nostril once daily, stepping down to 110 micrograms (1 spray in each nostril once daily) once symptoms are controlled. Paediatric (no per-kg dosing is given — verify against a children's formulary): children aged 12 years and over, same as adults (start 220 micrograms as 2 sprays in each nostril once daily, maintain on 110 micrograms); children aged 6 to 12 years, 110 micrograms as 1 spray in each nostril once daily, with 220 micrograms permitted in more severe symptoms but stepping back to the lowest effective dose once controlled; children aged 2 to 5 years, the recommended AND maximum dose is 110 micrograms as 1 spray in each nostril once daily. Continuous use beyond 3 months in children under 12 years is not recommended. Device care: the spray remains adequately primed for 2 weeks — if unused for more than 2 weeks it can be re-primed with one spray; wipe the nozzle after use and replace the cap; clean at least once a week (or more often if blocked) by soaking the cap and nozzle in warm water then rinsing under cold water — NEVER use a pin or sharp object on the spray hole. Discard the bottle after 30 actuations or within one month of starting treatment (6.5 g pack), or after 120 actuations or within 2 months (16.5 g pack). Take care when transferring patients from systemic steroid treatment if adrenal function may be impaired; use with caution after recent nasal septal ulcers, nasal surgery or trauma until healing has occurred. Treatment with higher than recommended doses may result in clinically significant adrenal suppression. Contains benzalkonium chloride — long-term use may cause oedema of the nasal mucosa. Source: eMC SPC for Nasacort 55 micrograms/dose, nasal spray, suspension.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Side effects

Flu syndrome, pharyngitis, rhinitis (common)
Headache (common)
Epistaxis, bronchitis, cough (common); nasal septum perforations (rare); nasal irritation, dry mucous membrane, nasal congestion, sneezing, dyspnoea (frequency not known)
Dyspepsia and tooth disorder (common); nausea (frequency not known)
Chorioretinopathy, cataract, glaucoma, increased ocular pressure, blurred vision; hypersensitivity (rash, urticaria, pruritus, facial oedema); steroid withdrawal syndrome; insomnia; decreased blood cortisol; reduction of growth velocity has been observed in children (all frequency not known)

Clinical monograph

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.

Reference: ARIA 2020; BSACI Allergic Rhinitis Guidelines; Nasacort SPC; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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