{
  "schema_version": 1,
  "kind": "condition",
  "id": "nose-symptoms",
  "name": "Nose Symptoms or Complaints",
  "category": "acute",
  "sources": "Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77) · Akhouri S, House SA. Allergic Rhinitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2023 Jul 16. Bookshelf ID: NBK538186.",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77) · Akhouri S, House SA. Allergic Rhinitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Updated 2023 Jul 16. Bookshelf ID: NBK538186.",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1267,
      "generic": "Fluticasone",
      "line": 1,
      "is_adjunct": false,
      "form": "spray",
      "strength_mg": null,
      "adult_dose": "Two spray actuations into each nostril once daily (110 mcg/day total if using the fluticasone furoate 27.5 mcg/spray product, or 200 mcg/day total if using the fluticasone propionate 50 mcg/spray product).",
      "adult_duration": "As directed",
      "dose_source": "Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77)",
      "rationale": "Most non-traumatic, bilateral 'nose symptoms' seen in general practice are due to allergic or perennial rhinitis, which is the formulary's actual indication for this nasal spray; it treats the likely cause, not the symptom code itself.",
      "cautions": [
        "Given as a nasal spray, not swallowed: the dose is two actuations per nostril.",
        "This dose treats nasal symptoms caused by allergic/perennial rhinitis, not nasal trauma, tumour, or infection - a nasal steroid spray will not help those and should not delay referral.",
        "A tense, painful septal swelling after trauma (possible septal haematoma) needs urgent surgical drainage, not a nasal spray.",
        "Persistent one-sided nasal symptoms with bleeding need referral to exclude a nasal tumour before treating symptomatically.",
        "Local irritation, dryness, and epistaxis are common; avoid in untreated local nasal infection.",
        "Use the lowest effective dose; prolonged high-dose use in adolescents carries a growth-suppression risk."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children 4-12 years: one spray per nostril once daily, preferably in the morning (27.5 mcg fluticasone furoate, max 55 mcg/day) or 50 mcg fluticasone propionate per spray (max 100 mcg/day); some cases need twice daily, to a maximum of two sprays per nostril.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": [
        {
          "label": "4 to 12 years",
          "age_min_months": 48,
          "age_max_months": 155,
          "dose_text": "One spray per nostril once daily, preferably in the morning - 27.5 mcg fluticasone furoate (maximum 55 mcg a day), or 50 mcg fluticasone propionate per spray (maximum 100 mcg a day). Some cases need twice daily, to a maximum of two sprays per nostril."
        }
      ],
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "RHINORELIEF NASAL SUSP. 50 MCG/METERED SPRAY DOSE",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ARAB DRUG COMPANY (ADCO)",
          "price_egp": 32.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.05,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "TICANASE 0.05% NASAL SPRAY 12 GM",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.",
          "price_egp": 70.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 12000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FLIX NASAL SPRAY 50 MCG/METERED SPRAY DOSE",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EVA PHARMA",
          "price_egp": 76.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.05,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FLIXONASE 50 MCG/METERED NASAL SPRAY 120 DOSE",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 133.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.05,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FLOHALE HFA 250MCG/DOSE AEROSOL 120 DOSES",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CIPLA LTD. - INDIA > STAR INTERNATIONAL COMPANY",
          "price_egp": 95.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.25,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "nose-symptoms"
    }
  ]
}