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Avamys (GlaxoSmithKline): fluticasone furoate 27.5 micrograms per spray, corticosteroid nasal spray suspension for allergic rhinitis symptoms; bottle of 120 sprays.

• Treatment of the symptoms of allergic rhinitisPopulation: Adults, adolescents and children 6 years and overelectronic medicines compendium (emc), MHRA-authorised SmPC
• Temporary relief of hay fever or other upper respiratory allergy symptoms: nasal congestion, runny nose, sneezing, itchy nose; itchy, watery eyes (12 years and older)Population: Adults and children 2 years and older (eye symptoms 12 years and older)DailyMed (US National Library of Medicine)

• Very common: epistaxis. Common: nasal ulceration, headache, dyspnoea. Uncommon: rhinalgia, nasal discomfort, nasal dryness. Rare: hypersensitivity reactions including anaphylaxis, angioedema, rash, urticaria. Very rare: nasal septum perforation. Not known: dysgeusia, ageusia, anosmia, blurred vision, bronchospasm, dysphonia, growth retardation (children).International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC

• Hypersensitivity to fluticasone furoate or to any of the excipients.International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC
• US OTC labelling: do not use in children under 2 years, to treat asthma, with an unhealed nasal injury or surgery, or after an allergic reaction to the product.International label, equivalent formulation · DailyMed (US National Library of Medicine)

• Systemic corticosteroid effects (Cushing's syndrome, adrenal suppression, growth retardation, cataract, glaucoma, psychological or behavioural effects) may occur, particularly at high doses for prolonged periods; use the lowest effective dose and consider total corticosteroid burden.International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC
• Visual disturbance: patients with blurred vision or other visual symptoms should be considered for ophthalmology referral (cataract, glaucoma, central serous chorioretinopathy).International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC
• Growth retardation has been reported in children on nasal corticosteroids (a -0.27 cm/year difference in growth velocity with 110 micrograms daily for one year); keep children on the lowest effective dose.International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC

• RitonavirCo-administration with ritonavir is not recommended because of the risk of increased systemic exposure to fluticasone furoate.electronic medicines compendium (emc), MHRA-authorised SmPC
• Potent CYP3A inhibitors (including cobicistat-containing products)Caution: increased risk of systemic corticosteroid side effects is expected; avoid unless benefit outweighs risk, and monitor.electronic medicines compendium (emc), MHRA-authorised SmPC
• KetoconazoleWith ketoconazole more subjects had measurable fluticasone furoate concentrations (6/20 vs 1/20), without a significant difference in 24-hour serum cortisol.electronic medicines compendium (emc), MHRA-authorised SmPC

• No adequate data in pregnant women; animal glucocorticoid findings (cleft palate, intra-uterine growth retardation) are unlikely to be relevant at recommended nasal doses given minimal systemic exposure. Use in pregnancy only if the benefit to the mother outweighs the potential risk to the foetus or child.International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC
• US OTC labelling: if pregnant or breastfeeding, ask a health professional before use.International label, equivalent formulation · DailyMed (US National Library of Medicine)
• Unknown whether nasally administered fluticasone furoate is excreted in human milk; use during breastfeeding only if the expected benefit to the mother outweighs any possible risk to the child.International label, same formulation · electronic medicines compendium (emc), MHRA-authorised SmPC

• Fluticasone furoate: Synthetic trifluorinated corticosteroid with very high affinity for the glucocorticoid receptor and potent anti-inflammatory action (UK SmPC).