# Disturbance of Smell or Taste - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - 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. - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77) ## Treatment metadata - Fluticasone — spray ## Complete treatment card ```text DISTURBANCE OF SMELL OR TASTE 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 against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (8) - Loss that came on suddenly usually follows a head injury or a viral illness - Loss that has crept up slowly points to allergic rhinitis, nasal polyps or a growth [allergic rhinitis · nasal polyps] - Smell that comes and goes fits allergic rhinitis or regular use of nose sprays and drops [allergic rhinitis] - The two commonest causes are long-standing rhinitis and head injury, so ask about both - Headache or a change in behaviour alongside it suggests a cause inside the skull [headache] - Loss of smell is a symptom, never a diagnosis in its own right [loss of smell] - Ask about work exposures to fumes, toxins or allergens - Ask about medicines; sometimes only stopping the suspect drug proves the link SIGNS - what you find (6) - In a very young patient with other features, think congenital causes such as Kallmann syndrome - Where that is suspected, examine the gonads and the nervous system carefully - In an older patient, weigh normal ageing against an early neurodegenerative illness such as Parkinson disease - Examine the nasal cavity and the sinuses closely - A neurological examination may uncover other deficits pointing to a wider brain problem - Look at the fundi for raised pressure inside the skull, which would justify imaging TESTS (8) - A rough bedside test with chocolate or coffee is easy but subjective - Formal testing gives a measured threshold that can be set against the patient's age group - The UPSIT odour identification test is the most widely used and takes about ten minutes - Suspected head injury, sinus disease or a tumour warrants an MRI or a CT - If allergic rhinitis is likely, allergy skin testing may give the answer - An ESR helps when the wider picture suggests inflammation - Depending on the suspected cause, consider blood count, creatinine, liver and thyroid tests, ANA and heavy metal levels - When no cause is apparent, MRI seldom explains it: across 839 patients it gave the answer 0.8% of the time IF NOT THIS - what else fits (8) - Hyposmia means a blunted sense of smell rather than a complete loss - Parosmia means a real smell is perceived wrongly - Phantosmia means smelling something when nothing is there - Chronic rhinitis and head injury together account for most cases - Nasal polyps and tumours produce the slow-onset picture - Kallmann syndrome is the congenital cause to consider in the very young - In older people, ordinary ageing or early Parkinson disease - A medicine can be the cause, and only withdrawal proves it Source StatPearls "Anosmia" - disease-level clinical article Status traced to the source above 1. FLUTICASONE [1st line] Adult 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. - Trial for at least several weeks; full benefit may take longer than 48 hours to appear. Peds 4 to 12 years: One spray per nostril once daily - a lower dose than the adult one. (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.) Source Egyptian National Drug Formulary - respiratory-2026.pdf, Fluticasone monograph (chapter PDF p77) Why 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. Caution 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. Egypt RHINORELIEF NASAL SUSP. 50 MCG/METERED SPRAY DOSE ARAB DRUG COMPANY (ADCO) 32.00 EGP TICANASE 0.05% NASAL SPRAY 12 GM EUROPEAN EGYP... 70.00 EGP FLIX NASAL SPRAY 50 MCG/METERED SPRAY DOSE EVA PHARMA 76.00 EGP FLIXONASE 50 MCG/METERED NASAL SPRAY 120 DOSE GLAXO SMITHKLINE 133.00 EGP FLOHALE HFA 250MCG/DOSE AEROSOL 120 DOSES CIPLA LTD. - INDIA > STAR INTE... 95.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)