Adrenal function during the use of dexamethasone aerosols in the treatment of ragweed hay fever

Local Effect of Intranasal Beclomethasone Dipropionate Aerosol in Hay Fever

“…The indications that there is no systemic action are firstly that it was not possible to show any significant change in the urinary excretion of 17-ketogenic steroids before and after treatment, and secondly that there was a pronounced discrepancy between the effect of the active aerosol on nasal symptoms and the lack of direct effect on eye symptoms. This is opposite to the effect obtained by intranasal application of 1 mg dexamethasone phosphate, where nasal as well as eye symptoms were alleviated in nearly the same degree (Norman and Winkenwerder, 1965). The results of the present study taken together with the last few years' experience with beclomethasone dipropionate aerosol in the treatment of asthma suggest that 400 tg of the drug given intranasally is an apparently harmless and effective treatment of nasal symptoms in hay fever.…”

“…This effect exceeds what has been obtained previously with dexamethasone phosphate intranasally (Norman and Winkenwerder, 1965) and depot steroids (Ganderton et al, 1969). While these two drugs always give varying degrees of adrenal suppression, this is apparently not the case with beclomethasone dipropionate aerosol intranasally.…”

“…Some authors have found intranasal applications of hydrocortisone and prednisone effective in the treatment of hay fever, but the symptomatic improvement has not been so convincing that these preparations have gained widespread use in therapy (Foulds et al, 1955;Godfrey et al, 1957;Uhde, 1957). Intranasal dexamethasone phosphate in a dose of 1 mg daily gives an appreciable improvement of hay fever symptoms in about 750,O of patients (Norman and Winkenwerder, 1965). However, this dose also gives nearly a 50% reduction of 17-ketogenic steroid excretion at the end of one week's use (Norman et al, 1967).…”

“…Intranasal dexamethasone phosphate in a dose of 1 mg daily gives an appreciable improvement of hay fever symptoms in about 750,O of patients (Norman and Winkenwerder, 1965). However, this dose also gives nearly a 50% reduction of 17-ketogenic steroid excretion at the end of one week's use (Norman et al, 1967). This form of treatment has little or no advantage over systemic steroid.…”

Topical glucocorticosteroids in rhinitis: clinical aspects

“…However, it was shown as early as 1967 [10] that the recommended therapeutic dosage has an effect on the HPA axis. This results from the long plasma half-life of the drug due to its lack of firstpass metabolism in the liver.…”