Flixonase

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Flixonase

What is Flixonase? (E-E-A-T Enhanced Overview)

Property Description
Active ingredient Fluticasone Propionate
Form Metered-dose Nasal Spray (Aqueous Suspension)
Pharmacological class Synthetic Glucocorticoid (Corticosteroid)
Origin Synthetic (Fluorinated derivative)
Route of Administration Intranasal (Local/Topic)

The preparation marketed as Flixonase contains the active medicinal ingredient Fluticasone Propionate. This medication is a synthetic, fluorinated corticosteroid, specifically a glucocorticoid, which is formulated as a single-ingredient aqueous suspension for topical use and is designed to act directly on the inflamed tissues of the nasal passages.

What Pharmacological Class Does Flixonase Belong To?

Flixonase belongs to the corticosteroid class of drugs, with Fluticasone Propionate serving as the core active compound. Corticosteroids are agents known for their potent anti-inflammatory activity. This classification confirms the medicine's fundamental role in reducing inflammation. The compound is clinically recognized for its high receptor affinity, meaning it binds strongly to target cells, a property that supports its effectiveness even in low, local concentrations.

Composition and Delivery Form

The medicine is supplied as a metered-dose nasal spray containing an aqueous suspension of the Fluticasone Propionate active ingredient. This is a single-ingredient product delivered intranasally to ensure the medication is deposited as a fine mist precisely onto the nasal mucosa. The formulation as an aqueous suspension is critical for its efficacy. Intranasal delivery of Fluticasone Propionate allows the medication to reach the target tissue directly while limiting systemic exposure. Flixonase is differentiated by its specific applicator design which optimizes mist delivery for localized treatment.

General Purpose and Benefit

The general therapeutic purpose of Flixonase is to utilize its potent local anti-inflammatory action to manage symptoms stemming from inflammation in the nose. By binding to glucocorticoid receptors, the medication suppresses the cells responsible for releasing inflammatory mediators, such as histamines and cytokines. This action effectively reduces chronic swelling, lessens excessive mucus production, and alleviates the general sensation of nasal congestion and pressure, providing relief in typical use scenarios where nasal inflammation is the primary discomfort.

Regulatory References

  1. National Library of Medicine

What side effects are possible with Flixonase?

Possible Side Effects and Safety Information

The officially documented safety profile of Flixonase (fluticasone propionate) includes adverse reactions categorized by frequency and requires specific safety considerations, particularly regarding local nasal effects and the potential for systemic effects with long-term use.

Frequency-Classified Adverse Reactions

Classification Examples of Documented Reactions
Very Common (ge 1/10) Epistaxis (nosebleed)
Common (ge 1/100 to < 1/10) Nasal/throat dryness, irritation, unpleasant taste or smell, headache, Candida albicans infection (thrush) in the nose/throat.
Very Rare (< 1/10,000) Nasal septal perforation (a hole in the nasal partition), serious hypersensitivity reactions (e.g., anaphylaxis, angioedema), signs of systemic corticosteroid effects.
Not Known Blurred vision, glaucoma, cataracts.

Safety-Related Restrictions and Considerations

Systemic Corticosteroid Effects: Although absorption is generally low, systemic effects—such as adrenal suppression and Cushing’s syndrome—are a documented very rare risk, most likely to appear with prolonged use at higher doses. Reduced bone mineral density has also been reported with long-term corticosteroid use.

Ocular Effects: The development of glaucoma and cataracts has been reported with intranasal and inhaled corticosteroid use, warranting close monitoring, especially in patients with a history of these conditions or those on long-term treatment.

Local Nasal Safety: Due to the risk of impaired wound healing, regulatory documents specify caution and avoidance of use in patients with recent nasal ulcers, trauma, or surgery until healing is complete. Periodic examination for adverse effects on the nasal mucosa is recommended for patients on therapy for several months or longer.

Infection and Immunosuppression: Caution is advised in patients with active or quiescent tuberculous infections, or any fungal, bacterial, or viral infections (e.g., ocular herpes simplex), as corticosteroids can weaken the immune system.

