Intranasal corticosteroid.

ABSTRACT

Rapidly metabolized intranasal corticosteroid (INS), with high topical potency and low systemic bioactivity, was introduced for perennial rhinitis in 1974 and found to be as effective as corticosteroids administered systemically. These second-generation INSs include beclomethasone dipropionate (BDP), budesonide (BUD), flunisolide (FLU), fluticasone propionate (FP), triamcinolone acetonide (TAA), mometasone furoate (MF), and fluticasone furoate (FF). Although these INSs represent improvements relative to earlier topical corticosteroids, they do vary from one to the other in potency and systemic bioactivity. For example, MF is equal in potency to FP and is considered to be the most potent INS to date and has almost undetectable systemic availability. FF, the most recently introduced INS, is a novel, enhanced-affinity glucocorticoid with potent anti-inflammatory activity administered in a unique side-actuated device. Among the therapeutic indications for INS are seasonal and perennial allergic rhinitis, nonallergic rhinitis, acute and chronic rhinosinusitis, rhinitis medicamentosa, and nasal polyposis.