NOW AVAILABLE WITHOUT A PRESCRIPTION!

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Dwayne Carr
5 years ago
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to treat nasal and ocular symptoms of seasonal and perennial allergic rhinitis, without a prescription. 1,2,4 It is approved for OTC* use in adults 18 years of age and older.

1 NOW AVAILABLE WITHOUT A RESCRITION! The same intranasal corticosteroid (INS) formula that has been trusted by doctors and pharmacists for over 20 years 1-3 Flonase Allergy Relief is the first and only INS indicated to treat nasal and ocular symptoms of seasonal and perennial allergic rhinitis, without a prescription. 1,2,4 It is approved for OTC* use in adults 18 years of age and older. 2 Flonase Allergy Relief (fluticasone propionate aqueous nasal spray) is indicated for the treatment of the symptoms associated with seasonal allergic rhinitis including hay fever, and perennial rhinitis and the management of sinus pain and pressure symptoms associated with allergic rhinitis. 2 * BTC in Quebec, Schedule II.

THE WORLD OF ALLERGIES IS CHANGING FOR THE WORSE Nasal allergy symptoms may be having a negative impact on your patients lives More people are affected than ever before and need effective options THE

2 THE WORLD OF ALLERGIES IS CHANGING FOR THE WORSE Nasal allergy symptoms may be having a negative impact on your patients lives More people are affected than ever before and need effective options THE WORLD OF ALLERGIES IS CHANGING FOR THE WORSE Left untreated, allergic rhinitis can impact quality of life due to:5-7 Fatigue Trouble sleeping Difficulty breathing The estimated number of workdays lost to allergies per year is 3.5 million8 WORSE WEATHER WORSE WEATHER ATTERNS 13 ATTERNS 13 MORE TRAVEL MORE TRAVEL11 11 Allergy season is every season Outdoor seasonal triggers:9 MORE URBANIZATION10 MORE URBANIZATION10 Increases CO2 and pollen Increases CO1960: 2 and pollen 1960: 2014: Ragweed 2014: 2030: 2030: Greater exposure to unfamiliar allergensexposure to unfamiliar Greater allergens 1950: 1950: 2012: 2012: tourists tourists tourists MORE ETS 14 tourists MORE ETS 14 cats and dogs Increases CO2 and pollen Grass 1990MORE2010: EMISSIONS12 Increases CO2 and pollen Tree pollen : cats and dogs BIGGER, BADDER ALLERGENS MORE EMISSIONS : 13 BIGGER, BADDER ALLERGENS : Mold spores Indoor year-round triggers:9 et dander Dust mites INS treatments, like Flonase Allergy Relief, are recognized as the most effective treatment option for allergic rhinitis2,16 While decongestant nasal sprays cannot be used for more than 3 days, Flonase Allergy Relief can be used every day* for sustained symptom relief.2 DAILY For maximum benefit, remind your patients to make Flonase Allergy Relief a part of their daily routine.2,16 Mold * When used as directed. After 3 months of daily use, patients should ask their doctor if they can keep using Flonase Allergy Relief FLO - harmacyackage_new_v9.indd :30 M

An MOA that controls 6 inflammatory mediators* More relief of allergy symptoms * Flonase Allergy Relief

histamine 16-18 INS Single-ingredient antihistamines The first prescription to over-the-counter

Histamine Cytokines Leukotrienes Chemokines Sneezing Itchy nose and throat rostaglandins Tryptases

hours Nasal congestion Sinus pain and pressure Maximum effect could take 2 3 days after the start of

Flonase Allergy Relief acts on multiple inflammatory substances (histamine, chemokines, leukotrinenes,

Flonase Allergy Relief provides relief of sneezing, itchy nose and throat, runny nose and itchy, watery

