Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Mometasone furoate monohydrate, Olopatadine hydrochloride may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for
Ryaltris contains two active substances: mometasone furoate and olopatadine.
2.
e Ryaltris
Do not take Ryaltris
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if you have recently had an operation on your nose or you have injured your nose. You should not use the nasal spray until your nose has healed.
Warnings and precautions Talk to your doctor or pharmacist before taking Ryaltris
Children and adolescents Ryaltris is not recommended in children below 12 years. Taking Ryaltris for a long time can cause children and adolescents to grow more slowly. The doctor will check your child's height regularly and make sure he or she is taking the lowest possible effective dose. Other medicines and Ryaltris Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. If you are taking other steroid medicines for allergy, either by mouth or injection, your doctor may advise you to stop taking them once you begin using Ryaltris. If you are taking other medicines by oral or local route (nasal or eye drops) containing olopatadine or other antihistamines, your doctor may advise you to stop taking them once you begin using Ryaltris. Some medicines may increase the effects of Ryaltris and your doctor may wish to monitor you carefully if you are taking these medicines (including some medicines for HIV: ritonavir, cobicistat). Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. Ryaltris should not be used during pregnancy unless considered appropriate by your doctor. If you are taking Ryaltris, your doctor will discuss with you whether you should breast-feed considering the benefit to you of your therapy and the benefit to your baby of breast-feeding. You should not do both.
Driving and using machines
Very rarely, you may experience dizziness, lethargy, fatigue and sleepiness. If this happens, do not drive or operate machinery. Please be aware that drinking alcohol may enhance these effects. Ryaltris contains benzalkonium chloride. This medicine contains 0.02 mg benzalkonium chloride in each actuation. Benzalkonium chloride may cause irritation or swelling inside the nose, especially if used for a long time.
3.
How to use Ryaltris
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Contact with the eyes should be avoided. Adults and adolescents (12 years and above) The recommended dose is two sprays into each nostril in the morning and evening. Use in children under 12 years This medicine is not recommended for children under 12 years. Method of administration The spray is for nasal use. Read the following instructions carefully and use only as directed. Shake the bottle for minimum 10 seconds before each use. When Ryaltris is not in use, the purple dust cap should always be kept tightly placed on the white nozzle tip. Your Ryaltris nasal spray bottle
Preparing the nasal spray bottle
1. Shake the bottle for minimum 10 seconds and then remove the purple dust cap (see figure 1). 2. If you are using the spray for the first time you need to 'prime' the bottle by pumping into the air. 3. Hold the nasal spray bottle firmly and upright with your index and middle finger on either side of the spray nozzle unit applicator (on finger rests) while supporting the grooved base of the bottle with your thumb. 4. Point the nozzle away from you and then press down and release the pump 6 times until a fine mist appears (see figure 2). 5. Now your pump is primed and ready to use. 6. If you have not used the spray for 14 days or more, you need to shake the bottle well and "re-prime" the bottle by pumping the spray 2 times or until a fine mist is produced
your nasal spray 1. Shake the bottle for minimum 10 seconds before each use (morning and evening). 2. Gently blow your nose to clear your nostrils. 3. Hold the bottle firmly with your index and middle finger on either side of the spray nozzle unit (on finger rests) while supporting the grooved base of the bottle with your thumb 4. Close one nostril with your finger and carefully insert the spray tip into the other nostril, pointing it slightly toward the outside of the nose (see figure 3). 5. Tilt your head forward slightly. Press down one time quickly and firmly on the finger rests to activate the pump. 6. Breathe in (inhale) gently through your nose as you spray. Then breathe out through your mouth (see figure 4). 7. Repeat the above steps and deliver a second spray in the same nostril. 8. Repeat with 2 sprays in the other nostril. 9. To prevent any blockage, after each use, wipe the nozzle carefully with a clean dry tissue or cloth (see figure 5). 10. Hold the nozzle unit and push the purple dust cap back on the nozzle until you hear a click (see figure 6).
Cleaning your nasal spray If the nozzle gets blocked, do as described in the following steps:
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Place the purple dust cap back on the spray nozzle tip and put it back on the bottle. After following the steps to clear your blocked spray nozzle tip see "Preparing the nasal spray bottle" section above and re-prime using 2 sprays. replace the purple dust cap, and your Ryaltris is ready for use. Repeat the unblocking steps if needed.
If you take more Ryaltris than you should You are unlikely to have any problems but if you are worried or if you have used doses higher than recommended over a long period, contact your doctor. If you use steroids for a long time or in large amounts they may rarely affect some of your hormones. In children this may affect growth and development. If you forget to take Ryaltris Use your nasal spray as soon as you remember, then take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose. If you stop taking Ryaltris It is very important that you use your nasal spray regularly. Do not stop your treatment even if you feel better unless your doctor told you. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4.
