Which medications in the drug class Corticosteroid nasal sprays are used in the treatment of Mold Allergy?

Updated: Sep 18, 2017
  • Author: Shih-Wen Huang, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Answer

Corticosteroid nasal sprays

Corticosteroids are potent anti-inflammatory agents that affect activation of many cells (eg, mast cells, eosinophils, macrophages, lymphocytes) and effect of mediators (eg, histamine, eicosanoids, interleukins [ILs], cytokines) that are important in allergic inflammatory process or hypersensitivity reactions. Therefore, they are important for treatment of the various diseases attributable to mold allergy.

Mometasone (Nasonex)

Mometasone has demonstrated no mineralocorticoid, androgenic, antiandrogenic, or estrogenic activity in preclinical trials. It decreases rhinovirus-induced up-regulation in respiratory epithelial cells and modulates pretranscriptional mechanisms. It reduces intraepithelial eosinophilia and inflammatory cell infiltration (eg, eosinophils, lymphocytes, monocytes, neutrophils, plasma cells). It is available as an aqueous nasal spray of 50-mcg per spray.

Fluticasone intranasal (Flonase, Veramyst)

Fluticasone intranasal is used to treat allergic rhinitis. It is available as an aqueous nasal spray. The propionate (Flonase) delivers 50 mcg per actuation, whereas the furoate (Veramyst) delivers 27.5 mcg per actuation. Fluticasone furoate is well tolerated compared with the older propionate version, particularly in children.

Budesonide inhaled (Rhinocort Aqua)

Budesonide inhaled inhibits bronchoconstriction mechanisms, produces direct smooth muscle relaxation, and may decrease the number and activity of inflammatory cells, in turn decreasing airway hyperresponsiveness. It has extremely potent vasoconstrictive and anti-inflammatory activity. It alters the level of inflammation in airways by inhibiting multiple types of inflammatory cells and decreasing the production of cytokines and other mediators. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. It is used for the treatment of allergic rhinitis.

Flunisolide

Flunisolide inhibits bronchoconstriction mechanisms, produces direct smooth muscle relaxation, and may decrease number and activity of inflammatory cells, in turn decreasing airway hyperresponsiveness. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. It does not depress the hypothalamus.

Ciclesonide (Omnaris)

Ciclesonide is a corticosteroid nasal spray indicated for allergic rhinitis. It is a prodrug that is enzymatically hydrolyzed to the pharmacologic active metabolite C21-desisobutyryl-ciclesonide following intranasal application. Corticosteroids have a wide range of effects on multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (eg, histamines, eicosanoids, leukotrienes, cytokines) involved in allergic inflammation. Each spray delivers 50 mcg. It is well tolerated in children.


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