Pediatric Monitoring: Growth velocity monitoring is specified in the pediatric population, as growth retardation is a documented systemic effect observed in children and adolescents using nasal corticosteroids.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory profile for Flixonase (Fluticasone Propionate Nasal Spray) defines overdose risk primarily through chronic high exposure to the corticosteroid active ingredient. This risk is associated with the prolonged use of dosages higher than those officially recommended, rather than a single acute event.

Overdose Context Official Regulatory Description
Primary Manifestations Hypercorticism and clinical signs of Adrenal Suppression (systemic corticosteroid effects).
Key Symptoms May include unusual tiredness, weakness, loss of appetite, mental depression, or fainting.
Severity Classified as a severe systemic outcome requiring immediate medical attention.
Population Note The risk of systemic effects also exists for susceptible individuals even when using recommended dosages.

Required Emergency Response:

In all suspected overdose situations, immediate action is mandated. You must seek medical help right away or contact a Poison Control Center. Management for documented Adrenal Suppression involves patient supervision and the slow, gradual discontinuation of the medication. No specific pharmacological antidote is documented in the official regulatory labeling.

Therapeutic Uses of Flixonase

What Flixonase Treats: Main Uses and Benefits

Flixonase (Fluticasone Propionate) is used to provide symptomatic relief across domains of nasal inflammation, and may support general well-being during periods of heightened symptoms. It is commonly used for the treatment and prevention of seasonal and perennial rhinitis.

The medication is generally applied in contexts involving recurrent or episodic manifestations to help address symptom clusters that may become intense or disruptive. The conditions it commonly assists with include seasonal hay fever, persistent perennial rhinitis, and is used for managing symptoms associated with nasal polyps.

A key therapeutic benefit is centered on easing the discomfort arising from nasal obstruction, frequent sneezing, and bothersome rhinorrhea (runny nose). It may offer symptomatic relief that helps patients cope more steadily with difficult episodes.

“The medication helps address groups of symptoms that create noticeable interference with daily stability.”

Quick Fact: Supportive Relief for Nasal Congestion

Flixonase is relevant for managing the symptoms related to physical discomfort and pressure caused by swelling, and may assist with maintaining functional stability when a blocked nose interferes with breathing or sleep.

Eligibility and Restrictions for Use

This information details the population eligibility for Flixonase (fluticasone propionate nasal spray) based on official regulatory documents, without providing clinical advice or therapeutic context.

Contraindications and Age Limits

  • Absolute Exclusion: Flixonase is contraindicated in patients with a known hypersensitivity or allergic reaction to fluticasone propionate or any non-active ingredient in the formulation.
  • Minimum Age: Use is generally not recommended or not established for children younger than four years of age.
  • Eligible Ages: The medicine is approved for use in adults and adolescents (typically 12 years and older), and for children aged 4 to 11 years, usually at a reduced starting dose.

Conditions Requiring Special Caution

Official labeling requires caution or restricted use for specific populations:

  • Nasal Integrity: Use should be avoided in patients with recent nasal ulcers, nasal surgery, or nasal trauma until healing is complete, as corticosteroids can inhibit wound healing.
  • Infections: Caution is advised for those with untreated local or systemic infections, such as tuberculosis or viral/fungal infections.
  • Physiological Status: Use in pregnancy and lactation is generally stated to require that the potential benefits outweigh the risks to the fetus or infant, due to inadequate or uninvestigated safety data in humans. Systemic exposure is expected to be minimal.
  • Severe Hepatic Impairment: Caution is advised as severe liver problems may increase systemic exposure to the drug.

What should I know about interactions with other medicines?

Flixonase (fluticasone propionate) is a corticosteroid that is a substrate of the Cytochrome P450 3A4 (CYP3A4) enzyme. This metabolic pathway is the primary basis for its clinically significant drug interactions.

Potential Drug Interactions

Strong CYP3A4 Inhibitors

Concomitant use of Flixonase with strong inhibitors of the CYP3A4 enzyme can significantly increase the systemic exposure of fluticasone propionate. This increase in the drug's concentration in the body raises the risk of systemic corticosteroid effects, such as hypercorticism (symptoms of excessive cortisol) and adrenal suppression.

  • Ritonavir: Coadministration with the highly potent CYP3A4 inhibitor ritonavir is not recommended.
  • Other Potent Inhibitors: Caution is advised when coadministering Flixonase with other potent CYP3A4 inhibitors, including certain medications for fungal infections (e.g., ketoconazole) and HIV treatment (e.g., cobicistat).

