Steroid nasal spray and ocular pressure

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Hi Anyone out there have any experience of taking a nasal steroid spray in particular Fluticasone and ocular pressures rising.  It is listed as a side effect on the leaflet with the spray.  I have been taking this for about 6 months along with an antihistamine for perrenial rhinitis.  I was assured that it was safe to take.  I am being treated for glaucoma in the left eye but have no changes in the right.  Following 2 cataract surgeries and laser treatment to lower pressure in the left eye (which did not work well enough) so I have been taking Azopt drops for about 1 year.  My pressure have been around 20 in each eye for this time but at my last visit to eye clinic they were found to be 26 in each eye.  I am due to go back after 6 weeks to see if they still remain high and then possibly change the drops.  Having recently moved 200 miles and so a new clinic it did not occur to me that the rise may be to do with the steroid spray.  I have stopped using it and am due to return to the clinic in 2 weeks.  Doctors never seem to believe that medications cause side effects  but I was told at my old eye clinic Moorfields that I was a steroid responder after the steroid eye drops given after cataract surgery caused a big rise in pressure which necessitated me to take glaucoma drops for a short while.  Any information appreciated.

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5 Replies

  • Posted

    A year ago, I was prescribed a  steroid nasal spray for shortness of breath.    I didn't get as far as a doctor, but a nurse prescribed them, despite me saying I didn't want a steroid spray, as I had heard they raised IOP.    I was assured they didn't.    At the chemists, I enquired of the pharmacist who also assured me they were OK.   I still did not believe either of them and phoned up the eye department that I had been attending for years.    They said that it was quite likely that the spray would increase IOP and that if I started using it, I would have to be checked for IOP every two weeks until it was known what was going to happen.    As I lived 300 miles from the Eye hospital, that was out of the question because of cost.    Consequently, I did not use them.     Follwoing me stopping drinking my three glasses of white wine every evening, my weight went from 11 1/2  stone donw to 10 1/2 stone, and then remained at that level.    One the extra 14 pounds was gone, so was the breathlessness.     Also as an added bonus, the IOP has gone down as well!

    • Posted

      Thank you so much for your reply.  I will certainly point this out to the consultant when I see him in 2 weeks.  I am limited to what glaucoma drugs I can take because I also suffer from blepharitis which makes the eyes sore so don't want to take more than I need especially if the rise has been caused by the nasal spray.  I doubt he will agree but I am still not going to use the spray any more.  How I wish sometimes that I could throw away all the medication I use and start again.  Of course I won't but every drug seems to have a long list of side effects and how do you know what is causing what side effect.  I need to lose some weight so perhaps that would help as well.  I also suffer from anxiety and I read that this nasal spray can cause this as well.

    • Posted

      Hello  About 3 weeks ago I mentioned to my gp about my nasal spray having the potential to cause a rise in eye pressure and she said possibly and agreed that I stop it for the moment.  Today I went to the eye clinic and told the doctor there and he say although not common it is a possibility.  My field tests were stable right eye fine and left eye (the one IO use Azopt in) as before showed an early nasal.  The pressures which 6 weeks ago were 26 in each are today 18 left eye 20 right.  He was happy and said they will see me again in 6months.  I don't think in view of this I will take the nasal spray again even though it did help my rhinitis.  I was assured by my gp that the anthistamine which I also discontinued is fine to take.  So might possibly go back on that.  

  • Posted

    I'm sorry I am joining this disussion so late, but your comments helped me back in December.  IOP in left eye continued upward until it hit 23 last fall.  Right eye stays between 17-18.  I used fluticasone regularly.  Read this thread and stopped flucticasone in December.  I had cataract surgery on January 18 (successul with a Toric lens), but it did not help lower IOP at all.  It isn't indicated for lowering pressure, but apparently does help some. 

    My left IOP prior to surgery dropped to 20 (no fluticasone for one month).  Pressure was back to 23 after surgery assumed to be temporary due to surgery.

    I am scheduled for another field of vision test and pressure check in 1 week.  Hoping the pressure is 20 or under.  It isn't much of a decrease, but I think getting rid of the steriod nasal spray helped.

     

    • Posted

      Hello Glad that my comments helped you.  I too have had cataracts removed  and in my case it did lower the IOP a bit although after the ops I had to have glaucoma drops as the IOP's rose (I was not being treated for glaucoma at this time).  I was told I was a steroid responder but did not at the time think sprays would cause a rise as well.  I have to use glaucoma drops in the left eye ( I had  laser treatment but it did not work at least not enough).  My last IOP's last month were 20 right eye and 18 left so stable.  With regard to the fluticasone what are you using instead.  I have diagnosed perrenial rhinitis so I just manage with salt water sprays.  

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