Avamys® (nasal fluticasone furoate)

Avamys® is a nasal corticosteroid spray containing the active ingredient fluticasone furoate.

Fluticasone furoate is a newer corticosteroid with a particularly high binding affinity for the glucocorticoid receptor and very low systemic absorption. This means: strong local action in the nose with minimal side effects in the rest of the body.

Avamys® also stands out for its pleasant spray profile – the fine mist spreads evenly in the nose.

Fluticasone furoate acts as a potent anti-inflammatory corticosteroid in the nasal mucosa:

Mechanism of action:

• Binds to the glucocorticoid receptor in the cells of the nasal mucosa
• Inhibits the release of inflammatory mediators (prostaglandins, leukotrienes, cytokines)
• Reduces the influx of inflammatory cells (eosinophils, mast cells, lymphocytes)
• Reduces swelling of the nasal mucosa

Effect on symptoms:

• Stuffy nose
• Runny nose
• Sneezing
• Itching
• Eye symptoms often improve as well (naso-ocular reflex)

Onset of action: A noticeable improvement often occurs after as little as 8 hours. The full effect develops over several days of regular use.

Avamys® is suitable for:

• Adults and adolescents aged 12 years and older with allergic rhinitis
• Children aged 6 years and older (under medical supervision)
• Seasonal and perennial allergic rhinitis
• Moderate to severe symptoms, especially nasal congestion

Especially recommended for:

• A stuffy nose as the main symptom
• Insufficient effect of oral antihistamines alone
• Combination with oral antihistamines for severe symptoms
• Long-term treatment of perennial allergies

Not suitable:

• Acute sinus infection (not without medical treatment)
• Nosebleeds or nasal injuries
• After nasal surgery (until fully healed)

Adults and adolescents aged 12 years and older:

• Starting dose: 2 sprays per nostril once daily (= 55 µg × 2 = 110 µg total)
• Maintenance dose once symptoms are controlled: 1 spray per nostril once daily (55 µg total)

Children 6–11 years:

• 1 spray per nostril once daily (55 µg total)
• If control is insufficient: 2 sprays per nostril (medical supervision)

Available strength:

• 27.5 µg fluticasone furoate per spray (120 sprays per bottle)

Duration of use:

• Seasonal: Throughout the entire pollen season
• Ideally start 1–2 weeks before the pollen season begins
• Perennial: Year-round use possible under medical supervision

How to use:

• Gently blow your nose before use
• Shake the bottle vigorously
• Insert the nozzle into the nostril, tilted slightly toward the outside
• Breathe in gently through your nose while spraying
• Do not blow your nose after spraying

Important notes:

• Use once daily, if possible always at the same time
• Regular use is essential – not just as needed
• Before first use: pump the spray head 6 times (priming)
• After 30 days of non-use: prime again
• Clean the spray head regularly

Correct technique:

• Do NOT tilt your head back
• Aim the spray slightly away from the nasal septum
• Do not sniff at the same time – breathing in gently is enough

Avamys® must not be used in cases of:

• Hypersensitivity to fluticasone furoate or any of the other ingredients

Caution in cases of:

• Severe hepatic impairment (increased systemic exposure)
• Concomitant treatment with ritonavir or other strong CYP3A4 inhibitors (increased cortisol suppression)
• Active or latent tuberculosis
• Untreated fungal infection of the nose
• Recent nasal surgery or nasal injury
• Children (long-term use under medical supervision because of growth)

Pregnancy and breastfeeding: Should only be used after a strict benefit-risk assessment. Systemic absorption is minimal; nevertheless, consulting a doctor is recommended.

Very common (10% or more):

• Nosebleeds (epistaxis) – most common side effect

Common (1–10%):

• Ulcers of the nasal mucosa
• Shortness of breath (dyspnea)
• Headache

Uncommon (0.1–1%):

• Nasal pain or discomfort
• Nasal dryness

Rare:

• Hypersensitivity reactions (urticaria, angioedema)
• Anaphylaxis
• Nasal septum perforation (with long-term use, very rare)

Systemic side effects: When used as directed, systemic cortisone effects (weight gain, osteoporosis) are not expected, as the systemic bioavailability of nasal fluticasone furoate is 0.5%. However, slowed growth has been reported in children, even at approved doses. During longer use, children's growth should therefore be checked regularly.

Note: Nosebleeds occur more often when the spray is sprayed directly onto the nasal septum. Correct application technique reduces this risk considerably.

Caution with concomitant use of:

• Ritonavir and other strong CYP3A4 inhibitors (increase systemic fluticasone exposure, risk of Cushing's syndrome)
• Ketoconazole, itraconazole (similar mechanism)
• Other nasal or inhaled corticosteroids (additive cortisol suppression)

No relevant interaction with:

• Oral antihistamines (safe and recommended combination)
• Leukotriene antagonists
• Decongestant nasal sprays (short-term)