XHANCE (fluticasone propionate)

Pronunciation: (floo-TIK-a-sone PRO-pee-oh-nate).

Generic name
fluticasone propionate (exhalation delivery system nasal spray)
Brand names
XHANCE
Drug class
Intranasal corticosteroid
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · Canada

Australia: · Full directory

What fluticasone propionate (exhalation delivery system nasal spray) is and how it works

XHANCE is a prescription corticosteroid nasal spray containing fluticasone propionate, approved in the United States for adults with chronic rhinosinusitis — long-lasting inflammation of the nose and sinuses — both with and without nasal polyps. It is not an ordinary nasal spray: XHANCE uses an exhalation delivery system, where you blow into a mouthpiece while the spray is released into one nostril, which helps carry the medicine deeper into the nasal passages. Each spray delivers 93 mcg of fluticasone propionate, and each bottle provides 120 metered sprays. Its safety and effectiveness have not been established in children. (1)

What fluticasone propionate (exhalation delivery system nasal spray) is used for

Chronic rhinosinusitis with nasal polyps (adults)

Treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) in adults. (1)

Chronic rhinosinusitis without nasal polyps (adults)

Treatment of chronic rhinosinusitis without nasal polyps (CRSsNP) in adults. (1)

Before taking fluticasone propionate (exhalation delivery system nasal spray)

Do not take / not appropriate for

  • Do not use XHANCE if you are allergic (hypersensitive) to any of its ingredients. (United States) (1)

Tell your clinician about

(1)

How to take fluticasone propionate (exhalation delivery system nasal spray)

  • The usual dose is 1 spray (186 mcg total) or 2 sprays (372 mcg total) per nostril twice daily, as prescribed; the maximum is 2 sprays per nostril twice daily.
  • XHANCE is used with its exhalation delivery system: blow into the mouthpiece while the pump sprays into one nostril — follow the device instructions supplied with the product.
  • Before the first use, prime the device: shake gently, then press the bottle 7 times or until a fine mist appears.
  • Discard the bottle after 120 sprays, even if it does not feel empty.
(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)

Missed dose

If a dose is missed, use the next dose at its regular time; do not double sprays to catch up. Ask the prescriber or pharmacist for advice on your specific schedule.

Overdose

Using more than the recommended dose over time can cause corticosteroid excess (hypercorticism) and adrenal suppression; the prescriber manages any suspected overuse. Contact a poison-information service if a large amount is used at once, particularly by a child. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Nosebleeds (epistaxis)

What to notice: The most common side effect — up to about 12% in nasal-polyp trials.

What to do: Tell the prescriber about frequent or heavy nosebleeds. (1)

Nasal septal ulceration or irritation

What to notice: Sores inside the nose, reported in about 7% of nasal-polyp trial participants.

What to do: Report soreness or crusting so the prescriber can examine the nose. (1)

Cold-like symptoms (nasopharyngitis), headache, nasal congestion, sinus infection

What to notice: Each reported by roughly 2–7% of trial participants.

What to do: Discuss persistent or troublesome symptoms with the prescriber or pharmacist. (1)

Possible septal perforation

What to notice: Whistling when breathing through the nose, persistent crusting or bleeding.

What to do: Arrange prompt prescriber review. (1)

Vision changes

What to notice: Blurred vision, eye pain, halos.

What to do: Report promptly; eye assessment may be needed. (1)

Serious warnings

Nasal injury: nosebleeds, ulceration, and septal perforation — serious

Symptoms: Nosebleeds (epistaxis), sores or crusting inside the nose, whistling sound when breathing through the nose, or nasal pain.

Action: Report these to the prescriber — nasal erosions, ulcerations, and (rarely) a hole in the nasal septum have been reported with XHANCE; the prescriber examines the nose and decides how treatment continues. (1)

Nasal thrush (Candida infection) — serious

Symptoms: White patches, soreness, or persistent irritation inside the nose.

Action: Report to the prescriber, who checks for localized Candida albicans infection and treats it if present. (1)

Eye effects: glaucoma and cataracts — serious

Symptoms: Blurred vision, eye pain, halos around lights, or other vision changes.

Action: Report vision changes promptly; nasal corticosteroids may contribute to glaucoma or cataracts, and eye examinations may be advised. (1)

Infections, chickenpox and measles exposure — serious

Symptoms: Fever or feeling unwell after contact with someone who has chickenpox or measles.

Action: Corticosteroid users can be more susceptible to infections — avoid exposure where possible and seek medical advice promptly after any exposure. (1)

Adrenal suppression with overuse — serious

Symptoms: Tiredness, weakness, nausea, or dizziness can accompany adrenal problems, particularly after high doses.

