Do Flonase and Nasacort Harm the Sense of Smell?

The benefits of steroid nasal spray for allergies are significant. There are, however, some side effects that you may want to know about before you start using them. A loss of the sense of smell or taste seems to be rare, but it is not always reversible.

Steroid Sprays and the Sense of Smell:

Q. After using a cortisone nasal spray to treat my allergies for 25 years, I lost my sense of smell. I even got thrush from using the spray at night. It ran down my throat while I was sleeping and created conditions for this fungal infection to flourish.

I no longer use this type of nasal spray. Instead, I rely on quercetin. When my allergies are really bad, I occasionally take a Benadryl.

A. Corticosteroid nasal sprays have become very popular since they became available over the counter because they are so effective. Regular use, however, may impact the sense of smell (Annals of Otology, Rhinology, and Laryngology, April 3, 2021). Such drugs may also predispose people to fungal infections such as thrush.

Quercetin is sold as a dietary supplement. This flavonoid is found in vegetables and fruits. It stabilizes mast cells that release histamine and other inflammatory compounds (PLoS One, March 28, 2012).  As a result, quercetin appears to be effective against seasonal allergies and contact dermatitis.

More Loss of Smell with Steroid Nasal Sprays:

Q. I used Flonase for many years and have lost about 90 percent of my sense of smell and have significant loss of taste. Six years ago I had sinus surgery in hopes of improving these senses but it didn’t work.

I stopped using Flonase last year. No doctor ever suggested my loss of my sense of smell was from using Flonase. In retrospect, though, I’m pretty certain Flonase was the cause.

A. Steroid nasal sprays such as fluticasone (Flonase) and triamincinolone (Nasacort 24HR) used to treat allergies are considered so safe that they are now available without prescription. Nevertheless, many other readers have reported problems with the senses of smell or taste associated with using such a steroid nasal spray.

Here is another report:

“I had very few problems with allergies until moving to Florida. About a year ago, I had congestion in my nasal passages. I bought some Nasacort and used it according to the directions for four days.

“Then I lost my senses of taste and smell. I wrote to the company to ask if they had any suggestions for a cure. I also asked my doctor who said, ‘Your senses will probably return.’ They haven’t. The company said they had never heard of such a problem. Do you know of anything that will help me regain my senses of smell and taste?”

We wish we had a solution. While this side effect is listed in the information for prescription Flonase, there is no mention of it on either OTC drug label. There may not be a cure for this distressing condition.