In fact, for rhinitis, or allergic rhinitis, nasal steroid hormone is currently the preferred treatment drug, and its safety is internationally recognized. We have listed the following questions that patients may often smell for the benefit of the patients, in fact, even if it is not nasal steroids, but oral or intravenous use, if used properly, it is an inexpensive and indispensable drug, and doctors will control the dosage of the drug and the course of use, in order to achieve the best therapeutic effect and minimal side effects.
1.Q: The instructions of the nasal steroid hormone spray say that the use time should not exceed three months, and the invalid need to go to the hospital for examination, does this mean that the drug cannot be used for a long time?
A: A large number of foreign studies have shown that it is safe to use nasal spray hormone for up to one year, and inhalation hormone in respiratory department (bronchial asthma) has been reported for more than two years. Therefore, the safety of long-term use of nasal steroid hormone sprays is guaranteed. How to look at the use of three months is considered more from the disease itself. Nasal spray hormone is the first-line medication recommended by ARIA guidelines for the treatment of allergic rhinitis, and the symptoms can be well controlled after 1 month of standardized use, but because there is the mildest persistent inflammatory response, it is recommended to continue the medication for a period of time and then the dosage can be reduced as appropriate according to the symptom control. If the medication is still ineffective after 3 months of standardized use, it means that the disease itself is probably more than simple allergic rhinitis, and you should go to the hospital for further examination. In my opinion, the instructions are written in this way from the perspective of protecting both doctors and patients.
2. Q: Nasal hormones have potential side effects when used in children. Does this mean that nasal hormones are unsafe, while antihistamines are safer?
A: Every drug has side effects, and the potential side effects of nasal hormones mentioned in ARIA are more from the perspective of long-term use, and it is true that there are not many reports in the literature in this regard, which is why it is mentioned in the instructions that doctors’ attention and guidance are needed. The 2010 edition of the ARIA guidelines clearly states that nasal spray hormone is strongly recommended for patients with allergic rhinitis, and that the ARIA guidelines were developed by world-renowned experts on the basis of a large amount of evidence-based medical evidence combined with clinical experience, which has a very strong clinical guidance. Moreover, the first-pass metabolism rate of the drug in the liver is 99%, and the bioavailability after intranasal use is only 0.42%, which makes it very safe as an OTC drug. Therefore, the ARIA guideline also recommends nasal spray hormone as the first choice for the treatment of allergic rhinitis rather than antihistamines in terms of recommendation strength (priority level).
3. Q: Some patients still have no effect after using nasal steroid hormone spray for a week, what is the reason?
A: There are many reasons for the ineffectiveness of drug treatment, such as whether the patient’s medication is used in the correct way? Is the medication being used in a standardized manner? Or is it used intermittently as needed? In addition, did the patient blow his nose clean before using the nasal spray hormone? This is so that the medication can directly contact the nasal mucosa and thus exert its therapeutic effect. There are many reasons that may affect the efficacy of a drug. Of course, nasal spray hormones are slow to work in some patients, and may take more than 2 weeks. The ARIA guidelines strongly recommend nasal spray hormones as the first-line drug for the treatment of allergic rhinitis, based on a wealth of evidence-based medical evidence and clinical experience. Therefore, we cannot easily dismiss the efficacy of nasal steroid hormone sprays, but need to make clinical observations and evaluations from various aspects.