How It Works
Ryaltris works by combining two active ingredients:
- Olopatadine hydrochloride: Olopatadine is an antihistamine. When you encounter an allergen, your body releases a natural chemical called histamine. This chemical triggers symptoms like itching, sneezing, and a runny nose. Olopatadine blocks histamine receptors to stop those allergic responses.
- Mometasone furoate: Mometasone furoate is a corticosteroid. Corticosteroids help reduce swelling and alleviate inflammation in the nasal passages. This process relieves nasal congestion so you can breathe more easily.
| Quick Facts | |
|---|---|
| Common Brands | Ryaltris |
| Drug Class | Antihistamine and corticosteroid |
| Generic Status | Generic is not available |
| Availability | Prescription only |
Dosing
The recommended dose of Ryaltris is two sprays in each nostril twice a day. The bottle contains 240 sprays and 6 priming sprays. The prescription packet will contain specific indications for using Ryaltris, but here are some general guidelines:
- Prime each new bottle by shaking it well and releasing six test sprays into the air, pointing away from the face. Reprime the bottle with two sprays if you have not used the bottle for 14 or more days.
- Blow your nose before each dose.
- Shake the bottle well.
- Close one nostril with a finger, insert the spray tip into the other nostril, and point it slightly outward toward your ear.
- Tilt your head slightly forward while keeping the bottle upright.
- Press down to release the spray, and breathe gently through your mouth.
- Repeat with the other nostril.
Note: Dosing information below is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Ryaltris nasal spray is FDA-approved to treat the symptoms associated with seasonal allergic rhinitis, such as:
- Nasal congestion
- Runny nose
- Sneezing
- Itchy nose or eyes
Off-Label Uses
You may see Ryaltris nasal spray prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
There are currently no common off-label uses for Ryaltris nasal spray.
Side Effects
Like all medications, Ryaltris nasal spray can cause side effects. Some common side effects may improve over time as your body adjusts to the medication. Other side effects may be serious and require medical attention.
Common Side Effects
- Nasal discomfort or irritation
- Headache
- Bitter or altered taste in the mouth
- Change in sense of smell
- Nosebleed
- Drowsiness
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Stop using Ryaltris and call your doctor immediately if you experience:
- Severe allergic reactions: Symptoms include swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; racing heart; severe rash or itching; and/or fever.
- Nasal problems: Ryaltris may cause nasal ulcerations (sores inside the nose) or nasal septal perforation (a hole in the cartilage separating the nostrils). Symptoms include persistent crusting in the nose, a whistling sound when breathing, nosebleeds, or a runny nose.
- Eye problems: Ryaltris may cause or worsen narrow-angle glaucoma or cataracts. Symptoms include blurry or foggy vision, seeing halos around lights, eye pain, vision loss or changes, and severe headache or vomiting.
- Infections: Using Ryaltris may increase your risk of infections. Symptoms may include a burning or stinging sensation when urinating, shortness of breath, diarrhea, stomach pain, weight loss, cough, coughing up blood, fever, chills, muscle aches, and white patches in the nose or throat.
- Adrenal gland issues: Long-term use or excessive doses of Ryaltris can lead to hypercorticism (too much stress hormone) or adrenal insufficiency (reduced adrenal function). Symptoms include fatigue, weakness, nausea, vomiting, dizziness, low blood pressure, a rounded face, easy bruising, acne, increased body or facial hair, weight gain, and fatty deposits around the upper back.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Prime Each New Bottle Before The First Use
Shake it well and release 6 test sprays into the air, pointing away from the face. If you haven’t used Ryaltris for 2 weeks or longer, re-prime the bottle by releasing 2 sprays into the air until a fine mist appears.
Blow Your Nose Before Your Dose
Gently clearing your nostrils helps ensure that nothing blocks the medication from reaching the nasal tissues.
Avoid Blowing Your Nose After Your Dose
Wait at least 15 minutes afterward to allow the medication to settle.
Avoid Tilting Your Head Backward Immediately After Your Dose
This can cause the liquid to drain into the throat, leading to a bad taste.
Clean The Bottle After Each Use
Carefully wipe the spray nozzle with a clean, dry tissue or cloth to prevent contamination.
Remove The Spray Pump And Dust Cap If It Becomes Clogged
Soak the pump in warm water for 15 minutes. Then rinse it and the dust cap with warm water. Let them both air dry completely before reassembling. Re-prime the bottle with 2 sprays before your next dose.
Know How To Stop A Nosebleed
Ryaltris may cause nosebleeds. Sit upright and lean forward. Pinch the soft part of your nose above the nostrils and breathe through the mouth for 10 minutes until the bleeding stops.
Prepare For Possible Drowsiness
Because Ryaltris can make you feel sleepy, it’s best to avoid driving or operating heavy machinery until you know how the medication affects you.
Store At Room Temperature
Ryaltris nasal spray should be stored at 68°F to 77°F (20°C to 25°C) in a cool, dry place away from light.
Tell Your Provider If You’re Pregnant Or Breastfeeding
It is unknown if Ryaltris nasal spray can affect pregnancy or pass into breast milk, so risk cannot be ruled out. Tell your healthcare provider if you are pregnant, breastfeeding, or planning to be, so they can advise whether you should keep taking the medication.
