Re: Flovent HFA (fluticasone propionate 220 mcg)

[Guest guest]

Thank you so much for writing this long post. Is this flovent similar to flixonase nasules? I'm really pleased for you that you have found something that has significantly improved your health and sense of smell, and I hope that you will continue to stay well, without having to take vast amounts of predisolone or antibiotics. Please let us know how you are doing in a couple of months to see if this is still working for you. Has anyone else has a similar response? Regards, Beckycondry <ondry@...> wrote: My Samters is possibly an anomaly because I had anosmia, congestion, aspirin allergy, polyps, and plugged sinuses but no asthma symptoms. Initially, before the aspirin allergy appeared, we were treating the symptoms as allergy. The congestion got so bad that in February 2006 I had anterior & posterior ethmoidectomy, bilateral maxillary atrosomy, and bilateral polypectomy. This helped but did not eliminate the congestion and discharge. In July 2006 I was recovering from a rotator cuff repair and took 400 mg of naproxen in the evening for the pain - thought I was going to die. Luckily the next day I was seeing the doctor who was treating my nasal symptoms and mentioned this. He said, "oh, you have Samters". With that we had a diagnosis and proceeded to try various treatments. Large doses of prednisone (60 mg/day) would give me

temporary relief but when I tapered off the symptoms would return. At first the large prednisone doses would give my some sense of smell and taste which disappeared when I tapered the dose. Later this effect was absent. I desensitized to aspirin and took 1300 mg daily for quite a long time with no benefit. More recently I was taking 325 mg aspirin daily and 20 mg of prednisone every other day but still needed phenyephrine nasal spray on occasion to open my nasal passages and had no drainage from my sinuses after irrigating. I'm a retired pharmacist, so my doc lets me try most everything if I think it might help. There was a post about using Flovent HFA 220 mcg (fluticasone propionate) as a nasal inhalant and I was willing to try. Using the Flovent with a baby bottle nipple with the end removed I started. Within 3 days my sinuses were

showing some drainage after flushing. By day 14 the post flush drainage was normal. Day 18 I was detecting faint sense of smell and taste. Day 20 sense of smell and taste was better and continued to improve. On day 40 I reduced my prednisone from 20 mg every other day to 15 mg every other day. Day 47 reduced prednisone to 10 mg every other day. Day 55 reduced the prednisone to 5 mg. Smell and taste still very good - this is the longest period I have been able to say that since 2005. My current regimen is 1 puff in each nostril of Flovent HFA 220 mcg AM and PM, 325 mg aspirin, 5 mg prednisone, and nasal irrigation AM & PM. Today, day 56, I'm going to switch to Flovent HFA 110 mcg and see if the good results continue. If after a couple of weeks I can still smell and taste I intend to try to eliminate the oral prednisone entirely. Today my doc checked me and said that the right nostril and sinus were perfect with no polyps. The left nostril which had a small polyp at my last exam was also polyp free and had just a small amount of crusting (1+ on a scale of 1-10). I apologize for the long posting but it might help someone. My very special thanks to whomever posted the information about using Flovent (an oral inhalant) in the nose. Fo me it worked - so far.

[Guest guest]

No asthma does not mean you don't have Samter's ; a good subgroup of

Samter's patients (including me) don't have asthma. Aspirin intolerance

and sinonasal polyps are sufficient to characterize Samter's - or AERD

as some now put it (I'm not going into any terminology debate).

Glad to know local Fluticasone propionate works ! Have you calculated

the prednisone equivalent of the amount of fluticasone that you deliver

daily to your nose ? I have not had time to check if there is a) an

available conversion rate to evaluate the pred equivalent, any risk

of HPA axis suppression with Fluticasone.

Since you have access to everything, I would recommend nebulized sodium

cromoglycate (Lomudal), or even irrigating with it (start with low doses

in saline), since most of your sinuses are open. You might consider that

if you stop aspirin or want to use entirely topical treatments. DSCG

takes a few days (weeks?) to reach full effect. Its effects

add/complement that of glucocorticoids, which, as you know, have rebound

effects (decongestants too).

