Can You Use Flonase Twice A Day?

In our latest question and answer, the pharmacist discusses whether or not it is safe to use Flonase nasal spray twice a day.


Can you use Flonase twice a day?

Asked by Shing On May 08, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On May 13, 2018

Nasal Spray BottleIntranasal corticosteroids, like Flonase and Nasacort, are often the first type of drug recommended for allergies. These type of medications are considered to be most effective for controlling nasal symptoms of allergies.

Flonase Dosing Recommendations

Flonase can be used as one spray in each nostril once daily, or two sprays in each nostril once daily. Alternatively, the two sprays in each nostril can be split into one spray in each nostril twice a day. However, it is not recommended that you use more than 4 sprays (200 mcg) per day due to increased risk of side effects.

Flonase Side Effects

When used correctly, less than 1% of Flonase is systemically absorbed, so it does not typically cause systemic side effects. These are typically rare and occur more with oral or inhaled corticosteroids. However, according to the prescribing information, some cases of altered smell and taste, increased pressure in the eyes, glaucoma, cataracts, and growth suppression (in children) have been reported. Although the chance of Flonase causing these side effects is very low since so little is systemically absorbed, other more common side effects may occur that are more local to the administration area, such as:

  • Throat irritation
  • Nosebleeds
  • Nasal burning/irritation
  • Cough
  • Headache

It may take a few days of use before your symptoms start getting better. It is also important to ensure you are correctly using the nasal spray to provide the maximal benefit.

How To Use Flonase

  1. Shake the bottle gently
  2. Remove the cap
  3. Gently blow your nose to clear your nostrils
  4. Place the tip of the spray inside one nostril and aim slightly away from the center of the nose
  5. Pinch the opposite nostril closed
  6. Breathe and spray (once or twice) then breathe out through the mouth
  7. Repeat the process in the other nostril

Other Nasal Sprays

Intranasal corticosteroids are typically most effective and recommended before other nasal sprays due to their effectiveness and use for multiple symptoms. There are other types of over-the-counter sprays to be aware of as well:

  • Decongestant sprays: oxymetazoline (Afrin), phenylephrine (Neo-Synephrine)
    • Help with nasal congestion
    • Should not be used for more than 3 days because they can cause rebound congestion
    • Not recommended for those with high blood pressure or glaucoma

  • Cromolyn Sodium (NasalCrom)
    • Help with runny nose, stuffy nose, and sneezing
    • Works best if you start using it before allergy season starts
    • Discuss with your doctor before use if you have lung problems

When To See The Doctor

  • You are a child or elderly person; a doctor should be consulted before starting an over-the-counter medication
  • You have symptoms that last more than 3 months or they make it hard to work or sleep
    • If you need relief sooner, see your doctor after a few weeks
  • You tried over-the-counter medications without symptom relief
  • You have a history of multiple sinus or ear infections or other health problems, such as heart disease, high blood pressure, glaucoma, diabetes, thyroid problems, liver disease, or kidney disease

About the Pharmacist

Dr. Anna Staudt Pharm.D

Dr. Anna Staudt graduated in 2017 with a Doctor of Pharmacy degree. She is completing a pharmacy fellowship focused on ambulatory care. Her current practice site is at a Federally Qualified Health Center (FQHC) where she deals with the underserved.

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