Tomer Boldes MD, Benny Nageris MD, Firas Kassem MD, Ameen Biadsee MD
Intranasal corticosteroids (INCS) are frequently prescribed for allergic rhinitis but can also be used for other indications, such as sinusitis and nasal congestion. INCS are considered effective in controlling nasal symptoms with a similar safety profile among the different INCS formulations. In this review, we presented all available INCS formulations marketed in Israel while emphasizing the differences among them with a practical approach for medical providers in selecting a specific INCS agent. We conducted a literature review using PubMed, Medline, and Google Scholar to identify articles related to INCS, triamcinolone acetonide, fluticasone propionate, and fluticasone furoate. Currently, five brands of INCS are available in Israel. While they all have similar efficacy in treating nasal symptoms, only fluticasone furoate consistently demonstrated a reduction in ocular symptoms compared to placebo. Other differences included sensory attributes, recommended regimens, approved age for use, and cost. When selecting INCS agent, a personalized approach is advised. Factors such as age, co-morbidities, concurrent medications, pregnancy, and patient preferences should be considered.