Also, since your sinuses are opened, you may drain them naturally after

irrigation simply by hanging your head down ( " facing the floor " ) for

10-15 min, as you may already have noticed (and re-irrigate/re-drain to

clean if necessary)

You have not tried Montelukast or Zileuton, but both are systemic.

Have you got any allergies that might justify desens ? Do antihistamines

help (rebound effect likely though) ?

Is the permanent discharge clear ?

>

> My Samters is possibly an anomaly because I had anosmia, congestion,

aspirin allergy, polyps, and plugged sinuses but no asthma symptoms.

Initially, before the aspirin allergy appeared, we were treating the

symptoms as allergy. The congestion got so bad that in February 2006 I

had anterior & posterior ethmoidectomy, bilateral maxillary atrosomy,

and bilateral polypectomy. This helped but did not eliminate the

congestion and discharge. In July 2006 I was recovering from a rotator

cuff repair and took 400 mg of naproxen in the evening for the pain -

thought I was going to die. Luckily the next day I was seeing the

doctor who was treating my nasal symptoms and mentioned this. He said,

" oh, you have Samters " . With that we had a diagnosis and proceeded to

try various treatments. Large doses of prednisone (60 mg/day) would

give me temporary relief but when I tapered off the symptoms would

return. At first the large prednisone doses would give my some sense of

smell and taste which disappeared when I tapered the dose. Later this

effect was absent. I desensitized to aspirin and took 1300 mg daily for

quite a long time with no benefit. More recently I was taking 325 mg

aspirin daily and 20 mg of prednisone every other day but still needed

phenyephrine nasal spray on occasion to open my nasal passages and had

no drainage from my sinuses after irrigating.

>

> I'm a retired pharmacist, so my doc lets me try most everything if I

think it might help. There was a post about using Flovent HFA 220 mcg

(fluticasone propionate) as a nasal inhalant and I was willing to try.

Using the Flovent with a baby bottle nipple with the end removed I

started. Within 3 days my sinuses were showing some drainage after

flushing. By day 14 the post flush drainage was normal. Day 18 I was

detecting faint sense of smell and taste. Day 20 sense of smell and

taste was better and continued to improve. On day 40 I reduced my

prednisone from 20 mg every other day to 15 mg every other day. Day 47

reduced prednisone to 10 mg every other day. Day 55 reduced the

prednisone to 5 mg. Smell and taste still very good - this is the

longest period I have been able to say that since 2005. My current

regimen is 1 puff in each nostril of Flovent HFA 220 mcg AM and PM, 325

mg aspirin, 5 mg prednisone, and nasal irrigation AM & PM. Today, day

56, I'm going to switch to Flovent HFA 110 mcg and see if the good

results continue. If after a couple of weeks I can still smell and

taste I intend to try to eliminate the oral prednisone entirely.

>

> Today my doc checked me and said that the right nostril and sinus were

perfect with no polyps. The left nostril which had a small polyp at my

last exam was also polyp free and had just a small amount of crusting

(1+ on a scale of 1-10).

>

> I apologize for the long posting but it might help someone. My very

special thanks to whomever posted the information about using Flovent

(an oral inhalant) in the nose. Fo me it worked - so far.

>

[Guest guest]

I posted the info about Flovent in the nose and I'm glad it has

helped you. I have been using it for several years, and it has

really helped me. I've been battling this for 30+ years and the

Flovent and Singulair combination has worked the best for the longest

period of time of any of the medicines or surgeries I've had over the

years. I still have to have polyps out from time-to-time, but they

grow slower and can be somewhat tamed by the Flovent. At this point,

if I can breathe through my nose and taste and smell most of the

time,I'm happy.

Enjoy the taste of your favorite foods and the smells of the holidays!

Diane

Florida

> My Samters is possibly an anomaly because I had

anosmia, congestion, aspirin allergy, polyps, and plugged sinuses but

no asthma symptoms. Initially, before the aspirin allergy appeared,

we were treating the symptoms as allergy. The congestion got so bad

that in February 2006 I had anterior & posterior ethmoidectomy,

bilateral maxillary atrosomy, and bilateral polypectomy. This helped

but did not eliminate the congestion and discharge. In July 2006 I

was recovering from a rotator cuff repair and took 400 mg of naproxen

in the evening for the pain - thought I was going to die. Luckily

the next day I was seeing the doctor who was treating my nasal

symptoms and mentioned this. He said, " oh, you have Samters " . With

that we had a diagnosis and proceeded to try various treatments.

Large doses of prednisone (60 mg/day) would give me temporary relief

but when I tapered off the symptoms would return. At first the large

prednisone doses would give my some sense of

> smell and taste which disappeared when I tapered the dose. Later

this effect was absent. I desensitized to aspirin and took 1300 mg

daily for quite a long time with no benefit. More recently I was

taking 325 mg aspirin daily and 20 mg of prednisone every other day

but still needed phenyephrine nasal spray on occasion to open my

nasal passages and had no drainage from my sinuses after irrigating.

>

> I'm a retired pharmacist, so my doc lets me try most everything

if I think it might help. There was a post about using Flovent HFA

220 mcg (fluticasone propionate) as a nasal inhalant and I was

willing to try. Using the Flovent with a baby bottle nipple with the

end removed I started. Within 3 days my sinuses were showing some

drainage after flushing. By day 14 the post flush drainage was

normal. Day 18 I was detecting faint sense of smell and taste. Day

20 sense of smell and taste was better and continued to improve. On

day 40 I reduced my prednisone from 20 mg every other day to 15 mg

every other day. Day 47 reduced prednisone to 10 mg every other

day. Day 55 reduced the prednisone to 5 mg. Smell and taste still

very good - this is the longest period I have been able to say that

since 2005. My current regimen is 1 puff in each nostril of Flovent

HFA 220 mcg AM and PM, 325 mg aspirin, 5 mg prednisone, and nasal

irrigation AM & PM. Today, day 56, I'm going to

> switch to Flovent HFA 110 mcg and see if the good results

continue. If after a couple of weeks I can still smell and taste I

intend to try to eliminate the oral prednisone entirely.

>

> Today my doc checked me and said that the right nostril and sinus

were perfect with no polyps. The left nostril which had a small

polyp at my last exam was also polyp free and had just a small amount

of crusting (1+ on a scale of 1-10).

>

> I apologize for the long posting but it might help someone. My

very special thanks to whomever posted the information about using

Flovent (an oral inhalant) in the nose. Fo me it worked - so far.

>

[Guest guest]

asfyso,

Sorry to be so late replying. When I decreased the dosages 110 mcg Fluticasone instead of 220 mcg and decreased the prednisone the anosmia and some congestion returned. Made a stupid mistake by changing two parameters at the same time - very bad scientific approach. I have returned to 220 mcg q nare bid and 20 mg pred every other day. Showing some improvement but still no sense of smell yet. Did not find a fluticasone/prednisone equivalence but did find a reference saying the systemic effect of fluticasone from oral inhalation was minimal. At my age (80 next June) I don't worry too much about long term side effects. My annual eye exam has shown no increase in intraocular pressure or cataract formation. Tried desens for over a year with no improvement. When I decreased my dosage I had some sneezing and colored nasal discharge, began amoxicillin 500 mg tid and in 4 days the discharge turned to clear. Will now stay on the higher steroid dose plus the amoxicillin for at least ten days to see if things improve.

Carl

[Guest guest]

Congratulations for being in such good ocular shape at your age !

>

> asfyso,

> Sorry to be so late replying. When I decreased the dosages 110 mcg

Fluticasone instead of 220 mcg and decreased the prednisone the anosmia

and some congestion returned. Made a stupid mistake by changing two

parameters at the same time - very bad scientific approach. I have

returned to 220 mcg q nare bid and 20 mg pred every other day. Showing

some improvement but still no sense of smell yet. Did not find a

fluticasone/prednisone equivalence but did find a reference saying the

systemic effect of fluticasone from oral inhalation was minimal. At my

age (80 next June) I don't worry too much about long term side effects.

My annual eye exam has shown no increase in intraocular pressure or

cataract formation. Tried desens for over a year with no improvement.

When I decreased my dosage I had some sneezing and colored nasal

discharge, began amoxicillin 500 mg tid and in 4 days the discharge

turned to clear. Will now stay on the higher steroid dose plus the

amoxicillin for at least ten days to see if things improve.

> Carl

>