Does Flonase Help Remove Fluid Behind The Eardrum?

In our latest question and answer, the pharmacist discusses whether or not Flonase can help to reduce fluid trapped behind the eardrum.

Question

Can Flonase Sensimist to help clear up fluid trapped behind the eardrum? I was told to use this at an urgent care facility.

Asked by Cath gran On Jun 26, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jun 29, 2022
Last updated Jun 29, 2022

Key points

  • Flonase and other nasal steroids are generally not a recommended treatment for fluid behind the eardrum (i.e. otitis media with effusion).

Hello and thanks for your question!

Fluid behind the eardrum is also referred to as otitis media with effusion and is more commonly a condition that children have to deal with, but adults can certainly have it as well.

In regard to treatment, otitis media with effusion generally resolves on its own, with at least some improvement often seen within a 3-month time frame.

However, if there is no improvement over time, or there are complications to consider (e.g. the fluid buildup causing hearing loss), intervention can be taken.

Flonase For Otitis Media With Effusion

Flonase is a 'steroid' nasal spray that contains the glucocorticoid fluticasone.

There are actually two forms of Flonase on the market, Flonase, and Flonase Sensimist. They contain two different steroids.

'Regular' Flonase contains fluticasone propionate, while Flonase Sensimist contains fluticasone furoate.

I have written an in-depth article explaining the difference between these two drugs previously.

In regard to using Flonase to treat otitis media with effusion (i.e. fluid behind the eardrum), or using any nasal steroid for that matter, most guidelines recommend against it.

There just appears to be little evidence for benefit.

One of the largest review studies (a Cochrane Review) that evaluated the use of nasal steroids for otitis media with effusion concluded that nasal steroids (referred to as 'topical steroids') had no benefit:

We found no evidence of benefit from treatment of OME with topical intranasal steroids, alone or in combination with an antibiotic, either at short or longer-term follow-up.
Cochrane Database Syst Rev . 2011 May 11;(5):

Other studies have reported similar findings.

There does appear to be some benefit with nasal steroids, like Flonase, if there are concurrent conditions, like allergies or nasal inflammation. Nasal steroids are very effective for these conditions.

There also doesn't appear to be much of a risk of using nasal steroids. They are generally well-tolerated and have only minor side effects in most individuals.

There could certainly be specific reasons why your provider recommended using Flonase to help with what you are going through, so I encourage you to reach out to them.

They or your primary care doctor are going to be your best resource as they know the most about your medical condition.

Final Words

I mentioned at the beginning of this answer that fluid behind the eardrum generally resolves on its own.

If it does not, there are other treatment options (such as tympanostomy tubes, balloon dilation of the Eustachian tube, adenoidectomy, decongestants, and oral steroids) that you should talk to your doctor about.

Thanks again for your question and feel free to reach out again if anything else comes up!

References

  • Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion, PubMed
  • Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children, PubMed
  • Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com!

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