In a pharmacokinetic study comparing flunisolide nasal solution (flunisolide nasal spray .025%) (29 mcg per spray) with flunisolide nasal solution (flunisolide nasal spray .025%) (25 mcg per spray), the original formulation, the two formulations were not bioequivalent. The total absorption of flunisolide nasal solution (29 mcg per spray) was 25% less than that of flunisolide nasal solution (25 mcg per spray), and the peak plasma concentration was 30% lower. The clinical significance of these differences is likely to be small, particularly since clinical efficacy is attributable to a local effect on nasal mucosa (see Pharmacodynamics ).
The precise mechanism through which fluticasone propionate affects rhinitis symptoms is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (., histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation. In 7 trials in adults, fluticasone propionate nasal spray has decreased nasal mucosal eosinophils in 66% of patients (35% for placebo) and basophils in 39% of patients (28% for placebo). The direct relationship of these findings to long-term symptom relief is not known.