Other Corticosteroids

Using Flixonase concurrently with other medicines that contain corticosteroids may lead to a cumulative increase in the total systemic corticosteroid load. This combination can increase the likelihood of experiencing systemic corticosteroid adverse effects. Patients should inform a healthcare professional if they are using any other form of corticosteroid, such as steroid tablets, injections, creams, or inhalers.

Mechanism of Action

Flixonase (fluticasone) is a synthetic corticosteroid that modulates immune and inflammatory responses by directly influencing genetic programming within cells. Its mechanism relies on specific binding to the intracellular Glucocorticoid Receptor (GR), acting as an agonist.

Molecular Targets and Gene Regulation

Upon binding, the drug-GR complex translocates to the cell nucleus. This alters the cell's genetic instructions, simultaneously activating anti-inflammatory genes (transactivation) and blocking the function of pro-inflammatory transcription factors like NF-kappa B (transrepression). This action influences the genetic signaling associated with inflammatory processes.

Modulation of Inflammatory Pathways

The modified genetic programming leads to the modulation of inflammatory pathways. This means the cell reduces its production and release of inflammatory signaling molecules, including cytokines, chemokines, and eicosanoids (prostaglandins and leukotrienes). The resulting physiological change is a decreased level of signaling molecules associated with vascular permeability and tissue edema.

Influencing Immune Cell Activity

The overall molecular and pathway modulation results in an altered presence and activity of key inflammatory cells in the tissue, notably promoting the programmed death (apoptosis) of eosinophils. By influencing the total number of cells that release signaling molecules, the mechanism influences cellular activity, contributing to the dampening of localized tissue responses.

Dosage and Administration Information

Official Administration Instructions (Intranasal Use)

Flixonase (fluticasone propionate) nasal spray is for intranasal use only and must be used at regular intervals to achieve maximum benefit, which may take several days of consistent use.

Dosing Schedule (50 mcg/actuation)

Age Group Starting Dose (Once Daily) Maintenance Dose Maximum Daily Dose
Adults 2 sprays in each nostril (200 mcg total) 1 spray in each nostril (100 mcg total) 200 mcg (4 total sprays)
Children 4–11 Years 1 spray in each nostril (100 mcg total) 1 spray in each nostril (100 mcg total) 200 mcg (4 total sprays)

Alternatively, adults may start with one spray in each nostril administered twice daily (morning and evening), totaling 200 mcg per day. For children 4–11 years, use is typically supervised by an adult and should be discussed with a healthcare provider if needed for longer than two months a year.

Procedural Steps and Rules

  1. Preparation: Gently shake the bottle before each use.
  2. Priming: Before using a new bottle, or if the spray has not been used for a week or more, the pump must be primed by releasing six sprays into the air away from the face.
  3. Administration: After gently blowing the nose, insert the nozzle tip into one nostril. While closing the other nostril, breathe in gently through the nose and press down on the applicator to spray. It is important to aim the spray slightly away from the center (nasal septum) of the nose.
  4. Missed Dose: If a dose is missed, do not add an extra dose to compensate; resume the regular dosing schedule at the next scheduled time.
  5. Not Recommended: Use is generally not recommended in children under 4 years of age.

Recent Clinical Evidence

Research Evidence for Flixonase / Overview of Studies

Evidence for use in Seasonal Allergic Rhinitis (SAR)

Research has extensively evaluated Flixonase in adults and children for conditions characterized by fluctuating or episodic manifestations, such as hay fever. These studies primarily include short-term randomized controlled trials (RCTs). These trials were studied for a limited number of weeks, research examined how symptoms related to allergic inflammation—such as sneezing, runny nose, and nasal congestion—changed over defined time intervals. The outcomes relevant in trials assessing short-term or episodic symptom patterns were mainly patient-reported outcomes describing perceived discomfort and scores on specific rating scales.

The findings describe patterns observed in the studies where participants reported how symptoms evolved in the observed populations in the intervention group compared to the control group. These results provide insight into short-term changes over the active season when symptoms become more noticeable. However, since most of these trials were short-term, the data show patterns related to symptom intensity only during the defined research period.