Like all medicines, this medicine can cause side effects, although not everybody gets them. Immediate hypersensitivity (allergic) reactions may occur after use of this product. These reactions may be severe. You should stop taking Ryaltris and get immediate medical help if you experience symptoms such as: swollen face, tongue or pharynx; trouble swallowing; hives; wheezing or trouble breathing. Common (may affect up to 1 in 10 people): A bitter taste in your mouth; Nosebleed; Slight irritation of the inside of the nose; Uncommon (may affect up to 1 in 100 people): Dizziness; Headaches; Sleepiness; Nasal dryness; Dry mouth; Abdominal pain; Nausea; Fatigue; Rare (may affect up to 1 in 1,000 people): Bacterial vaginosis (bacterial infection of the vagina); Anxiety, depression, insomnia; Lethargy, migraine; Dry eye, blurred vision, eye discomfort; Ear pain; Sore throat;
Sneezing; Throat irritation; Constipation; Sore tongue; Swelling and ulcers inside your nose.
Not known (frequency cannot be estimated from the available data): Increase in pressure in the eye (glaucoma) and/or cataracts causing visual disturbances; Damage to the partition in the nose which separates the nostrils; Difficulty in breathing and/or wheezing; Respiratory tract infection. Systemic side effects (side effects concerning the whole body) may occur when this medicine is used at high doses for a long time. These effects are much less likely to occur if you use a steroid nasal spray than if you take steroids by mouth. These effects may vary in individual patients. Nasal steroids can affect the normal production of hormones in your body, particularly if you use high doses for a long time. In children and adolescents this side effect can cause them to grow more slowly than others. Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5.
Ryaltris
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the bottle and carton after "EXP". The expiry date refers to the last day of that month. Do not freeze. The bottle should be used within 2 months of first opening. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6.
What Ryaltris contains The active substances are: mometasone furoate (as monohydrate) and olopatadine (as hydrochloride). One delivered dose (the dose that leaves the actuator) contains mometasone furoate monohydrate equivalent to 25 microgram mometasone furoate and olopatadine hydrochloride equivalent to 600 micrograms olopatadine. The other ingredients are: microcrystalline cellulose (E460), carmellose sodium (E 466), dibasic sodium phosphate heptahydrate (E 339), sodium chloride, benzalkonium chloride, glycerol, disodium edetate, polysorbate 80 (E 433), hydrochloric acid (E 507), sodium hydroxide (E 524) and water for injections. What Ryaltris looks like and contents of the pack Ryaltris is a white, homgenous suspension. Ryaltris is contained in a white, high density polyethylene bottle supplied with a metered-dose, manual polypropylene spray pump actuator. The actuator is protected by a HDPE purple cap.
Pack sizes: 1 bottle of 20 ml with 56 actuations, 1 bottle of 20 ml with 120 actuations, 1 bottle of 30 ml with 240 actuations. Not all pack sizes may be marketed. Marketing Authorisation Holder: Glenmark Pharmaceuticals Europe Limited Laxmi House, 2B Draycott Avenue Kenton, Middlesex, HA3 0BU United Kingdom
Manufacturer: Glenmark Pharmaceuticals s.r.o. Fibichova 143, 566 17 Vysoke Myto, Czech Republic
This leaflet was last revised in March 2025
Ryaltris 25 micrograms/actuation + 600 micrograms/actuation Nasal Spray, suspension comes as oral solution containing 25mcg / 600mcg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Ryaltris 25 micrograms/actuation + 600 micrograms/actuation Nasal Spray, suspension is mometasone furoate monohydrate, olopatadine hydrochloride.
This leaflet reproduces the patient information leaflet approved for Ryaltris 25 micrograms/actuation + 600 micrograms/actuation Nasal Spray, suspension, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Ryaltris is indicated in adults and adolescents 12 years of age and older for the treatment of moderate to severe nasal symptoms associated with allergic rhinitis.
Posology
Adults and adolescents (12 years and older)
The usual recommended dose is two actuations in each nostril twice daily (morning and evening).
Children below 12 years
Ryaltris is not recommended for use in children below 12 years of age as safety and efficacy has not been established in this age group.
Elderly
No dose adjustment is required in this population.
Renal and hepatic impairment
There are no data in patients with renal and hepatic impairment, however no dose adjustment is expected to be required in these populations considering the absorption, metabolism and elimination of the active substances (see section 5.2).
Method of administration
Ryaltris is for nasal use only.
Prior to administration of the first dose, shake container well and actuate the pump 6 times (until a uniform spray is obtained). If the pump is not used for 14 days or longer, re-prime the pump with 2 actuations until a uniform spray is observed, before next use.
Shake container for minimum 10 seconds before each use. After using the spray, wipe the nozzle carefully with a clean handkerchief or tissue and replace the cap, to avoid that the nozzle gets blocked. The bottle should be discarded after the labelled number of actuations or within 2 months of first use.
Hypersensitivity to the active substances or to any of the excipients listed in section 6.1.
