The subtle nuances of intranasal corticosteroids

J Otolaryngol Head Neck Surg. 2021 Mar 17;50(1):18. doi: 10.1186/s40463-020-00480-z.

Abstract

Background: In the specialty of Otolaryngology - Head and Neck Surgery, intranasal corticosteroids are the mainstay treatment for inflammatory processes within the nasal cavity. All too often, physician prescribing patterns are based on previous training, personal experience, and interactions with industry. The purpose of this commentary is to review the nuances of each intranasal corticosteroid.

Commentary: There are nine intranasal corticosteroids approved for use in Canada. Each are discussed in detail, including their indication, bioavailability, effects on intranasal environment, and factors around patient adherence. Off-label use of budesonide irrigations is also discussed and cost information is presented in reference format for all available intranasal corticosteroids.

Conclusion: Although the efficacy of each intranasal corticosteroid has been shown to be similar, prescribing should be tailored based on bioavailability, intranasal environment, and factors that impact patient adherence such as dosing, cost and tolerability.

Keywords: Intranasal corticosteroid; Rhinitis; Rhinosinusitis.

Publication types

  • Editorial

MeSH terms

  • Administration, Intranasal
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / economics
  • Canada
  • Humans
  • Nose Diseases / drug therapy*
  • Off-Label Use
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Therapeutic Irrigation

Substances

  • Adrenal Cortex Hormones