What remains uncertain is the sustained presence of the measured outcomes linked to inflammatory or irritative states over an entire season or across multiple years. The follow-up durations were limited, meaning long-term effects are not fully established regarding daily functioning. The results apply only to the populations studied and under the specific research scenarios of the trial.

Evidence for use in Perennial Rhinitis (PAR)

Flixonase was studied for conditions involving periods of heightened symptoms that occur year-round. The design of these studies often included trials extending slightly longer than those for seasonal allergies; these studies assessed outcomes related to systemic or functional imbalance throughout the year. Research describes the patterns observed when individuals were studied over several months. Outcomes applied in studies examining patient-reported experiences included measures of daily symptom severity and how these symptoms impacted overall activity level.

The evidence contributes to understanding symptom patterns related to chronic, non-seasonal issues. Reports indicate changes measured during the study period in congestion and nasal airflow, which are outcomes related to physical discomfort. However, evidence quality varies across studies, and findings were mixed depending on the population studied and the exact methodology used.

There is limited information for long-term outcomes that span multiple years of use for this chronic condition. The research so far suggests short- to moderate-term patterns, but certainty remains low regarding very long-term effects on nasal structure or overall health. Sample sizes were modest in some of the longer studies, meaning subgroup findings are uncertain, particularly for those with varying degrees of severity in their conditions where symptoms may vary in intensity.

Evidence for use in Chronic Rhinosinusitis (CRS)

Research has explored the use of Flixonase in populations with conditions associated with acute or disruptive episodes, such as Chronic Rhinosinusitis (CRS), sometimes with nasal polyps. These trials typically were evaluated in populations where symptoms are persistent, often examining outcomes linked to inflammatory or irritative states, including scores related to the size and status of nasal polyps. Studies used in research exploring how symptoms change over time often looked at patient-reported measures of facial pain and pressure.

The findings describe patterns observed in the studies related to changes in patient-reported severity of nasal and facial symptoms in the study populations. Studies explored specific changes in the nasal passages relevant in evidence describing how symptoms are measured via endoscopy. The overall evidence contributes to the broader evidence landscape for this persistent condition.

However, many of these studies are considered supportive, and the comparative evidence is lacking to fully understand how these patterns compare directly to other approaches for CRS. Data for certain groups remain insufficient, particularly in individuals with severe or refractory disease. The research does not determine whether an individual will respond similarly to the patterns observed in the study populations, and information on preventing recurrences over many years is not fully established.

Long-term Studies and Follow-up

This section outlines the limited nature of available evidence concerning extended use. Research has explored long-term safety indicators, particularly focusing on ocular effects. Studies monitored outcomes such as intraocular pressure and the development of cataracts in specific observed populations. However, evidence is generally derived from studies where follow-up durations were limited (e.g., up to one year) and may not capture effects that develop over many years.

What is known about the durability of the reported symptom changes is mainly inferred from these short- and moderate-term safety studies. The question of the measured patterns in daily functioning or activity level beyond the one-year mark is not well characterized. Therefore, data are still emerging, and long-term effects are not fully established regarding continuous use over a lifetime.

Evidence in Special Populations

Flixonase was evaluated in children and adolescents across various age groups, particularly for seasonal and perennial allergic conditions. These studies research explored short-term symptom changes and were designed specifically to account for the unique physiology of younger individuals. Findings help contextualize how patients reported their experience in pediatric groups, which is critical since children may describe symptoms differently than adults.

Conversely, Data for certain groups remain insufficient. For instance, there is limited information for long-term outcomes in geriatric populations (older adults) or in individuals with complex, pre-existing comorbid conditions (e.g., severe liver or kidney impairment). Evidence for this population remains limited. Therefore, the subgroup findings are uncertain, and results apply only to the populations studied in the available pediatric trials.

What is Still Uncertain about Flixonase

This section synthesizes the critical evidence gaps and areas where certainty is low. A major gap is that long-term effects are not fully established for use extending beyond a year or two, including potential rare systemic effects that take time to manifest. Comparative evidence is lacking in many head-to-head scenarios, making it difficult to fully contextualize how patients reported their experience against all other available therapies.

