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I'm trying to find out what the difference is between Xhance and Flonase, generic (fluticasone propionate) nasal spray.

For those who don't know: Xhance is fluticasone propionate with a different delivery system than the generic fluticasone propionate sold at a warehouse store. As you can see in the diagram, the Xhance delivery system is inserted in the nose and sprayed, while while the user simultaneously blows into the dispenser to presumably distribute the medicine further into the nasal cavity; while the generic medication is delivered as a simple nasal spray.

My wife's insurance won't cover her Xhance prescription, which is about $450 out of pocket a month. While generic in the standard nasal spray bottle is about $40 for a 3 or four month supply. So of course my question is, if we could get the same effect using the generic, if we were able to build a similar delivery mechanism; i.e. 3D printer, etc?

Anyone have any thoughts on this?

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    @Narusan thank you for retracting the answer posted. Fluticasone IS a mainstay treatment for rhinitis, but unlike Afrin and other vasoconstrictive nasal sprays, fluticasone is NOT addictive because it works very differently. It's a topical corticosteroid used to reduce inflammation and reactivity of the respiratory passages. It's similarly used in asthma via inhaler (different formulation, however). – DoctorWhom Jan 28 '19 at 5:06
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I do not recommend constructing your own device to administer fluticasone propionate. Although it is true that there are common mistakes in administration of fluticasone nasal spray, there are some other ways of improving administration and distribution other than using your mouth to blow it up into your sinuses - which raises hygiene/infection concerns. If I were ever to consider using or prescribing Xhance, I would certainly have to read about how it filters the exhaled air from the mouth. There have been rare but serious brain infections from using tap water for nasal irrigation that contained pathogens that were considered safe for oral ingestion, which spread from the nasal passageways into the brain. The venous/lymphatic drainage of some regions of sinuses drain to the dural sinuses, which is a potential portal for CNS infections.

There are a few ways to improve administration of fluticasone nasal spray.

  1. Watch a video like this one on how to properly spray it. Many people are just coating their septum or lateral nasal passageways and not getting it into the sinuses.

  2. Make sure you blow your nose well before using the spray.

  3. Consider nasal irrigation prior to administering the fluticasone. Talk to your doctor about it - it's not for everyone, but it works great for most people with normal anatomy, and some people don't end up needing medications if they do it regularly combined with allergen avoidance. It needs to be done properly, so don't try it without educating yourself on it first.

  4. Look into what your particular allergic triggers are, and consider methods of allergen avoidance to address the underlying problem. Triggers aren't always inhaled allergens; foods, soaps, perfumes, etc can also trigger nasal congestion.

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