Suggest A Remedy For Dizziness After Stopping Flonase Cold Turkey

Posted on Tue, 12 Jan 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 12 Jan 2016 Answered on

Tue, 2 Feb 2016 Last reviewed on

Question : I was having some issues that seemed linked to Flonase which I had been taking for 4 months. I immediately quit taking it and things have improved. ive been doing some reading and have found that I should not have stopped taking it cold turkey. how much trouble am I in? am still having some anxiety,a little dizziness that I do not know if is related and have noticed that my blood pressure drops low for me in the evening when I am resting, normal the rest of the day. how possible is it that I have adrenal suppression? what should do?

Answered by Dr. Ajish TP (23 minutes later)

Brief Answer:
Do a stimulated Cortisol values

Detailed Answer:
Hi,

Welcome to HCM. I have gone through your questions and understand your concerns.

Adrenal suppression with inhaled fluticasone ( flonase) is very rare. Still if you feel there is tiredness and BP fall, it is better to have your Cortisol levels checked.

We usually do a stimulation test (You have to consult an endocrinologist for that). What we do is take a sample of Cortisol at 8 am, after that we give an injection called SYNACTHEN and check your Cortisol after 30 and 60 minutes. This will say whether adrenal suppression has occurred or not.

Hope I have answered your questions. If you have any further questions, I will be pleased to help you.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (13 minutes later)

thank you. if it has indeed occurred, can it be fixed? can or will it eventually return to normal on its own? or, how can it be treated?

just for further history - when this began I ended up in the ER out of the blue due to high blood pressure of 233/120. had never had high blood pressure before. this was accompanied with high anxiety that I could not seem to control. high bp problems have gone away since I discontinued the Flonase three weeks ago. only issues remaining are the rather low bp at bedtime when I am relaxed and some anxiety - but not like it was before - milder.

also, you did not answer my question about quitting the Flonase cold turkey. how much of an issue does that cause for my body? is it a real health risk? my Flonase is a prescription of 50 mcg, two sprays in each nostril once a day. Is that a high dose of the cortisosteriod

Answered by Dr. Ajish TP (10 minutes later)

Brief Answer:
It can return to normal

Detailed Answer:
Hi,

If your Cortisol is low we can treat you with milder steroids like hydrocortisone till your adrenal gland recovers. Usually the adrenal suppression will recover after short term steroids use.

Low BP can be a feature of adrenal suppression. I think before worrying we should first confirm whether you have Cortisol deficiency or not.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (13 minutes later)

please answer my question about quitting the Flonase cold turkey, if you know the answer. Is the amount of fluticasone I was taking a high one? is it a health risk to quit taking it like I did?

Answered by Dr. Ajish TP (25 minutes later)

Brief Answer:
It is OK to stop like that, dose is mild, not of high risk

Detailed Answer:
Hi,

Welcome back.
The answers to your questions

1. Oral steroids if taken for more than 2 weeks we advise patients to taper and stop as the chance of adrenal suppression is there.

In inhaled steroids the chance of adrenal suppression is low so we will ask the patients to stop all of a sudden even if they are taking it for more than 6 months.

2. The dose in steroid sprays are very less - about 1/100 th strength of oral tablet.

3. Usually there won't be an issue with stopping the medications cold turkey. The chance of developing adrenal suppression is very very less.

Regards.

Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar