The recommended dose is one or two sprays in each nostril once daily. Before use of the nasal spray, the nose should be blown gently, and the inhaler or spray should be shaken. The head should be tilted backwards, with the nozzle inserted into one nostril, the opening of the nozzle toward the swollen area. The other nostril should be closed. and the spray or inhaler activated while breathing in through the nose and out through the mouth. The inhaler or spray should be cleaned daily. The canister should be removed from the inhaler, rinsing the cap, nosepiece, and the inhaler with warm water and then drying them thoroughly.
Persons who are using drugs that suppress the immune system (., corticosteroids) are more susceptible to infections than healthy individuals. Chickenpox and measles , for example, can have a more serious or even fatal course in susceptible children or adults using corticosteroids. In children or adults who have not had these diseases or been properly immunized, particular care should be taken to avoid exposure. How the dose, route, and duration of corticosteroid administration affect the risk of developing a disseminated infection is not known. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not known. If a patient is exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If a patient is exposed to measles, prophylaxis with pooled intramuscular immunoglobulin ( IG ) may be indicated (see the respective package inserts for complete VZIG and IG prescribing information). If chickenpox or measles develops, treatment with antiviral agents may be considered.