Evidence quality varies across studies, and findings were mixed when comparing different doses or formulations. The research does not determine whether an individual will respond similarly to the group average, as personal factors often influence outcomes. The data are still emerging regarding the appropriate use of Flixonase in combination with other interventions, and subgroup findings are uncertain for many less-studied patient populations.

Frequently Asked Questions (FAQ)

Common questions about Flixonase (FAQ)

Q: Does Flixonase interact with common pain relievers like acetaminophen or ibuprofen?

A: According to official drug interaction summaries, fluticasone propionate nasal spray is not known to interact with common over-the-counter pain relievers such as acetaminophen or ibuprofen.


Q: Can Flixonase be used for treating a cold or sinus infection?

A: This medicine is approved to manage symptoms associated with inflammation from allergic rhinitis. Regulatory documents advise caution in populations with untreated local or systemic infections, such as fungal, bacterial, or viral infections.


Q: Does Flixonase stop working if you use it for a long time?

A: Studies and official information indicate that this type of medicine (a corticosteroid) is designed for continuous, long-term daily use as part of a treatment plan. Unlike some other nasal spray classes, it is not known to cause the physical rebound congestion that is sometimes associated with them.


Q: Is it possible to become reliant on Flixonase?

A: The medicine belongs to the corticosteroid class, which is fundamentally different from decongestant nasal sprays. Regulatory guidance indicates that this class of medicine is not associated with the rebound congestion that users often mistake for reliance or addiction.


Q: Can using Flixonase affect healing from nasal surgery or injury?

A: Use is specified to be avoided in populations with recent nasal ulcers, nasal surgery, or nasal trauma until healing is complete. This caution is specified because corticosteroids can inhibit (slow down) the natural wound healing process.


Q: Is Flixonase considered safe to use during pregnancy, based on regulatory sources?

A: Official information indicates that use during pregnancy is advised only if the potential benefits are judged to outweigh potential risks to the unborn child. This statement reflects that human safety data is often limited or uninvestigated in this population.


Q: Is there official information about using Flixonase while breastfeeding?

A: Similar to pregnancy, regulatory documents state that use while breastfeeding is advised only if the potential benefits are judged to outweigh potential risks to the breastfed infant. The systemic absorption of the medicine is generally expected to be minimal.


Q: Is there any information about Flixonase causing weight changes?

A: Weight gain is not listed as a common effect of this nasal spray. However, potential signs of systemic corticosteroid effects, such as Cushing’s syndrome (which may include weight changes), are documented as a very rare risk associated with prolonged use, typically at higher doses.


Q: What information is available regarding the effect of Flixonase on growth in children?

A: The potential for reduced growth velocity (growth retardation) is a documented systemic effect observed in children and adolescents using nasal corticosteroids. Due to this documented systemic effect, monitoring of growth velocity is specified in pediatric use information.


Q: Are there reports of paradoxical congestion or 'rebound' from Flixonase?

A: This medicine is a corticosteroid, which reduces inflammation rather than constricting blood vessels like a decongestant. Its mechanism is not associated with the paradoxical or 'rebound' congestion (rhinitis medicamentosa) that can occur with decongestant nasal sprays.


Q: How does Flixonase affect driving or operating machinery?

A: Official information generally indicates that for most people, using fluticasone nasal spray is not expected to impair the ability to drive a car or operate machinery. Side effects such as headache are common, which may warrant caution.


Q: Is Flixonase the same kind of medicine as Nasonex or Rhinocort?

A: These medicines all belong to the same pharmacological class, corticosteroids, and work in a similar way to reduce inflammation in the nasal passages. However, they contain different active ingredients (fluticasone vs. mometasone or budesonide) and may be formulated differently.


Q: How is Flixonase different from a decongestant nasal spray?

A: Flixonase is a corticosteroid that works to reduce inflammation over time and is designed for regular, ongoing use. Decongestant sprays are a different class of medicine that offer quick, temporary relief by shrinking blood vessels, but are typically only intended for use over a few days.


Q: How quickly does Flixonase start working after the first time you use it?

A: Symptom relief may begin within a few hours of the first dose. However, because the medicine works by gradually reducing inflammation, it is designed to be used regularly. Full, consistent benefits described in the research may take several days up to two weeks to be achieved.


Q: Is Flixonase used to treat conditions other than hay fever or allergies?

