Ryaltris
Ryaltris is a combination of two medications: olopatadine (an antihistamine) and mometasone (a corticosteroid). It's a nasal spray used to treat eye and nasal symptoms of seasonal allergies (e.g., runny nose, stuffy nose, sneezing, itchy eyes) in people ages 12 and older. The dosage is 2 sprays in each nostril twice per day. Ryaltris (olopatadine / mometasone) doesn't have a generic version since it's only available as a brand-name medication. Side effects aren't common, but include a bad taste in the mouth and nosebleeds.
What is Ryaltris (olopatadine / mometasone)?
What is Ryaltris (olopatadine / mometasone) used for?
Eye and nasal symptoms of seasonal allergies (e.g., runny nose, stuffy nose, sneezing, itchy eyes)
How Ryaltris (olopatadine / mometasone) works
Ryaltris (olopatadine / mometasone) is a combination of two medications that work together in your nose to treat eye and nasal allergy symptoms:
Olopatadine is an antihistamine. It blocks a natural chemical in the body called histamine which causes symptoms like runny nose, stuffy nose, sneezing, and itchy eyes.
Mometasone is a corticosteroid. It lowers swelling and inflammation in the nose, helping you breathe more easily.
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What are the side effects of Ryaltris (olopatadine / mometasone)?
Common Side Effects
- Altered taste (3%)
- Nosebleed (1%)
- Nasal discomfort (1%)
Other Side Effects
- Drowsiness
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
- Irritation inside the nose or throat
Pros and cons of Ryaltris (olopatadine / mometasone)
Pros
Combines two first-choice medications into a single spray
Starts to work within 15 minutes
Less side effects than antihistamines and steroids taken by mouth
Cons
Can cause nosebleeds and nasal irritation
Need to use twice per day
Available by prescription only
Pharmacist tips for Ryaltris (olopatadine / mometasone)
Although it's rare, using Ryaltris (olopatadine / mometasone) can make your nosebleed. To stop a nose bleed, sit upright and lean forward. Pinch the soft part of your nose above your nostrils for at least 10 minutes while you breathe through your mouth. Get medical help if the bleeding is hard to stop or if you feel dizzy.
Even though you spray Ryaltris (olopatadine / mometasone) into the nose, it can still interact with certain medications taken by mouth. Medications like clarithromycin, itraconazole, and ritonavir can cause your body to absorb more Ryaltris (olopatadine / mometasone), raising your risk for side effects. Ask your prescriber if it's safe for you to use Ryaltris (olopatadine / mometasone) with other medications.
Don't use other over-the-counter (OTC) intranasal steroids or antihistamines while taking Ryaltris (olopatadine / mometasone). Doing so raises your risk for side effects.
Ryaltris (olopatadine / mometasone) can cause drowsiness. Avoid drinking alcohol or taking other medications that can also cause drowsiness. Don't drive or operate any machinery until you know how this medication will affect you.
There isn't enough information to know if Ryaltris (olopatadine / mometasone) is safe to use in pregnancy, but it's generally considered safe. Let your prescriber know if you're pregnant, or planning to become pregnant before using this medication.
It's not known if Ryaltris (olopatadine / mometasone) passes into breast milk or if it can harm breastfed babies. Speak to your prescriber about the risks and benefits of using this medication while breastfeeding.
Store Ryaltris (olopatadine / mometasone) at room temperature in the original container to protect it from light.
Prime each new bottle of Ryaltris (olopatadine / mometasone) before using it. Shake the bottle well and spray it 6 times into the air away from your face. If you haven’t used Ryaltris (olopatadine / mometasone) for 2 weeks, prime the bottle again by spraying it twice into the air until you see a fine mist.
Before using Ryaltris (olopatadine / mometasone), blow your nose to clear your nostrils. This makes sure there's nothing blocking the medication when it’s sprayed into your nose.
Shake the bottle well before each dose. Close one nostril with a finger and insert the spray tip into the other nostril, pointing slightly outward toward your ear. Tilt your head forward, keep the bottle upright, and press to release a spray. Breathe through your mouth. Clean the spray nozzle with a clean, dry tissue or cloth after each use.
After using Ryaltris (olopatadine / mometasone), avoid blowing your nose for at least 15 minutes to allow the medication to stay in place. Also, avoid tilting your head back immediately, as this can cause the spray to leak into your throat.
If the spray pump gets clogged, don’t use a pin or sharp object to unblock it. Instead, gently pull off the spray pump, remove the dust cap, and soak the pump in warm water for 15 minutes. Rinse both the spray pump and dust cap with warm water, then let them dry completely before putting it back together. After cleaning, re-prime Ryaltris (olopatadine / mometasone) by releasing two sprays into the air before using it again.
