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Because of the inhibitory effect of corticosteroids on wound healingpatients who have experienced recent nasal septum ulcersnasal surgeryor nasal trauma should not use a nasal corticosteroid until healing has occurred.

Visual disturbance may be reported with systemic and topicalincludingintranasalinhaled and intraocularcorticosteroid useIf a patient presents with symptoms such as blurred vision or other visual disturbancesthe patient should be considered for referral to an ophthalmologist for evaluation of possible causes of visual disturbances which may include cataractglaucoma or rare diseases such as central serous chorioretinopathyCSCRwhich have been reported after use of systemic and topical corticosteroids.

Keep track of the number of sprays used from the containerDiscard the container after you have used the number of sprays specified on the manufacturer’s packageFollow the package instructions to unblock the spray tip if needed and to clean the spray bottle.

Co-treatment with CYP3A inhibitorsincluding cobicistat-containing productsis expected to increase the risk of systemic side-effectsThe combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effectsin which case patients should be monitored for systemic corticosteroid side-effects.

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