Allergy and cold
Steroid nasal sprays
Nasal corticosteroid spray
Other names: Flonase, Veramyst, Xhance, Nasonex, Nasacort, Rhinocort
Wait
no wait after the first dose or after later doses (the FAA's MedGuide)
Two FAA documents give different waits. Both are below.
Examiner
The examiner can issue when the document's criteria are met
FAA label
ACCEPTABLE
The FAA's two documents on steroid nasal sprays give different waits.
Track your medicationsCompare FAA documents: Steroid nasal spraysWhat each of the three FAA documents says, in plain wordsOpen
The FAA's documents differ. The FAA's allergy sheet requires a 48-hour ground trial after the first use of any new medication; the FAA's MedGuide, newer and written medicine by medicine, gives these no wait after the first dose. Both are current FAA documents and both name the medicine, so neither is set aside.
Wait
- 48-hour ground trial after first use of any new medication (the FAA's allergy sheet)
The FAA's MedGuide names beclomethasone (Beconase AQ, Qnasl), budesonide (Rhinocort), ciclesonide (Omnaris, Zetonna), flunisolide (Nasalide), fluticasone (Flonase, Veramyst, Xhance), mometasone furoate (Nasonex) and triamcinolone (Nasacort) nasal sprays as allowed, for allergic rhinitis (fluticasone also for nasal polyps), with no wait after the first dose, after later doses or after the final dose.
The FAA's allergy sheet lists corticosteroid nasal sprays as acceptable allergy medication, which may be used as a single agent or in any combination product, if other certification criteria are met. Under new medications, the allergy sheet says symptoms must be controlled without adverse side effects and a mandatory 48-hour ground trial is required after initial use; for acceptable medications, it says the initial observation time is not required (see chart below); and its footnote prohibits flight/safety-related duties after initial use of a new medication until after a 48-hour ground trial and no side effects are noted. The allergy sheet also says airmen who are exhibiting symptoms, regardless of the treatment used, must not fly.
The FAA's general over-the-counter guide lists fluticasone (Flonase), mometasone (Nasonex) and triamcinolone (Nasacort) among its nasal steroid allergy products in its "Generally Safe to Fly" column. The MedGuide defines allowed as acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.
Show the FAA's words: Steroid nasal spraysThe official FAA wording: four passages, each with its document and dateOpen
New medications:
Symptoms must be controlled without adverse side effects.
Initial observation time: Mandatory 48-hour ground trial required after initial use.
Acceptable medications:
Initial observation time: Not required for acceptable medications (see chart below).
ACCEPTABLE* (Non-Sedating) Antihistamine and Allergy Medications
May be used as a single agent or in any combination product, if other certification criteria are met.
Nasal spray: Corticosteroid
* Airmen are prohibited from flight/safety-related duties after initial use of a new medication until after a 48-hour ground trial and no side effects are noted.
Generic: beclomethasone (nasal)
Brand Name: Beconase AQ; Qnasl
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: As prescribed
Generic: budesonide (nasal)
Brand Name: Rhinocort
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions
Generic: ciclesonide (nasal)
Brand Name: Omnaris; Zetonna
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: As prescribed
Generic: flunisolide (nasal)
Brand Name: Nasalide [INTL]
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: As prescribed
Generic: fluticasone (nasal)
Brand Name: Flonase; Veramyst; Xhance
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis; Nasal polyps
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions
Generic: mometasone furoate (nasal)
Brand Name: Nasonex
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions
Generic: triamcinolone (nasal)
Brand Name: Nasacort
Drug Class: Corticosteroid, nasal
Underlying Condition: Allergic rhinitis
Use: ALLOW
INITIAL Wait Time (after first dose): None
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions
Airmen who are exhibiting symptoms, regardless of the treatment used, must not fly.
GENERALLY SAFE TO FLY
GO
Nasal steroid Allergy products azelastine (Astepro) fluticasone (Flonase) mometasone (Nasonex) triamcinolone (Nasacort)
ALLOWED: The medication is acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.