3 An MOA that controls 6 inflammatory mediators* More relief of allergy symptoms * Flonase Allergy Relief does more to control the allergic cascade: It works to control 6 key inflammatory mediators not just histamine INS Single-ingredient antihistamines The first prescription to over-the-counter intranasal corticosteroid (INS) spray indicated for relief of the following allergy symptoms: 2,19 Histamine Cytokines Leukotrienes Chemokines Sneezing Itchy nose and throat rostaglandins Tryptases Runny nose Itchy, watery eyes Fast onset Some patients may feel relief as soon as the first day hours Nasal congestion Sinus pain and pressure Maximum effect could take 2 3 days after the start of therapy days OF ALLERGY SYMTOMS Trusted formula Fluticasone propionate, the active ingredient in Flonase Allergy Relief, has a well-established safety profile with over 20 years of clinical experience. 1,2 * Mechanism vs. most OTC allergy pills. Flonase Allergy Relief acts on multiple inflammatory substances (histamine, chemokines, leukotrinenes, cytokines, tryptases and prostaglandins). The exact number and precise mechanism are unknown. Flonase Allergy Relief provides relief of sneezing, itchy nose and throat, runny nose and itchy, watery eyes. It also relieves nasal congestion and sinus pain and pressure. * vs. single-ingredient antihistamines, which are not indicated for sinus pain and pressure BTC in Quebec, Schedule II.

Who is your Flonase Allergy Relief patient?

management of sinus pain and pressure symptoms associated with allergic rhinitis.

23 Ask your patients: 24 Do you have 2 or more of the following symptoms for >1 hour on most days?

4 Who is your Flonase Allergy Relief patient? Recommended first line, year round Flonase Allergy Relief is indicated for the treatment of the symptoms associated with seasonal allergic rhinitis including hay fever, and perennial rhinitis and the management of sinus pain and pressure symptoms associated with allergic rhinitis. 2 Diagnose allergic rhinitis by examining your patient s history of allergic symptoms in combination with diagnostic tests. 23 Ask your patients: 24 Do you have 2 or more of the following symptoms for >1 hour on most days? Watery, runny nose Sneezing, especially violent and in bouts Nasal obstruction Nasal itching Conjunctivitis (red, itchy eyes) Evaluate: 24 First line ARIA treatment guidelines, issued in partnership with the World Health Organization, recommend INS treatments like Flonase Allergy Relief as first-line treatment for allergic rhinitis, calling them the most efficacious medication available for the treatment of allergic and nonallergic rhinitis. 23 INS treatments are recognized as the most effective long-term treatment option. 23 Flonase Allergy Relief has been approved for year-round use. After 3 months of daily use, patients should ask their doctor if they can continue using Flonase Allergy Relief. 2 Suffering from allergic rhinitis may go beyond symptoms Your patient may also be experiencing these physical and emotional impacts: Tiredness Irritability Feeling Miserable Sleep Distces Feelings of Depression Embarrassment 15% 5 28% 5 60% 5 57% 8 67% 5 85% 5 Watery, runny nose + 1 other symptom Allergic rhinitis Watery, runny nose alone Sneezing, nasal itching and/or conjunctivitis BUT NO watery, runny nose May have allergic rhinitis Consider alternate diagnosis/refer to a specialist Flonase Allergy Relief contains the #1 prescribed allergy ingredient. 2,26,27 Other: Recommend the following diagnostic tests:* 23 1) Allergen-specific IgE in the skin 2) Blood (specific IgE) ARIA=Allergic Rhinitis and Its Impact on Asthma * atient should consult their doctor. For adults 18 years of age and older. Flonase Allergy Relief is not recommended in patients <18 years of age. Flonase Allergy Relief should not be continued beyond three weeks in the absence of significant symptomatic improvement. After 3 months of daily use, the patient should consult their doctor if he/she can continue using Flonase Allergy Relief. 2 Based on U.S. data.

5 Instructions for use Recommended dose2 Some patients may feel relief as soon as the first day. Maximum effect could take 2 3 days after the start of therapy.2 2 sprays (50 mcg each) in each nostril once a day If symptoms are under control after one week of use: 1 spray in each nostril once a day How to use Flonase Allergy Relief 2 1 Shake 2 rime 1 Shake 2 rime 3 Blow 4 Aim 3 Blow Breathe 45AimBreathe 5 and spray and spray Close one nostril Blow nose gently and put tip of to clear nostrils. spray nozzle in other nostril. While Close onesniffing nostrilgently, While sniffing gently, down andpress put tip of on spray press down on spray nozzle once spray nozzle inor twice nozzle once or twice (according other nostril. to dosing (according to dosing instructions). You ll feelinstructions). You ll feel a light mist in your nose. a light mist in your nose. Breathe Tip out through Breathe out through your mouth. your mouth. Do this when:do this when: Starting new bottle Starting new bottle Haven t used it in a week Haven t used it in a week Just cleaned nozzle Just cleaned nozzle Otherwise go to step 3 Otherwise go to step 3 Gently shake spray Gently shake spray bottle. bottle. Blow nose gently to clear nostrils. Aim away from face. Aim away from face. Grasp spray bottle as Grasp spray bottle as shown. ump until fine shown. ump until fine Warning mist appears. mist appears. Do not spray in your eyes. Only for use in your nose. umped six times and umped six times and Remove green cap. still no mist? Spray still no mist? Spray Remove green cap. nozzle may be clogged. nozzle may be clogged. Tip Warning Do not spray in your eyes. Only for use in your nose. ut just Repeat in other nostril. Wipe spray nozzle with clean tissue Aim slightly ut just Aim slightly andinto replace the tip into away from the tip awaycap. from your nose. centre of nose. your nose. Repeat in other nostril. Wipe spray nozzle with clean tissue and replace cap. centre of nose. lease see roduct Monograph for complete patient instructions FLO - harmacyackage_new_v9.indd :31 M