Try To Avoid Missing A Dose
If you miss a dose of Ryaltris, use it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and only take your next dose as usual. Do not take double or extra doses of Ryaltris nasal spray to make up for a missed one.
Drug Interactions
Certain medications and substances can interact with Ryaltris nasal spray, potentially altering its effectiveness or increasing the risk of side effects. For example:
- Alcohol: It is highly recommended to avoid drinking alcohol while using Ryaltris. Combining the two can increase the risk of drowsiness and affect your alertness.
- Other medications that cause drowsiness: Ryaltris may increase the risk of side effects when you use it with muscle relaxants, oral antihistamines, or medications for sleep, anxiety, or pain.
- Antifungal and antibacterial drugs: Medications that treat infections, such as ketoconazole, itraconazole, or clarithromycin, can interact with Ryaltris.
- HIV/AIDS medications: Protease inhibitors (e.g., ritonavir, atazanavir, nelfinavir) or medications containing cobicistat can interact with Ryaltris nasal spray.
- Other nasal sprays: Using other over-the-counter intranasal steroids or antihistamines with Ryaltris increases the risk for side effects.
- Nefazodone: This antidepressant can interact with Ryaltris.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
How fast does Ryaltris start working compared to an over-the-counter steroid spray like Flonase?
Ryaltris is designed for rapid onset and can begin relieving allergy symptoms within 15 minutes. Over-the-counter steroid sprays like Flonase can be effective, but may take several days to reach full efficacy. With Ryaltris, you may feel initial relief quickly, with symptoms continuing to improve over the first 2 weeks of regular use.
Why do I suddenly taste a nasty or metallic flavor in the back of my throat after spraying this?
An altered or bitter taste is a common side effect of Ryaltris. This usually happens when the medication drips down into the throat from your nasal passages. To minimize this, providers typically recommend tilting your head slightly forward when spraying and avoiding tilting your head backward immediately after your dose.
Is it normal to feel drowsy or fatigued after using this nasal spray?
The antihistamine component of Ryaltris (olopatadine) may cause drowsiness or sleepiness. The risk of experiencing it may increase if you drink alcohol or take other medications that cause drowsiness or sleepiness.
Do I have to “prime” the bottle with test sprays every single time I use it, or just when it’s brand new?
You do not need to prime it every single time. You only need to prime the bottle when it is brand new by releasing 6 sprays into the air away from your face. If you have not used the medication for 2 weeks or more, you should re-prime it by releasing 2 test sprays.
Can I use Ryaltris spray if I am already taking an antihistamine for my allergies?
You should not use other over-the-counter antihistamines or intranasal steroids while using Ryaltris. Combining them can increase your risk for experiencing side effects, including excessive drowsiness and nasal irritation.
Can using this spray continuously trigger “rebound” congestion?
Because Ryaltris is not a decongestant nasal spray, it does not typically cause the rebound congestion associated with rapid-acting nasal decongestants.
What should I do if I miss my morning dose?
If you forget a dose of Ryaltris, use it as soon as you remember. However, if it is almost time for your next scheduled dose, you should skip the missed dose and resume your normal schedule that night. Never use double or extra doses to make up for a missed one.
Does this medication treat a bacterial sinus infection?
No. Ryaltris is designed only to treat inflammation and allergic reactions associated with seasonal allergies, or hay fever. It does not have antibacterial properties. If you think you have a bacterial sinus infection, consult a healthcare provider.
Will Ryaltris spray provide immediate relief, or does it take days to build up in my system?
It provides a blend of both fast and sustained relief. The antihistamine component allows Ryaltris to start working within approximately 15 minutes. However, the corticosteroid component reduces inflammation over time, meaning your symptoms will likely continue to improve over the first 1–2 weeks of consistent treatment.
Does this medication interact with asthma inhalers?
Many asthma inhalers contain corticosteroids. Because Ryaltris also contains a corticosteroid (mometasone), taking both at the same time could increase your overall systemic exposure to steroids. Discuss all inhaled, oral, and topical medications with your prescribing physician to ensure your total steroid load remains safe.
Can I use Ryaltris spray if I have high blood pressure?
Ryaltris does not contain a stimulant-based nasal decongestant, which is a typical ingredient known to spike blood pressure. Even so, it is important to share your full health history with your healthcare provider before starting Ryaltris so they can ensure it is safe for you to take.
Comparable Medications
Ryaltris nasal spray, Dymista (azelastine / fluticasone), Nasonex (mometasone), Flonase (fluticasone), Patanase (olopatadine), Afrin (Oxymetazoline)?
There are several medications your doctor can prescribe instead of Ryaltris nasal spray. Here are a few possible alternatives below.
Dymista
A combination prescription antihistamine and corticosteroid nasal spray used to relieve allergy symptoms.
Nasonex
An over-the-counter corticosteroid nasal spray used to relieve allergy symptoms.
Fluticasone Nasal Spray
From $27.99
An over-the-counter corticosteroid nasal spray used to relieve allergy symptoms.
Olopatadine Nasal Spray
From $49.99
A prescription antihistamine nasal spray used to relieve allergy symptoms.
Afrin
An over-the-counter decongestant spray used to relieve allergy or cold symptoms.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.