Can You Safely Use Flonase If You Have High Blood Pressure?

Quick Answer

Nasal corticosteroids, like Flonase (fluticasone propionate), are generally considered safe for those with high blood pressure due to their minimal systemic absorption.

Detailed Answer

Flonase contains fluticasone propionate, a corticosteroid. Corticosteroids are used for a wide variety of conditions and fluticasone propionate specifically is available in many different dosage forms (e.g., creams, ointments, nasal sprays, inhalation sprays etc...).

While some corticosteroids (e.g., prednisone, methylprednisolone, dexamethasone etc...) are associated with blood pressure increases when taken chronically by mouth, there is little evidence to suggest that nasal steroids like Flonase increase blood pressure.

This is because when administered intranasally, corticosteroids have a very low bioavailability, which means that only a small fraction of the administered dose reaches systemic circulation. This is certainly the case with Flonase. Per the prescribing information for the drug:

Indirect calculations indicate that fluticasone propionate delivered by the intranasal route has an absolute bioavailability averaging less than 2%. Trials using oral dosing of labeled and unlabeled drug have demonstrated that the oral systemic bioavailability of fluticasone propionate is negligible (<1%), primarily due to incomplete absorption and presystemic metabolism in the gut and liver.

In other words, less than 2% of an intranasal dose of Flonase will be absorbed systemically, and any drug you swallow (if it travels through your nasal cavity), less than 1% of that will be absorbed.

There is just no evidence that nasal steroids, like Flonase, increase blood pressure, or put those with high blood pressure at any additional risk in that regard.

In fact, one study that evaluated the effect of nasal steroids on blood pressure in patients with allergic rhinitis found that nasal steroids significantly improved nasal symptoms compared to placebo and, interestingly enough, there was a significant decrease in systolic BP (SBP) and diastolic BP (DBP) in the nasal steroid group compared to placebo.

The authors of the study concluded that nasal steroids may have a beneficial effect on blood pressure by reducing inflammation and improving nasal patency (a measure of how open the nasal passages are).

Although there haven't been specific studies that have evaluated all available nasal steroids and their effects on blood pressure, the safe assumption would be that they are all considered generally safe in that regard.

Other nasal steroids that are available include:

• Flonase Sensimist (fluticasone furoate)
• Nasacort AQ (triamcinolone acetonide)
• Rhinocort (budesonide)
• Nasonex (mometasone)

Final Words

I hope you found this answer helpful! Unless you have any other condition that would preclude the use of Flonase, it is a good option to treat allergy symptoms in those diagnosed with high blood pressure.