Flunisolide Nasal Inhalation (patient information)

# Why this medication is prescribed
Flunisolide, a corticosteroid, is used to prevent allergy symptoms including sneezing, itching, and runny or stuffed nose.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# How this medication should be used
Flunisolide comes as an solution to inhale through the nose. It usually is inhaled one to four times a day at evenly spaced intervals. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use flunisolide exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not stop using flunisolide without talking to your doctor.
Before you use flunisolide the first time, read the written instructions that come with it. Ask your doctor, pharmacist, or respiratory therapist to demonstrate the proper technique. Practice using the inhaler while in his or her presence.
To use the inhaler, follow these steps:
- Wash your hands.
- Gently blow your nose to clear your nasal passages.
- Remove the cap from the nasal inhaler.
- Shake the inhaler.
- With the nasal sprayer aimed away from all people and animals, prime the pump before each use. #Hold the sprayer by placing two fingers on the 'shoulders' of the bottle and your thumb on the bottom. Use your thumb to push the spray bottle firmly and quickly until a fine spray appears.
- Insert the tip of the nasal inhaler approximately 1/4 inch into one nostril, pointing the tip toward the outer side of your nose.
- Close your other nostril with your finger and tilt your head back slightly.
- Press down on the container to release the medication and sniff gently with your mouth closed.
- Hold your breath for a few seconds.
- Breathe out through your mouth.
- Remove the nasal inhaler from your nose.
- Clean the tip of the nasal inhaler with a tissue and replace the cap.
- Repeat Steps 3 through 12 for your other nostril if directed to do so by your doctor.
- Wash your hands again.
Avoid blowing your nose for 15 minutes after inhaling the prescribed dose.

# Special precautions
Before using flunisolide:
- tell your doctor and pharmacist if you are allergic to flunisolide or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin), arthritis medications, aspirin, cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), diuretics ('water pills'), estrogen (Premarin), ketoconazole (Nizoral), oral contraceptives, phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), theophylline (Theo-Dur), and vitamins.
- if you have a nose infection or a fungal infection (other than on your skin), do not use flunisolide without talking to your doctor.
- tell your doctor if you have or have ever had tuberculosis (TB); liver, kidney, intestinal, or heart disease; diabetes; an underactive thyroid gland; high blood pressure; mental illness; myasthenia gravis; osteoporosis; herpes eye infection; seizures; or ulcers.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using flunisolide, call your doctor.

# What to do if you forget a dose
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

# Side effects

## Minor side effects
Flunisolide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- nasal irritation or dryness
- sore throat
- sneezing
- nosebleed

## Severe side effects
If you experience any of the following symptoms, call your doctor immediately:
- increased difficulty breathing
- swollen face, lower legs, or ankles
- vision problems
- cold or infection that lasts a long time
- muscle weakness
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. Avoid puncturing the aerosol container, and do not discard it in an incinerator or fire.

# Other information
Keep all appointments with your doctor.
Your symptoms may improve after just a few days. If they do not improve within 3 weeks, call your doctor.
Avoid exposure to chicken pox and measles. This drug makes you more susceptible to these illnesses. If you are exposed to them while using flunisolide, call your doctor. Do not have a vaccination or other immunization unless your doctor tells you that you may.
Report any injuries or signs of infection (fever, sore throat, pain during urination, and muscle aches) that occur during treatment.
If your sputum (the matter that you cough up during an asthma attack) thickens or changes color from clear white to yellow, green, or gray, call your doctor; these changes may be signs of an infection.
Inhalation devices require regular cleaning, and some require periodic replacement. Follow the directions that come with your inhaler.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Nasalide