Steroid nasal sprays rarely cause side-effects. This is because they are applied directly to the nose and very little of this medicine is absorbed into the body. Therefore, they are much less likely to cause side-effects in other parts of the body. Occasionally, they cause dryness, crusting, and bleeding of the nose. If this occurs, stop it for a few days and then restart. There have been reports of nasal steroids possibly having an effect on behaviour, particularly in children. This is thought to be rare. However, a few people have reported hyperactivity, problems sleeping, anxiety, depression, and aggression.
Weeks ago Breo Ellipta , a combination corticosteroid and long acting beta agonist (Laba) inhaler became available by prescription for control of asthma in those age 18 or older. Currently a 100 microgram strength (based on the inhaled steroid component) is available, but a higher 200 mcg is on the way. Breo Ellipta also contains a fluticasone derivative (same as Arnuity Ellipta) similar to Flovent and Advair. The Laba in Breo Ellipta is vilanterol and is completely different from salmeterol, which is the Laba in Advair. Breo Ellipta has a box warning, as does Advair and other similar combination inhalers because of the Laba component.