How Flonase Allergy Relief compares References NASAL SYMTOMS OCULAR SYMTOMS Congestion Runny nose Sneezing Itchy nose Sinus pressure and discomfort Itchy eyes Watery eyes FLONASE Allergy Relief 2

GlaxoSmithKline Consumer Healthcare Inc. August 23, 2016. 3. Flonase roduct Monograph. GlaxoSmithKline Inc. Dec. 10, 2015. 4. Nasacort Allergy 24HR/Nasacort AQ roduct Monograph.

Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich C.

6 How Flonase Allergy Relief compares References NASAL SYMTOMS OCULAR SYMTOMS Congestion Runny nose Sneezing Itchy nose Sinus pressure and discomfort Itchy eyes Watery eyes FLONASE Allergy Relief 2 Single-Ingredient Antihistamine * Other Nonprescription INS 4,28 1. Data on file. GSK group of companies Flonase Allergy Relief roduct Monograph. GlaxoSmithKline Consumer Healthcare Inc. August 23, Flonase roduct Monograph. GlaxoSmithKline Inc. Dec. 10, Nasacort Allergy 24HR/Nasacort AQ roduct Monograph. Sanofi-Aventis Canada Inc. December 11, Brooks M. Allergic rhinitis a significant burden. ublished March 30, Accessed March 27, Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich C. Nasal congestion secondary to allergic rhinitis as a cause of sleep distce and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol. 1998;101(5): Sardana N, Craig TJ. Congestion and sleep impairment in allergic rhinitis. Asian ac J Allergy Immunol. 2011;29(4): World Allergy Organization. World Allergy Organization (WAO) White Book on Allergy. Milwaukee, WI: World Allergy Organization; University of Maryland Medical Center. Allergic rhinitis. allergic-rhinitis. Accessed December World Health Organization, Global Health Observatory, Urban population growth. _health/situation_trends/_population_ growth_text/en/. Accessed October 16, World Tourism Organization UNWTO. Tourism market trends. files/docpdf/markettrends.pdf. ublished December Accessed October 15, World Health Organization. Energy: shared interests in sustainable development and energy services: In: Social Determinants of Health Sectoral Briefing Series 5. Geneva, Switzerland: World Health Organization; National Wildlife Federation. Extreme allergies and global warming. NWF_AllergiesFinal.pdf. Accessed October 15, Batson A. Global Companion Animal Ownership and Trade: roject Summary, June London, UK: World Society for the rotection of Animals Hallgren J, ejler G. Biology of mast cell tryptase: an inflammatory mediator. FEBS J. 2006;273(9): Broide DH. The pathophysiology of allergic rhinoconjunctivitis. Allergy Ashthma roc. 2007;28(4): GSK data on file. GSK Consumer Healthcare announces Flonase Allergy Relief for over-the-counter relief in Canada. ress Release. August 26, Claritin roduct Monograph. Bayer Inc. December 17, Reactine roduct Monograph. McNeil Consumer Healthcare. June 11, Allegra roduct Monograph. Sanofi-Aventis Canada Inc. September 8, Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma (ARIA). Allergy. 2008;63(suppl 86): Allergic Rhinitis and Its Impact on Asthma. Management of allergic rhinitis and its impact on asthma: pocket guide. Based on the 2007 ARIA Workshop Report and the IAG Handbook, in collaboration with WHO, GA 2 LEN, AllerGen, and Wonca; Small, Frenkiel S, Becker A, et al. Rhinitis: an executive summary of a practical and comprehensive approach to assessment and therapy. J Otolaryngol. 2007;36(Suppl 1);S1-S Data on file. FANS Clinical Overview. GlaxoSmithKline IMS Health Incorporated. IMS National rescription Audit. June 2013-May Nasacort ackage Leaflet. Cheshire, UK: Aventis harma, Bousquet J, Chanal I, Alquié MC, et al. revention of pollen rhinitis symptoms: comparison of fluticasone propionate aqueous nasal spray and disodium cromoglycate aqueous nasal spray: a multicenter, double-blind, double-dummy, parallel-group study. Allergy. 1993;48(5): Darnell R, ecoud A, Richards DH. A double-blind comparison of fluticasone propionate aqueous nasal spray, terfenadine tablets and placebo in the treatment of patients with seasonal allergic rhinitis to grass pollen. Clin Exp Allergy. 1994;24(12): Beggs J. Impacts of climate change on aeroallergens: past and future. Clin Exp Allergy. 2004;34(10): Derendorf H, Meltzerr EO. Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications. Allergy. 2008;63(10: Benincasa C, Lloyd RS. Evaluation of fluticasone propionate aqueous nasal spray taken alone and in combination with cetirizine in the prophylactic treatment of seasonal allergic rhinitis. Drug Invest. 1994;8(4): * Reactine only.

