{
  "schema_version": 1,
  "kind": "condition",
  "id": "smell-or-taste-disturbance",
  "name": "Disturbance of Smell or Taste",
  "category": "acute",
  "sources": "Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77) · Li X, Lui F. Anosmia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last update July 3, 2023.",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1713,
      "generic": "Fluticasone",
      "line": 1,
      "is_adjunct": false,
      "form": "spray",
      "strength_mg": null,
      "adult_dose": "Two spray actuations in each nostril once daily (110 mcg/day total for fluticasone furoate, or 200 mcg/day total for the fluticasone propionate product) to treat the underlying nasal cause.",
      "adult_duration": "Trial for at least several weeks; full benefit may take longer than 48 hours to appear.",
      "dose_source": "Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77)",
      "rationale": "When smell or taste disturbance is due to nasal congestion, allergic rhinitis, or sinus inflammation, an intranasal corticosteroid treats the underlying nasal cause; it is not itself a licensed anosmia treatment and does not replace referral when red flags are present.",
      "cautions": [
        "Given as a nasal spray, not swallowed: the dose is two actuations per nostril.",
        "This treats nasal congestion/allergic rhinitis as a likely underlying cause of smell or taste disturbance - it is not a direct treatment for anosmia itself, and evidence for post-viral (including post-COVID) smell loss is limited.",
        "Unilateral smell loss with headache or a visual change needs urgent referral to exclude an intracranial mass, not empirical nasal steroid.",
        "Onset after head trauma needs referral rather than routine treatment.",
        "Loss persisting beyond several months without an obvious cause warrants ENT referral.",
        "Local irritation or epistaxis can occur - correct spray technique (angled away from the septum) reduces this."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "A different, lower intranasal dose applies to children 4-12 years (one spray per nostril once daily); not the focus here as this is being used for a nasal cause of smell disturbance in an adult.",
      "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 - a lower dose than the adult one."
        }
      ],
      "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": "smell-or-taste-disturbance"
    }
  ]
}