Flunisolide nasal spray in the treatment of perennial rhinitis

In an 8-week double-blind study of the clinical effectiveness of flunisolide, a new synthetic corticosteroid intended for topical use, 73 persons with perennial rhinitis received 300 microgram/d of either flunisolide or placebo. The flunisolide group showed a significantly greater reduction than the placebo group in the daily duration of sneezing, stuffy nose, nose blowing and postnasal drip, but not of runny nose, and a significantly greater reuction in the severity of all these manifestations. Substantial or total control of manifestations was reported by 73% of the flunisolide group and 25% of the placebo group, a significant difference. Careful monitoring of the plasma cortisol concentration revealed no evidence of adrenal suppression, and in no patient did the value fall below normal. The lack of adrenal suppression may be due to the very small amount of corticosteroid administered and the rapid metabolism of flunisolide into a relatively inactive metabolite.