Dosing and Administration

XHANCE is easy to use¹

Please see Instructions for Use for detailed administration instructions.

Video of the journey through the nasal anatomy using the Exhalation Delivery System

How to administer XHANCE

To prime XHANCE for the first use²:

Remove the cap and shake the device well
Spray the device 7 times or until a fine mist is expelled

To use XHANCE²

1. SEAL

First, shake well. Then, using 1 or 2 hands, place your fingers on the indented grip BELOW the mouthpiece
Gently insert the nosepiece into your nose to form a tight seal, then rotate to insert the flexible mouthpiece into your mouth while keeping the nosepiece deep in the nostril

Keep a tight seal between the nosepiece and your nostril.

2. AIM

Aim the device upwards between your eyes.

It may help to use a mirror.

3. BLOW

Take a deep breath and exhale hard into the mouthpiece, as if blowing up a balloon

Blow, don’t sniff. Don’t block your other nostril.

4. PRESS

Keep blowing as you press the bottle with your thumb, releasing the medicine deep into your nasal passages

Continue blowing hard while pressing the bottle. Repeat these steps for the other nostril.

In a clinical trial questionnaire, most patients reported that XHANCE was easy to use¹

Dosing Information for XHANCE²

XHANCE is administered in each nostril twice daily

The recommended dosage is 1 spray per nostril (equal to 186 mcg) twice daily.

1 XHANCE unit=30 days

XHANCE is also approved for 2 sprays per nostril (equal to 372 mcg) twice daily.

2 XHANCE units=30 days

The maximum total daily dosage should not exceed 2 sprays in each nostril twice daily (8 sprays total). For best results, patients should use XHANCE regularly, twice daily.

XHANCE Dosing Card

Keep a reminder of the approved dosages of XHANCE.

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References

Leopold DA, Elkayam D, Messina JC, Kosik-Gonzalez C, Djupesland PG, Mahmoud RA. NAVIGATE II: randomized, double-blind trial of the exhalation delivery system with fluticasone (EDS-FLU) for nasal polyposis. J Allergy Clin Immunol. 2019;143(1):126-134.e5.
Full Prescribing Information for XHANCE (fluticasone propionate). OptiNose US, Inc.; 2024.

INDICATIONS

XHANCE is a corticosteroid indicated for the treatment of chronic rhinosinusitis with or without nasal polyps in adults.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS:
Hypersensitivity to any ingredient in XHANCE.

WARNINGS AND PRECAUTIONS:

Local nasal adverse reactions, including epistaxis, erosion, ulceration, septal perforation, Candida albicans infection, and impaired wound healing, can occur. Monitor patients periodically for signs of possible changes on the nasal mucosa. Avoid use in patients with recent nasal ulcerations, nasal surgery, or nasal trauma until healing has occurred.
Glaucoma and cataracts may occur with long-term use. Consider referral to an ophthalmologist in patients who develop ocular symptoms or use XHANCE long-term.
Hypersensitivity reactions (e.g., anaphylaxis, angioedema, urticaria, contact dermatitis, rash, hypotension, and bronchospasm) have been reported after administration of fluticasone propionate. Discontinue XHANCE if such reactions occur.
Immunosuppression and infections can occur, including potential increased susceptibility to or worsening of infections (e.g., existing tuberculosis; fungal, bacterial, viral, or parasitic infection; ocular herpes simplex). Use with caution in patients with these infections. More serious or even fatal course of chickenpox or measles can occur in susceptible patients.
Hypercorticism and adrenal suppression may occur with very high dosages or at the regular dosage in susceptible individuals. If such changes occur, discontinue XHANCE slowly.
Assess for decrease in bone mineral density initially and periodically thereafter.

ADVERSE REACTIONS:

Chronic rhinosinusitis without nasal polyps: The most common adverse reactions (incidence ≥ 3%) are epistaxis, headache, and nasopharyngitis.
Chronic rhinosinusitis with nasal polyps: The most common adverse reactions (incidence ≥ 3%) are epistaxis, nasal septal ulceration, nasopharyngitis, nasal mucosal erythema, nasal mucosal ulcerations, nasal congestion, acute sinusitis, nasal septal erythema, headache, and pharyngitis.

DRUG INTERACTIONS:
Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. May increase risk of systemic corticosteroid effects.

USE IN SPECIFIC POPULATIONS:
Hepatic impairment. Monitor patients for signs of increased drug exposure.

Please see Full Prescribing Information pdf opensfull Prescribing Information, including Instructions for Use.

References

Leopold DA, Elkayam D, Messina JC, Kosik-Gonzalez C, Djupesland PG, Mahmoud RA. NAVIGATE II: randomized, double-blind trial of the exhalation delivery system with fluticasone (EDS-FLU) for nasal polyposis. J Allergy Clin Immunol. 2019;143(1):126-134.e5.
Full Prescribing Information for XHANCE (fluticasone propionate). OptiNose US, Inc.; 2024.