For adults, the recommended dose is two sprays daily into each nostril once daily to control symptoms. Once symptoms have eased, you should reduce your daily dose to one spray into each nostril, providing a total of 55 micrograms per day.

Avamys works best if it is used on a regular basis. Symptom relief can begin up to 8 hours or more after you first start using Avamys, however, you will receive the maximum benefit when you use Avamys every day during the time that you are exposed to your allergy.

Additionally, if you miss an Avamys dose during your treatment course, you should never double-up on a dose. Instead, resume your usual treatment schedule on the following day.

Follow the instructions below to ensure appropriate use of this medication:

• If you are using Avamys for the first time, you must prepare the bottle before using it by shaking the bottle gently.
• Place your middle finger and forefinger on either side of the nozzle, with your thumb placed underneath the bottle.
• Point the nozzle away from you before pressing down with your fingers to pump the spray. Do this around 10 times until the bottle starts to spray a fine mist.
• To use Avamys correctly, shake the nasal spray bottle vigorously and then remove the cap.
• Start by blowing your nose gently (if comfortable) to remove as much mucus as possible
• Close one nostril with your finger before putting the nozzle into the other nostril.
• Slightly tilt your head forward and make sure the bottle is kept upright.
• Begin gently breathing in through your nose. While doing this, squirt the spray into your nose. Do this ONCE by pressing down with your fingers.
• Breathe out through your mouth. Repeat the steps again to inhale a second spray in the same nostril if needed.
• Remove the nozzle from your nostril and breathe out through your mouth.
• Repeat these steps for the other nostril.
• After using the spray, carefully wipe the nozzle with a clean tissue and replace the dust cap.

Always use this medication exactly as your clinician has told you. Check with our clinical team or your GP or pharmacist if you are not sure.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Some of the more common side effects include:

• An unpleasant taste or smell
• A dry nose, or nosebleeds
• A dry or sore throat, or hoarse voice
• Headache
• Nasal irritation
• Nasal ulceration

Uncommon side effects include:

• Pain in the nose
• A sting or burning in the nose
• Soreness
• Dryness or crustiness in the inside of the nose

For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, or you are experiencing any of the side effects mentioned in the patient information leaflet whilst taking this medication, please contact our clinical team or speak to your GP.

Allergic reactions are a possibility after using Avamys. These can be severe. If this happens, stop taking Avamys straightaway, and seek immediate medical help if you experience symptoms like: difficulty swallowing; swelling of the tongue, face or throat; trouble breathing or wheezing; hives.

Speak to your doctor as soon as possible if any of the following serious side effects of Avamys occur:

• Sores or ulcers inside the nose
• Nasal septum perforation (small holes in the wall between the nostrils)
• Heart palpitations (feeling that your heart is racing)
• Chest tightness causing difficulty in breathing (dyspnoea)
• Blurred vision or changes to vision — this may indicate cataracts (clouding of the lens of the eye) or glaucoma (increase in pressure in the eye)
• High blood pressure — signs are headaches, vision changes, nausea and vomiting
• Increased frequency of infection — signs are cold or flu-like symptoms
• Mood and behavioural changes such as anxiety, depression, hyperactivity or aggression
• Cushing's syndrome, Cushingoid features or adrenal suppression
• Slowed growth in children and adolescents
• Symptoms of decreased adrenal function — signs are tiredness, weakness, nausea, vomiting and low blood pressure
• Symptoms of a fungal infection in the nose — nasal discharge, fever, headache, fatigue, generally feeling unwell
• Symptoms of high blood sugar — frequent urination, increased thirst, excessive eating, unexplained weight loss, infections, fruity breath odour
• Symptoms of too much corticosteroid — such as weight gain (particularly around the body and face), sweating, thinning of the skin, bruising easily, muscle and bone weakness

Get emergency medical help if you have signs of an allergic reaction to this medication. These include:

• Hives
• Dizziness
• Fast or pounding heartbeats
• Wheezing
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

It is important that you let us know which prescription, over-the-counter medicines and recreational drugs you are currently taking. You must also tell us about any other medical conditions that you currently have (or had in the past). This will help us ensure the prescribed medication is safe and appropriate for you to take.

For full information on warnings, medication interactions and contraindications, refer to the Patient Information Leaflet. Please read all packaging and the Patient Information Leaflet before taking any new medicine and inform our clinical team or your GP of medicines you are taking or intend to take.