azelastine / fluticasone
Dymista is a combination nasal spray containing azelastine (an antihistamine) and fluticasone (a corticosteroid). It's used by people ages 6 years and older to treat nasal allergy symptoms, such as runny, stuffy, or itchy nose. The typical dose is to spray one spray into each nostril twice per day. Side effects aren't common, but include headache and a bad taste in the mouth. Dymista (azelastine / fluticasone) is available as both brand-name and generic medications.
What is Dymista (azelastine / fluticasone)?
What is Dymista (azelastine / fluticasone) used for?
Nasal allergy symptoms (e.g., runny, stuffy, or itchy nose, sneezing, itchy or watery eyes)
How Dymista (azelastine / fluticasone) works
Dymista (azelastine / fluticasone) is a combination of two medications:
Azelastine is an antihistamine. It blocks a chemical called histamine that's responsible for causing allergy symptoms, such as runny or itchy nose.
Fluticasone is a corticosteroid. It lowers swelling and inflammation in the nose to help ease congestion and lessen mucus.
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What are the side effects of Dymista (azelastine / fluticasone)?
Common Side Effects
- Changes in taste (4%)
- Nosebleed (up to 4%)
Other Side Effects
- Headache
- Sleepiness
Serious Side Effects
- Severe allergic reaction: hives; rash; swelling in the face, lips, tongue, or throat; trouble breathing
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Crusting or sores inside the nose
- Frequent or severe nosebleeds
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Thrush—white patches in the nose or mouth
- Whistling through one or both nostrils that does not go away
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Change in sense of smell
- Change in taste
- Drowsiness
- Headache
- Irritation inside the nose or throat
- Nosebleed
Pros and cons of Dymista (azelastine / fluticasone)
Pros
Combines two medications into a single spray
Starts to work within 30 minutes after the first dose
Likely safe to use during pregnancy
Cons
Prescription only
Need to use daily for 2 weeks to experience the full effects of fluticasone in Dymista
Need to use twice per day
Pharmacist tips for Dymista (azelastine / fluticasone)
Fluticasone in Dymista (azelastine / fluticasone) can raise the risk for nosebleeds. To lower the risk of nosebleeds, you can use a humidifier when you're indoors or a saline nasal spray to ease nasal irritation.
Azelastine in Dymista (azelastine / fluticasone) might make you feel more sleepy. It's best to avoid drinking alcohol while taking this medication doing so can worsen this side effect. Also, don't drive or do any activities that need a lot of focus and attention until you know how this medication makes you feel.
Don't use other over-the-counter intranasal steroids or antihistamines while you're taking Dymista (azelastine / fluticasone). Doing so raises your risk for side effects, including headaches and nosebleeds.
Store Dymista (azelastine / fluticasone) at room temperature in the original container to protect it from light.
You'll need to prime each new bottle of Dymista (azelastine / fluticasone) before you can use it. To do so, shake the bottle well and spray 6 times into the air away from your face, until you see a fine mist. If you haven't used Dymista (azelastine / fluticasone) for 2 weeks, you'll need to prime the bottle again by spraying 2 sprays into the air.
Before using Dymista (azelastine / fluticasone), blow your nose to clear your nostrils. This makes sure there's nothing blocking the medication's way when it's sprayed into the nose.
Shake the Dymista (azelastine / fluticasone) bottle well before each dose. Hold 1 nostril closed with a finger and insert the spray pump tip into the other nostril, pointing the tip away from the center of your nose. Tilt your head slightly forward, keep the medication bottle upright, and press to release a spray into your nose. Breathe out through your mouth. The repeat on the other side.
After using Dymista (azelastine / fluticasone), avoid blowing your nose for at least 15 minutes so the medication can stay in your nose. Also, avoid tiling your head back right away because this can cause the medication to leak into your throat.
Clean the spray pump tip at least once a week to prevent it from getting clogged. Remove the pump tip and wash it under warm tap water and allow to dry before putting it back on the bottle. You'll need to prime your Dymista (azelastine / fluticasone) bottle again before you use it.
Frequently asked questions about Dymista (azelastine / fluticasone)
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What are the risks and warnings for Dymista (azelastine / fluticasone)?
Dymista (azelastine / fluticasone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Sleepiness
People who took Dymista (azelastine / fluticasone) have reported sleepiness. Don't drive or do anything dangerous that requires a lot of focus or attention until you know how this medication makes you feel. It's best to avoid drinking alcohol while using this medication because doing so can worsen this side effect.
Nose bleeds, discomfort, and injury
Risk factors: Nasal surgery | Injury to the nose | Ulcers in the nose
Using Dymista (azelastine / fluticasone) can sometimes cause nose bleeds. Some people also had damage in the nose after using this medication. This damage can sometimes lead to serious injuries to the bony cartilage between your nostrils (the nasal septum). Using Dymista (azelastine / fluticasone) can also make it more difficult for any injuries or damage to the inside of the nose to heal.
