Dymista is a prescription nasal spray used to treat symptoms of seasonal allergic rhinitis (inflammation of the lining of the nose) such as runny nose, stuffy nose, itching, and sneezing. Dymista contains two medicines, azelastine hydrochloride and fluticasone propionate, which are also available individually as nasal sprays. In Dymista, azelastine hydrochloride an antihistamine, and fluticasone propionate, a corticosteroid work in different yet complementary ways.

Azelastine hydrochloride blocks the release and actions of histamine, a chemical responsible for causing many of the symptoms of allergy. Fluticasone propionate is a corticosteroid that reduces inflammation and the body's immune response. When used together, azelastine hydrochloride and fluticasone propionate provide better relief of symptoms than either medicine alone. In clinical trials, Dymista was superior to azelastine nasal spray, fluticasone nasal spray, and placebo in providing symptom relief.

• Dymista was approved by the FDA in May, 2012.
• Dymista is the brand name for azelastine hydrochloride and fluticasone propionate.
• Dymista is not available in generic form.
• You need a prescription for Dymista.

The most common side effects of Dymista are changes in taste, nosebleeds, and headache.

Dymista may cause some more serious side effects including:

• sleepiness or drowsiness,
• slow wound healing,
• fungal infections of the nose or throat,
• eye problems such as glaucoma or cataracts,
• increased risk of infections,
• adrenal insufficiency,
• slow or delayed growth in children, and
• nasal problems.

The recommended dose to treat seasonal allergic rhinitis is 1 spray in each nostril twice daily.

Taking Dymista with alcohol or CNS depressants may cause additive drowsiness or sleepiness.

Fluticasone propionate is metabolized or broken down by the CYP3A4 enzymes in the liver. Strong inhibitors of CYP3A4 enzymes such as ritonavir (Norvir), ketoconazole (Extina, Nizoral), fluconazole (Diflucan), and itraconazole (Onmel, Sporanox) may increase its blood levels and increase the risk of side effects. Dymista should not be used with ritonavir or medicines containing ritonavir.

• It is not known if Dymista is excreted in breast milk.
• Because many drugs are excreted into breast milk and can potentially harm the nursing infant, Dymista should be used cautiously during nursing.

What preparations of azelastine hydrochloride and fluticasone propionat are available?

Nasal spray: 137 mcg of azelastine hydrochloride and 50 mcg of fluticasone propionate (137 mcg/50 mcg) in each metered spray. Each canister delivers 120 metered sprays after priming.

How should I keep azelastine hydrochloride and fluticasone propionate stored?

Dymista nasal spray should be stored upright at room temperature, between 20 C to 25 C (68 F to 77 F).