RYALTRIS is a prescription nasal spray designed to treat the symptoms of seasonal allergic rhinitis in patients 12 years of age and older. It contains a combination of two active ingredients: olopatadine, a fast-acting antihistamine, and mometasone, a potent anti-inflammatory corticosteroid. While it is effective for many, it is important for users to be aware of the full range of potential side effects, from common, minor issues to more serious and systemic risks.
Common side effects of RYALTRIS
In clinical trials, the most frequently reported side effects for RYALTRIS were generally mild and centered around local nasal and oral discomfort. These reactions occurred in a small percentage of patients but are important to be aware of.
- Dysgeusia (unpleasant taste): This was the most common side effect, reported by about 3% of patients in short-term trials. This is likely due to the medication dripping down the back of the throat.
- Epistaxis (nosebleeds): Another frequently reported issue, epistaxis was observed in about 1% of patients during 2-week studies.
- Nasal discomfort: This can include irritation, dryness, or a stinging sensation in the nose.
- Somnolence (drowsiness): While less common, some patients have reported sleepiness or drowsiness. Patients should be cautious about driving or operating machinery until they know how the medication affects them.
Serious warnings and precautions
Due to its corticosteroid component, RYALTRIS carries warnings for more serious, though less frequent, side effects. These risks require careful monitoring and communication with a healthcare provider.
Nasal problems
The use of RYALTRIS and other nasal corticosteroids can lead to localized problems in the nasal passages. These include:
- Nasal septal perforation: A hole in the cartilage separating the nostrils, which may present with nose crusting, whistling noises when breathing, or persistent nosebleeds.
- Nasal ulceration: The development of sores inside the nose.
- Impaired wound healing: Corticosteroids can slow down wound healing. Patients who have had recent nasal surgery or injury should avoid using RYALTRIS until the nose has fully healed.
- Infections: Long-term use can increase the risk of developing a localized fungal infection, specifically Candida albicans (thrush), in the nose or throat.
Eye problems
Regular eye exams are recommended for individuals using RYALTRIS, especially for an extended period, because nasal corticosteroids can potentially lead to eye conditions.
- Glaucoma: Increased pressure within the eye.
- Cataracts: Clouding of the lens of the eye.
Systemic effects
RYALTRIS can cause systemic side effects, particularly with long-term use or in susceptible individuals.
- Adrenal insufficiency: Prolonged use of corticosteroids can suppress the adrenal glands, which produce natural steroid hormones. Symptoms can include weakness, fatigue, nausea, and low blood pressure.
- Increased risk of infection: The immunosuppressive effects of corticosteroids can make users more susceptible to infections like chickenpox and measles. Exposure to contagious illnesses should be avoided, and a healthcare provider should be contacted immediately if exposure occurs.
Pediatric considerations
For patients under 12 years of age, the safety and effectiveness of RYALTRIS have not been established. In children using nasal corticosteroids, there is a risk of slowed growth velocity. A child’s growth should be regularly monitored during treatment.
Comparison of RYALTRIS and other nasal allergy treatments
Choosing the right nasal allergy treatment involves understanding the different active ingredients and their potential side effect profiles. RYALTRIS combines both an antihistamine (olopatadine) and a corticosteroid (mometasone). Other common treatments use just one or the other. Here is a comparison of side effects for RYALTRIS versus other single-ingredient nasal sprays based on clinical data.
| Side Effect | RYALTRIS (Olopatadine + Mometasone) | Mometasone Furoate Nasal Spray (e.g., Nasonex) | Olopatadine HCl Nasal Spray | Fluticasone Nasal Spray (e.g., Flonase) |
|---|---|---|---|---|
| Unpleasant Taste (Dysgeusia) | ~3.0% | Not observed in comparative study | ~2.1% | Less common |
| Nosebleeds (Epistaxis) | ~1.0% | ~0.8% | ~1.5% | ~6-7% |
| Nasal Discomfort | ~1.0% | ~0.5% | ~0.5% | Less common |
| Headache | Less common | ~19.3% in some reviews | Frequent | ~7-16% |
| Drowsiness/Somnolence | <1.0% | No | Not applicable | No |
How to minimize side effects
Managing and minimizing the potential adverse effects of RYALTRIS is possible by following your doctor's instructions and being aware of best practices.
- Use as directed: Follow the recommended dosage of two sprays per nostril, twice daily. Do not use more than prescribed.
- Prime and shake: Always shake the bottle well before each use and prime it properly if not used for 14 days or more. This ensures a consistent, correct dose.
- Proper technique: Aim the spray away from the nasal septum (the wall separating the nostrils) to reduce the risk of irritation, perforation, or nosebleeds.
- Avoid alcohol and CNS depressants: Due to the risk of drowsiness, avoid combining RYALTRIS with alcohol or other central nervous system depressants.
- Post-spray precautions: Do not blow your nose for at least 15 minutes after use, and avoid tilting your head back, which can cause the medication to run into your throat.
- Monitor symptoms: Be vigilant for any signs of serious side effects, such as vision changes, fungal infections, or severe nasal problems, and contact your doctor immediately if they occur.
Conclusion
RYALTRIS is an effective combination nasal spray for treating seasonal allergic rhinitis, but like all medications, it comes with potential side effects. While most are mild, such as an unpleasant taste or nasal irritation, serious risks, including nasal damage, eye problems, and adrenal suppression, are possible, especially with long-term or improper use. Patients should always use the medication as directed, monitor for any adverse reactions, and maintain open communication with their healthcare provider to ensure safe and effective treatment. Being proactive about potential risks and knowing how to mitigate them can lead to a more positive treatment experience. For comprehensive prescribing information, refer to the official FDA product labeling.