A: The medicine is approved for the treatment of symptoms associated with both seasonal and perennial allergic rhinitis. Depending on the product formulation, some specific fluticasone propionate products are also approved for nonallergic rhinitis.


Q: Are there any specific foods or drinks that should be avoided while using Flixonase?

A: Official warnings advise avoiding grapefruit or grapefruit juice. This caution is due to the potential for grapefruit to interact with how the body processes the medicine, which could increase systemic exposure (the amount of drug absorbed into the body).


Q: Does Flixonase have any known interactions with herbal supplements or vitamins?

A: Official documents often advise caution regarding herbal remedies and supplements because they are not typically tested for interactions. Patients should inform a healthcare professional of any supplements they are using.


Q: Can Flixonase cause changes in mood or sleep patterns?

A: Psychological or behavioral effects are documented as rare side effects that may occur from systemic corticosteroid exposure. These effects can include sleep disorders, anxiety, depression, or aggression.


Q: Can Flixonase affect the sense of smell or taste?

A: An unpleasant taste or an unpleasant smell in the nose or throat is listed as a common adverse reaction in official documents. This is often caused by the medicine mist dripping down into the throat after administration.


Q: What should I do if I miss a scheduled time to use Flixonase?

A: Regulatory instructions advise that a patient should not double the dose to compensate, but should resume the regular dosing schedule at the next scheduled time.


Q: Can I use Flixonase after its expiration date?

A: Official regulatory guidance mandates that outdated or unused medication must be discarded. The stability and efficacy of the product are not assured past the expiration date listed on the packaging.


Q: Does Flixonase have any known contraindications with alcohol use?

A: Official drug interaction summaries and prescribing information indicate that the medicine is not known to interact with alcohol.


Q: Is there a limit to how long one should continuously use Flixonase?

A: Regulatory studies generally support the continuous daily use of this medicine over extended periods for the management of chronic conditions. For over-the-counter versions, package labeling often includes a time limit or suggests consulting a healthcare provider if used continuously for longer periods.


Q: Why do some people feel a strong taste in their throat after using the spray?

A: An unpleasant taste in the mouth or throat is a commonly reported side effect in clinical trials. This is often described as a result of the medicine mist dripping down from the nasal passage into the throat.


Q: Is Flixonase recommended for non-allergic rhinitis?

A: The active ingredient (fluticasone propionate) is approved for the treatment of perennial non-allergic rhinitis symptoms in adults and children four years of age and older.


Q: What evidence exists regarding Flixonase for treating nasal polyps?

A: Fluticasone is explored in research for Chronic Rhinosinusitis, a condition sometimes involving nasal polyps. Fluticasone propionate nasal drops are specifically indicated in some markets to shrink nasal polyps and relieve related congestion.


Q: Is there a risk of fungal infections in the nose or throat with Flixonase use?

A: The risk of a Candida albicans infection, commonly known as thrush or a fungal infection, in the nose or throat is documented as a common side effect in official documents.


Q: What regulatory information is available on Flixonase use and underlying liver disease?

A: Caution is advised for patients with severe hepatic (liver) impairment. This caution is specified because severe liver problems may increase the systemic exposure (the amount of drug absorbed into the body).


Q: Are there special considerations for using Flixonase in older adults?

A: Official documents for some fluticasone products state that no dose adjustment is required in the elderly population (12 years and older). However, general caution is specified for all patient groups with complex or pre-existing health conditions.

How should Flixonase be stored and disposed of?

How to Store and Dispose of Flixonase (Fluticasone Propionate)

The storage and disposal of Flixonase nasal spray are governed by strict regulatory requirements to maintain product stability and safety.


Storage Requirements

Category Official Storage Requirement
Temperature Store below 30°C (86°F), typically between 4°C and 30°C.
Protection Protect from freezing, direct heat, and sunlight.
Child Safety Must be stored out of the sight and reach of children.
Packaging Keep the medicine in its original, closed container.

Disposal and Stability

Official labeling mandates that the nasal spray unit must be discarded after the labeled number of sprays has been used, even if liquid remains. Do not keep outdated or unused medication. Disposal of the unused product and waste material must be done according to local regulations and generally should not involve flushing the medicine down a toilet or drain.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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