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HomeAnswersAllergy SpecialistfluticasoneI am having adverse effects from taking Flonase. Why?

I took Flonase for hay fever and had chest tightness. Can I continue taking it?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At May 22, 2018
Reviewed AtFebruary 23, 2024

Patient's Query

Hello doctor,

I started taking Flonase at night for hay fever and when I wake up in the morning I am having wheezing and my chest is tight. I do not want to stop taking it because it is so helpful for my allergy symptoms but I am really worried about this side-effect. Current medications are Cymbalta 120 mg/day and Suboxone 5 mg/day and Sprintec. I am a 29-year-old female with a height of 5’1" and a weight of 108 lbs.

Hello,

Welcome to icliniq.com.

Flonase (Fluticasone) is an intranasal steroid spray that has very less systemic absorption. It will help relieve allergy symptoms and will not cause wheezing. In fact, for wheezing, you may need another steroid, like an inhalant steroid using an inhaler or Rotavap (rotary evaporator). Budesonide or Seroflo and Salbutamol are such inhalers.

The other medicines you are taking, namely Cymbalta (Duloxetine) and Suboxone (Buprenorphine), are they prescribed by the same doctor? Usually, antidepressants are not combined with the deaddiction drug. Do you experience any other symptoms? Since when are you taking the two drugs together? Is the wheezing only after starting the Flonase? Or along with hay fever, you got wheezing as well? Please write back.

Patient's Query

Thank you doctor,

Cymbalta and Suboxone are prescribed by the same doctor. I have been taking those for many years. I started Flonase a week ago and I take it at night and that is when the wheezing started the next morning. I have been taking someone else’s Albuterol inhaler which seems to help but it is not usually something that happens with my normal allergy symptoms which are sneezing, runny nose, congestion, and itchy watery eyes.

Hi,

Welcome back to cliniq.com.

Flonase should not cause wheezing. Fluticasone the active ingredient is a corticosteroid and we give the same for wheezing also. Seroflo inhaler has Salmeterol (similar to Albuterol but long-acting) and Fluticasone. Continue using Albuterol (Salbutamol) if not getting better we may need a Seroflo inhaler in addition to Albuterol. Albuterol is a short-acting beta agonist. Seroflo has a long-acting agonist with a corticosteroid (Fluticasone). The steroid removes inflammation and hypersensitivity. Have you checked if the stoppage of Flonase relieves you from wheezing?

Patient's Query

Thank you doctor,

No, I have not. I will skip it tonight and see what happens. I am a heavy smoker and get bronchitis sometimes or upper respiratory infections. Could this be the beginning of one of those?

Hi.

Welcome back to icliniq.com.

Wheezing is definitely one of the symptoms of bronchitis. Bronchitis can be due to smoking and associated inflammation. How many cigarettes do you smoke and what cigarettes do you use? Nicotine can cause severe bronchoconstriction which may be worsened by hay fever and seasonal issues.

Patient's Query

Thank you doctor,

I do not have a cough like I normally do with bronchitis but I had asthma as a kid. Maybe it is coming back. I smoke a pack a day of menthol cigarettes.

Hi,

Welcome back to icliniq.com.

Asthma and allergy are components of airway hyperreactivity. Some people develop asthma later in life. I feel it is due to the allergy only. Hay fever only. Nasal symptoms of allergy are what you wrote down earlier. The lower respiratory tract produces mucus or a cough or constriction. Constriction of small airways of the lower tract causes wheeze.

When you go out wear a mask and always carry an inhaler. Stay away from smoke dust and pollution. Avoid spicy and cold foods. Stop smoking till you get better. Do not stop Flonase. You can take Mucolyte (Bromhexine HCl) tablet to remove mucus and Acetylcysteine 600 mg or Ambroxol 30 mg you may take to bring out the mucus. If no mucus and still you feel like cellaring throat, you may take Dextromethorphan (Alex) lozenges and Pantoprazole 40 mg. Alex whenever you feel the urge. Pantoprazole twice daily before meals. Reflux symptoms can aggravate your respiratory conditions and allergy.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shyam Kalyan. N
Dr. Shyam Kalyan. N

Otolaryngology (E.N.T)

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