7 Frequently asked questions Q. What is Flonase Allergy Relief and how does it work? A. Flonase Allergy Relief (fluticasone propionate aqueous nasal spray 50 mcg) is an over-the-counter (OTC*) intranasal corticosteroid (INS) treatment for relief of symptoms associated with seasonal allergic rhinitis (SAR) including hay fever and perennial rhinitis (AR) as well as the management of associated sinus pain and pressure symptoms. It works by acting on several key inflammatory substances (histamine, chemokines, leukotrienes, cytokines, tryptases and prostaglandins) the body releases when it has an allergic reaction. 2 Q. Is the new OTC Flonase Allergy Relief just as strong as prescription Flonase? A.Yes. The dosing may be different, but Flonase Allergy Relief is the same INS formula (fluticasone propionate) that has been trusted for over 20 years for patients 18 and older. 1-3 Q. How long does it take for Flonase Allergy Relief to start providing relief? A. Some patients may feel relief as soon as the first day. Maximum effect could take 2 to 3 days after the start of therapy. 2 Q. How does Flonase Allergy Relief compare to other nasal sprays? A. Flonase Allergy Relief is the first prescription to non-prescription INS spray indicated for relief of nasal and eye-related allergy symptoms including runny nose, sneezing, itchy nose, nasal congestion, itchy and watery eyes as well as nasal congestion and sinus pain and pressure. 2,4 Fluticasone propionate, the active ingredient in Flonase Allergy Relief, has a well-established safety profile with over 20 years of clinical experience. 1 Q. Should I recommend Flonase Allergy Relief as the first-line treatment for nasal allergies? A. Canadian guidelines recommend INS treatments for moderate to severe intermittent symptoms, or mild persistent rhinitis, alone or in combination with antihistamines. 25 INS treatments are recognized as the most effective long-term treatment options. 23 Q. What should I tell my patients if they are concerned about taking a steroid nasal spray? A. Flonase Allergy Relief is not an anabolic steroid. Flonase has been used for over 20 years as a prescription product and has a well-established safety profile. With less than 1% systemic absorption, it does not cause drowsiness or sleeplessness. 1,2 Q. Is Flonase Allergy Relief covered by insurance? A. atients should contact their insurance provider for coverage information. Q. Where can I get more information about Flonase Allergy Relief? A. lease visit flonaseprofessional.ca for more information. Q. How is Flonase Allergy Relief different from antihistamine pills? A.Flonase Allergy Relief controls several key inflammatory substances (histamine, chemokines, leukotrienes, cytokines, tryptases and prostaglandins) that the body releases when it has an allergic reaction, whereas single-ingredient antihistamine pills will only act on one of these substances (i.e., histamine) INS treatments, like Flonase Allergy Relief, are recognized as the most effective treatment option for allergic rhinitis 2,16 Q. Can Flonase Allergy Relief prevent allergies? A. Used preemptively whenever exposure to allergens is expected, Flonase Allergy Relief has been shown to prevent nasal allergy symptoms by reducing the sensitivity of the nasal membranes to allergens * BTC in Quebec, Schedule II. Mechanism vs. most OTC allergy pills. Flonase Allergy Relief acts on multiple inflammatory substances (histamine, chemokines, leukotrinenes, cytokines, tryptases and prostaglandins). The exact number and precise mechanism are unknown.

