medicationsxhanceXhance dosage

Xhance Dosage, forms & strengths

Jamie Winn, PharmD
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Medically reviewed by  Jamie Winn, PharmD

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Xhance (fluticasone) is a prescription corticosteroid with a unique exhalation delivery system that is manufactured by OptiNose US, Inc. It gained FDA approval in 2017 for the treatment of nasal polyps (growths in your nasal passages) in adults 18 years of age and older.

How does Xhance work?

It is not known exactly how Xhance works to treat nasal polyps. Fluticasone, which is the active ingredient in Xhance, is a corticosteroid. Steroids such as Xhance decrease inflammation and swelling by blocking the activity of inflammatory cells such as eosinophils, mast cells, and macrophages. Reducing swelling and inflammation helps reduce symptoms such as nasal congestion.

Xhance dosage forms and strengths

  • Nasal spray with 93 mcg of fluticasone propionate in each spray.

Xhance dosage

The recommended dose in adults is 1 spray in each nostril twice a day for a total daily dose of 372 mcg. If this is not effective, the dose can be increased to 2 sprays in each nostril twice a day for a total daily dose of 744 mcg.

The safety and effectiveness of Xhance have not been established in pediatric patients under the age of 18.

Xhance dosage restrictions

There have not been studies that looked at the use of Xhance in patients with kidney (renal) or liver (hepatic) impairment. Because fluticasone is mainly cleared by the liver, patients with liver impairment should be monitored for an increase in adverse effects.

How to take Xhance

  • Read the Full Prescribing Information, Instructions for Use, and Medication Guide that comes with Xhance.
  • Use Xhance exactly as your healthcare provider tells you to. Do not change your dose or stop taking Xhance without talking with them first.
  • You have to prime the spray pump if you are using Xhance for the first time or if you haven’t used it in the last 7 days. Once Xhance has been properly primed, remove the cap and shake the Xhance container well. Tilt your head forward and insert the nosepiece into a nostril and the flexible mouthpiece in your mouth. Blow hard into the mouthpiece like you are blowing up a balloon. While blowing into the mouthpiece, use your thumb to press the spray pump to deliver the medication. Do not close your other nostril or breathe in through your nose while blowing into the mouthpiece.
  • Store your Xhance nasal spray at room temperature between 59°F and 77°F (15°C and 25°C) away from light. Throw away your Xhance container after using 120 sprays following the initial priming.

Xhance dosage FAQs

What are the most common side effects of Xhance?

The most common side effects of Xhance in clinical trials include:

  • Epistaxis (nosebleeds)
  • Nose sores or ulcers
  • Pharyngitis (sore throat)
  • Common cold
  • Crusting around the nostrils
  • Slow wound healing
  • Runny nose
  • Acute sinusitis (sinus infection)
  • Headache

Xhance can sometimes cause more serious side effects, including:

  • Severe allergic reactions (hives, angioedema, and shortness of breath)
  • Hole or tear in your septum (septal perforation)
  • Extreme tiredness
  • Serious or life-threatening cases of chickenpox or measles
  • Increased risk of new or worsening cataracts or glaucoma
  • Changes in adrenal hormone levels
  • Decreased bone mineral density

Contact your healthcare professional for medical advice about any adverse effects you experience while taking Xhance. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What drug interactions occur with Xhance?

When Xhance is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:

  • Strong CYP3A4 inhibitors such as itraconazole, ritonavir, voriconazole, clarithromycin, or ketoconazole

Are there any contraindications or precautions with Xhance?

Xhance should not be taken if you have the following conditions:

  • Known hypersensitivity reaction to fluticasone propionate or any ingredients in Xhance

Xhance should be used with caution in the following medical conditions:

  • Nasal surgery or injury
  • Osteoporosis
  • History of eye problems such as glaucoma, ocular herpes simplex, or cataracts
  • Current bacterial, viral, or fungal infection

Can you take Xhance while you are pregnant or breastfeeding?

Available data on the use of inhaled or intranasal fluticasone in pregnant women did not show an association with adverse effects on the unborn baby. There is no data on whether Xhance is found in breast milk during lactation or the effects it may have on the infant. Fluticasone was found in rat milk during animal studies. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

What if I miss a dose of Xhance?

If you miss a dose, take it right away on the same day. If it is almost time for your next dose, skip the missed dose and take it at your regularly scheduled time. Do not take extra doses to make up for a missed dose or take more than is prescribed for you.

Does Xhance contain any alcohol or fragrance?

No, Xhance does not contain any alcohol, fragrances, dyes, gluten, or lactose.

How long will my Xhance last before it expires?

You can use your Xhance nasal spray until the expiration date that is printed on the label of each bottle or after using 120 sprays, whichever comes first. If you use 1 spray in each nostril per day, Xhance will last 30 days. If you use 2 sprays in each nostril per day, Xhance will last 15 days.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.