Contact your primary care provider if you experience painful discomfort in your nose, have regular nosebleeds, hear a whistling sound from your nose when you breathe, or have painful sores in your nose as you use Dymista (azelastine / fluticasone).
Risk of infection
Risk factors: Using Dymista (azelastine / fluticasone) for several months | Taking other medications that weakens your immune system | Currently have an infection
Taking corticosteroids, like fluticasone in Dymista, can raise your risk for getting an infection. These infections can include fungal infections in the nose or throat area, which are more likely to happen when you use corticosteroid nasal sprays for several months. Other possible infections include viral infections like chickenpox. Once you develop an infection, you might have a harder time recovering from your illness.
Although there haven't been any reports of serious infections linked directly with Dymista (azelastine / fluticasone), be on the lookout for any signs of infection while you're using this medication. Stop using Dymista (azelastine / fluticasone) and contact your primary care provider if you have a fever, pain, aches, or chills, pain while swallowing, redness in the mouth, or white patches in your nose or throat. You might need to stop using Dymista (azelastine / fluticasone) and take prescribed medication to treat the infection.
Altered stress hormone levels
Risk factors: Using Dymista (azelastine / fluticasone) for a long time | Using too much of Dymista (azelastine / fluticasone)
Using Dymista (azelastine / fluticasone) for long periods of time or using too much of it can cause more medication to get absorbed into the body. This can affect your body in different ways since corticosteroids like fluticasone in Dymista act similarly to cortisol, a natural stress hormone made by your body.
When your body absorbs more of the medication than intended, you might experience symptoms of too much cortisol. These symptoms include weight gain around your gut, fatty deposits around your face and upper back, and fat loss around the arms and legs.
On the other hand, fluticasone can also cause your body to make less natural cortisol. Symptoms of low cortisol include muscle weakness, loss of appetite, nausea, and vomiting.
If either problem is severe enough, you might need additional medical treatment. Use Dymista (azelastine / fluticasone) only as directed and don't use more than the maximum number of sprays per day. Use the lowest dose possible for the shortest amount of time.
Delayed growth in children
Risk factors: Using higher-than-recommended doses of Dymista (azelastine / fluticasone)
Corticosteroids like fluticasone in Dymista might cause slower growth in children. To lower this risk, children should use the lowest dose of Dymista (azelastine / fluticasone) for the shortest amount of time needed to treat their symptoms. Discuss with your child's pediatrician or primary care provider if you're concerned about how Dymista (azelastine / fluticasone) might affect your child's growth. Speak with them about whether this medication is right for your child.
Allergic reactions
Allergic reactions to Dymista (azelastine / fluticasone) are possible. These reactions can include life-threatening facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after you use Dymista (azelastine / fluticasone).
Eye and vision problems
Risk factors: History of glaucoma or cataracts | History of high pressure in the eye
Although it's not common, fluticasone in Dymista can raise the pressure in your eyes and cause vision problems, including glaucoma or cataracts. Talk to your optometrist (eye specialist) before you use Dymista (azelastine / fluticasone) if you have glaucoma or cataracts. Contact your optometrist if you notice any concerning changes to your vision while you're using the medication.
Dymista (azelastine / fluticasone) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 23g of 137mcg/50mcg | 1 nasal spray | $124.00 | $124.00 |
Typical dosing for Dymista (azelastine / fluticasone)
Each spray contains 137 mcg of azelastine and 50 mcg of fluticasone.
People ages 6 years and older: The typical dose is 1 spray in each nostril two times per day.
How much does Dymista (azelastine / fluticasone) cost?
What are alternatives to Dymista (azelastine / fluticasone)?
Nasal allergy symptoms (e.g., runny, stuffy, or itchy nose, sneezing, itchy or watery eyes)
Temporary relief of allergy symptoms (e.g., stuffy or runny nose, sneezing, itchy nose) (OTC only)
Prevention of seasonal allergies (prescription only)
Treatment of long-term nose and sinus inflammation with nasal polyps (prescription only)
Eye and nasal symptoms of seasonal allergies (e.g., runny nose, stuffy nose, sneezing, itchy eyes)
What is the latest news about Dymista (azelastine / fluticasone)?
Dymista (azelastine / fluticasone) images
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References
Best studies we foundApotex Corp. (2024). Azelastine hydrochloride and fluticasone propionate spray, metered [package insert]. DailyMed.
Meda Pharmaceuticals Inc. (2024). Dymista- azelastine hydrochloride and fluticasone propionate spray, metered [package insert]. DailyMed.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison's disease.
You and Your Hormones. (2019). Cortisol.
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