8 roduct Information Notes Indications and clinical use: 2 Flonase Allergy Relief (fluticasone propionate aqueous nasal spray) is indicated for the treatment of the symptoms associated with seasonal allergic rhinitis including hay fever, and perennial rhinitis; and the management of sinus pain and pressure symptoms associated with allergic rhinitis. Contraindications: 2 Flonase Allergy Relief (fluticasone propionate aqueous nasal spray) is contraindicated in patients who are hypersensitive to fluticasone propionate, or to any ingredient in the formulation or component of the container and patients with untreated fungal, bacterial or tuberculosis infections of the respiratory tract. Flonase Allergy Relief is not recommended for children and adolescents younger than 18 years of age. Most serious warnings and precautions: 2 atients should be informed that the full effect of Flonase Allergy Relief (fluticasone propionate aqueous nasal spray) therapy is not achieved until 2 to 3 days of treatment have been completed. Treatment of seasonal rhinitis should, if possible, start before the exposure to allergens. Although Flonase Allergy Relief will control seasonal allergic rhinitis in most cases, an abnormally heavy challenge of summer allergens may in certain instances necessitate appropriate additional therapy. Under most circumstances, treatment with corticosteroids should not be stopped abruptly but tapered off gradually. atients should be advised to inform subsequent physicians of prior use of corticosteroids. Other relevant warnings and precautions: 2 Ear/Nose/Throat: Epistaxis, nasal ulceration, Candida infection, nasal septal perforation, impaired wound healing. Endocrine and Metabolism: Hypercorticisms and adrenal suppression, effects on growth, hypothyroidism. Hematologic: Acetylsalicylic acid should be used cautiously with corticosteroids in hypothrombinemia. Hepatic/Biliary/ancreatic: Concomitant use of fluticasone propionate and ritonavir should be avoided, unless the potential benefit to the patient outweighs the risk of systemic corticosteroid side effects. There is an enhanced effect of corticosteroids in patients with cirrhosis. Immune: Hypersensitivity reactions including anaphylaxis, immunosuppression; use with caution in patients who have had recent nasal surgery or trauma. Ophthalmologic: Close monitoring is warranted in patients with a change in vision or with a history of increased intraocular pressure, glaucoma, and/or cataracts. sychological and Behavioural: Rare: psychological and behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression. Respiratory: Careful attention must be given to patients with asthma or other clinical conditions in whom a rapid decrease in systemic steroids may cause a severe exacerbation of their symptoms. regnant and Nursing Women: The safety of fluticasone propionate in pregnant and nursing women has not been established. If used in pregnancy, the expected benefits should be weighed against the potential hazard to the fetus, particularly during the first trimester of pregnancy. The use of fluticasone propionate in nursing mothers requires that the possible benefits of the drug be weighed against the potential hazards to the infant. lease consult the product monograph at or by calling for information relating to adverse reactions, drug interactions, and dosing information.

DISCOVER MORE RELIEF OF YOUR ALLERGY SYMTOMS* Flonase Allergy Relief

GlaxoSmithKline Consumer Healthcare Inc.

9 DISCOVER MORE RELIEF OF YOUR ALLERGY SYMTOMS* Flonase Allergy Relief provides relief of sneezing, itchy nose and throat, runny nose and itchy, watery eyes. It also relieves nasal congestion and sinus pain and pressure. GlaxoSmithKline Consumer Healthcare Inc GSK group of companies or its licensor. All rights reserved. *vs. single ingredient anti-histamine pills, which are not indicated for sinus pain and pressure. C16206A

Fluticasone propionate, 50 mcg per spray. Please read this leaflet carefully before you use FLIXONASE ALLERGY & HAYFEVER 24 HOUR.

FLIXONASE ALLERGY & HAYFEVER 24 HOUR Fluticasone propionate, 50 mcg per spray Consumer Medicine Information What is in this leaflet? Please read this leaflet carefully before you use FLIXONASE ALLERGY