Frequently asked questions about Ryaltris (olopatadine / mometasone)
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What are the risks and warnings for Ryaltris (olopatadine / mometasone)?
Ryaltris (olopatadine / mometasone) 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.
Nasal problems
Risk factors: Nasal surgery | Injury to the nose | Ulcers in the nose | Using Ryaltris (olopatadine / mometasone) for several months
Using Ryaltris (olopatadine / mometasone) can sometimes cause problems with the nose like nosebleeds, sores, or damage inside the nose. 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). Let your prescriber know if you notice crusting in the nose, nosebleeds, runny nose, or a whistling sound when you breathe.
Ryaltris (olopatadine / mometasone) can also make it harder for nasal injuries or damage to heal. Avoid using the medication if you have nasal ulcers, an injury, or have recently had nasal surgery, until the area has healed.
Ryaltris (olopatadine / mometasone) can also raise the risk of fungal infections in the nose and throat, especially when you use it for several months. Let your prescriber know if you have any redness or white-colored patches in your nose or mouth.
Drowsiness
Risk factors: Drinking alcohol | Taking other medications that cause drowsiness
Ryaltris (olopatadine / mometasone) can make you feel drowsy. Avoid driving, using machinery, or doing anything that requires you to be alert until you know how it affects you. Don’t drink alcohol or take other medications that raise your risk for drowsiness.
Eye and vision problems
Risk factors: History of glaucoma or cataracts | History of high pressure in the eye
Although it's not common, Ryaltris (olopatadine / mometasone) can raise the pressure in your eyes and cause vision problems, including glaucoma or cataracts. Talk to your eye prescriber before you use Ryaltris (olopatadine / mometasone) if you have glaucoma or cataracts. Let them know you notice any concerning changes to your vision while you're using the medication.
Allergic reactions
Allergic reactions to Ryaltris (olopatadine / mometasone) are possible, including wheezing. Get medical attention right away if you notice hives, rash, swelling of the lips or tongue, or trouble breathing after you use this medication.
Risk of infection
Risk factors: Currently have an infection
Ryaltris (olopatadine / mometasone) can weaken your immune system and raise your risk for getting an infection. Possible infections include viral infections like chickenpox and measles. Once you develop an infection, you might have a harder time recovering from an illness.
Although there haven't been any reports of serious infections linked directly with Ryaltris (olopatadine / mometasone), be on the lookout for any signs of infection while you're using this medication. Stop using it and contact your primary care provider if you have a fever, pain, aches, sore throat, or chills. You might need another medication to treat the infection.
Altered stress hormone levels
Risk factors: Using too much of Ryaltris (olopatadine / mometasone)
Using high doses of Ryaltris (olopatadine / mometasone) can affect cortisol levels, a natural stress hormone your body makes. Symptoms of high cortisol levels include weight gain, fatty deposits around your face and upper back, and loss of fat around your arms and legs. On the other hand, symptoms of low cortisol levels include muscle weakness, loss of appetite, nausea, and vomiting. If either of these issues are severe enough, additional medical treatment might be needed. Use Ryaltris (olopatadine / mometasone) only as directed, stay within the maximum sprays per day, and use the lowest dose for the shortest time possible.
Slowed growth in children
Ryaltris (olopatadine / mometasone) might cause slower growth in children. To lower this risk, children should use the lowest dose for the shortest amount of time needed to treat their symptoms. Discuss with your child's pediatrician if you're concerned about how this medication might affect your child's growth.
Ryaltris (olopatadine / mometasone) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 240 metered sprays of 665mcg/25mcg/spray | 1 nasal spray | $257.30 | $257.30 |
Typical dosing for Ryaltris (olopatadine / mometasone)
Each nasal spray contains 665 mcg of olopatadine and 25 mcg of mometasone.
Ages 12 and older: The typical dose is 2 sprays in each nostril two times per day.
How much does Ryaltris (olopatadine / mometasone) cost?
What are alternatives to Ryaltris (olopatadine / mometasone)?
Eye and nasal symptoms of seasonal allergies (e.g., runny nose, stuffy nose, sneezing, itchy 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)
Nasal allergy symptoms (e.g., runny, stuffy, or itchy nose, sneezing, itchy or watery eyes)
What is the latest news about Ryaltris (olopatadine / mometasone)?
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References
Best studies we foundHikma Specialty USA Inc. (n.d.). How to administer Ryaltris®.
Hikma Specialty USA Inc. (2024). Ryaltris- olopatadine hydrochloride and mometasone furoate spray, metered [package insert]. DailyMed.
Patel, R. H., et al. (2023). Biochemistry, histamine. StatPearls.
Your and Your Hormones. (2019). Cortisol.
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