High-dose nasal corticosteroids

These POMs can be supplied for sinusitis through a PGD in the England Pharmacy First scheme. The use of high dose nasal corticosteroid is off-label in sinusitis and is based on the NICE review of relevant clinical trials. (‘Off-label’ use is where a medicine is being used in a way that is different to that described in the licence.)

NICE concluded that there is evidence that high dose nasal corticosteroid (equivalent to mometasone 400mcg a day) for 14-21 days produced a statistically significant improvement in symptoms in adults and children aged 12 years and over compared with placebo.

The following side-effects are listed in the product SPC or BNF as very common or common with intranasal fluticasone (or other intranasal steroids): epistaxis; headache; throat irritation; nasal ulceration; dyspnoea; altered smell; altered taste. As use is ‘off label’ these may not reflect all side-effects when used for sinusitis.