Action: Use only the prescribed number of sprays; the prescriber manages any signs of hypercorticism or adrenal suppression. (1)

Interactions

Medicine or testEffectAction
Strong CYP3A4 inhibitors (ritonavir, ketoconazole, and similar)Not recommended with XHANCE — they raise systemic corticosteroid exposure and effects.Give the prescriber and pharmacist a complete medicine list before starting. (1)
Other corticosteroids (nasal, inhaled, oral, topical)Combined use adds to total corticosteroid exposure.Tell the prescriber about every corticosteroid product you use so total exposure can be considered. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Published data on fluticasone propionate in pregnancy have not reported a clear association with adverse developmental outcomes; use in pregnancy is decided with the prescriber. (1)

Breastfeeding

There are no data on fluticasone propionate in human milk (it is present in animal milk); the decision weighs the benefit of treatment and of breastfeeding with the care team. (1)

Children

Safety and effectiveness have not been established in pediatric patients; nasal corticosteroids may reduce growth velocity in children. (1)

Older_adults

Used at the same labeled doses; the prescriber considers overall corticosteroid exposure and eye health. (1)

Monitoring

Before starting

  • Nasal examination, including for recent ulcers, surgery, or trauma (use is delayed until healed)
  • Review of eye history (glaucoma, cataracts), infections, and the full medicine list including CYP3A4 inhibitors

During treatment

  • Periodic nasal examination for erosions, ulceration, septal changes, or Candida infection
  • Attention to vision changes and, with long-term use, eye examinations as advised by the clinician
(1)

Storage

Store at room temperature, 15–25°C (59–77°F). Discard after 120 sprays even if the bottle is not empty. Keep out of reach of children.

Professional information

Clinician-facing context only. This section does not replace current product labeling.

United States

Indication: Chronic rhinosinusitis with nasal polyps (CRSwNP); chronic rhinosinusitis without nasal polyps (CRSsNP) — adults

Dose summary: 186 mcg (1 spray of 93 mcg per nostril) or 372 mcg (2 sprays per nostril) twice daily via the exhalation delivery system; maximum 2 sprays per nostril twice daily. Prime before first use (7 presses or until fine mist). 120 metered sprays per unit; discard after 120 sprays.

Renal context: No renal dosing adjustments described in the label; systemic exposure concerns center on strong CYP3A4 inhibition and overuse (hypercorticism/adrenal suppression) rather than renal elimination. (1)

Frequently asked questions

Is “Xacthane” a real medicine?

No — “xacthane” is a historical misnaming in this site’s records, and no medicine by that name exists. This page describes XHANCE, a fluticasone propionate corticosteroid nasal spray with an exhalation delivery system, distributed by OptiNose. (1)

How is XHANCE different from ordinary fluticasone nasal sprays?

XHANCE uses an exhalation delivery system — you blow into a mouthpiece while the spray releases into a nostril — designed to carry medicine deeper into the nasal passages, and it is specifically approved for chronic rhinosinusitis with or without nasal polyps in adults. Ordinary fluticasone sprays have different strengths and uses. (1)

Is XHANCE a steroid tablet or injection?

No. XHANCE is a nasal spray only. It contains a corticosteroid (fluticasone propionate) delivered into the nose; it is not a tablet, oral suspension, or injection. (1)

Why does my nose bleed on XHANCE?

Nosebleeds are its most common side effect (up to about 12% in trials). Tell your prescriber about frequent or heavy nosebleeds so your nose can be examined for irritation or ulceration. (1)

Can children use XHANCE?

Safety and effectiveness have not been established in children, and nasal corticosteroids can slow growth in pediatric patients — its US approval is for adults. (1)

What is the generic name of XHANCE (fluticasone propionate)?

The generic name is fluticasone propionate (exhalation delivery system nasal spray). It is sold under brand names including XHANCE.

What class of drug is fluticasone propionate (exhalation delivery system nasal spray)?

XHANCE (fluticasone propionate) is classed as: Intranasal corticosteroid.

References

  1. XHANCE (fluticasone propionate) spray, metered — prescribing information, OptiNose US Inc., revised 2024-03US FDA prescribing information via DailyMed (U.S. National Library of Medicine) · United States · dated 2024-03 · accessed 2026-08-08 · source 1
  2. ALLERGY RELIEF NASAL (FLUTICASONE PROPIONATE) SPRAY, METERED [AMAZON.COM SERVICES LLC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
  3. Fluticasone Nasal Spray — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
  4. Fluticasone Propionate — FDA approval record (Drugs@FDA ANDA219060)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
  5. fluticasone propionate — RxNorm normalized drug concept (RXCUI 41126)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5

Brand names by country

Single-ingredient fluticasone propionate (exhalation delivery system nasal spray) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • FLONASE ALLERGY RELIEF27.5 ug, 50 ug · haleon us holdings llc
  • FLOVENT HFA50 ug, 220 ug, 100 ug · a-s medication solutions
  • XHANCE93 ug · optinose us, inc.
  • Arnuity Ellipta100 ug, 50 ug, 200 ug · glaxosmithkline llc
  • CHILDRENS FLONASE ALLERGY RELIEF50 ug · haleon us holdings llc
  • Kirkland Signature Aller Flo50 ug · costco wholesale company
  • FLUTICARE50 ug · innovus pharmaceuticals, inc.
  • Welby Fluticasone50 ug · aldi inc
  • 365 WHOLE FOODS MARKET FLUTICASONE PROPIONATE50 ug · whole foods market, inc.
  • Nasopro 2450 ug · h e b

Canada

  • FLOVENT
  • ARNUITY
  • FLONASE - AEM-SUS NAS
  • FLONASE ALLERGY RELIEF
  • AVAMYS
View brands in additional countries.

General information only — not a diagnosis, prescription, or substitute for professional medical advice.

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