Ryaltris should not be used in the presence of untreated localised infection involving the nasal mucosa, such as herpes simplex.
Because of the inhibitory effect of corticosteroids on wound healing, patients who have experienced recent nasal surgery or trauma should not use a nasal corticosteroid until healing has occurred
Local Nasal Effects
Instances of nasal ulceration and nasal septal perforation have been reported in patients following the intranasal application of antihistamines.
Instances of nasal septal perforation have been reported following the intranasal application of corticosteroids.
Patients using Ryaltris over several months or longer should be examined periodically for possible changes in the nasal mucosa.
Ryaltris is not recommended in case of nasal septum perforation (see section 4.8).
Instances of epistaxis have been reported in patients following the intranasal application of antihistamines and corticosteroids (see section 4.8).
In clinical studies with mometasone furoate administered intranasally, the development of localised infections of the nose and pharynx with Candida albicans has occurred. When such an infection develops, it may require treatment with appropriate local therapy and discontinuation of treatment with Ryaltris. Patients using Ryaltris over several months or longer should be examined periodically for evidence of Candida infection or other signs of adverse effects on the nasal mucosa.
Visual disturbances
Visual disturbance may be reported with systemic and topical (including, intranasal) corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes of visual disturbances which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids.
Hypersensitivity Reactions
Hypersensitivity reactions, including instances of wheezing, may occur after the intranasal administration of mometasone furoate monohydrate and olopatadine hydrochloride. Discontinue Ryaltris if such reactions occur (see section 4.8).
Immunosuppression
Persons who are using drugs that suppress the immune system, such as corticosteroids, are more susceptible to infections than healthy individuals. Chickenpox and measles, for example, can have a more serious or even fatal course in susceptible children or adults using corticosteroids. In children or adults who have not had these diseases or been properly immunized, particular care should be taken to avoid exposure. How the dose, route, and duration of corticosteroid administration affect the risk of developing a disseminated infection is not known.
Corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculous infections of the respiratory tract, untreated local or systemic fungal or bacterial infections, systemic viral or parasitic infections, or ocular herpes simplex because of the potential for worsening of these infections.
Systemic Effects of Corticosteroids
Potential systemic effects may include Cushing's syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, cataract, glaucoma and more rarely, a range of psychological or behavioural effects including psychomotor hyperactivity, sleep disorders, anxiety, depression or aggression (particularly in children).
When intranasal steroids are used at higher than recommended dosages or in susceptible individuals at recommended dosages, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear. If such changes occur, the dosage of Ryaltris should be discontinued slowly, consistent with accepted procedures for discontinuing oral corticosteroid therapy. The concomitant use of intranasal corticosteroids with other inhaled corticosteroids could increase the risk of signs or symptoms of hypercorticism and/or suppression of the HPA axis.
If there is evidence for higher than recommended doses being used, then additional systemic corticosteroid cover should be considered during periods of stress or elective surgery.
The replacement of a systemic corticosteroid with a topical corticosteroid can be accompanied by signs of adrenal insufficiency, and some patients may experience symptoms of withdrawal (e.g., joint and/or muscular pain, lassitude, and depression). Patients previously treated for prolonged periods with systemic corticosteroids and transferred to topical corticosteroids should be carefully monitored for acute adrenal insufficiency in response to stress. In those patients who have asthma or other clinical conditions requiring long term systemic corticosteroid treatment, too rapid a decrease in systemic corticosteroids may cause a severe exacerbation of their symptoms.
Somnolence
Like other antihistamines, olopatadine may cause somnolence in same patients when absorbed systemically.
Patients should be cautioned against engaging in hazardous occupations requiring complete mental alertness and motor coordination, such as operating machinery or driving a motor vehicle, after administration of Ryaltris. Concurrent use of Ryaltris with alcohol or other central nervous system (CNS) depressants should be avoided because additional reductions in alertness and additional impairment of CNS performance may occur.
Somnolence has been reported following administration of Ryaltris in clinical studies (see section 4.8).
Antihistamine effects
Concomitant use of olopatadine (e.g. eyes drops) or other antihistaminic drugs administered via nasal, ocular or oral route may increase the risk of antihistamine adverse effects.
Paediatric population
It is recommended that the height of children receiving prolonged treatment with nasal corticosteroids is regularly monitored. If growth is slowed, therapy should be reviewed with the aim of reducing the dose of nasal corticosteroid if possible, to the lowest dose at which effective control of symptoms is maintained. In addition, consideration should be given to referring the patient to a paediatric specialist.
Excipients:
Ryaltris contains 0.02 mg benzalkonium chloride in each actuation. Benzalkonium chloride may cause irritation or swelling inside the nose, especially if used for a long time.
No interaction studies have been performed with Ryaltris.
Any drug drug interactions from the combination of olopatadine and mometasone furoate are expected to reflect those of the components taken individually, as no pharmacokinetic interaction between olopatadine and mometasone furoate was observed when administered in combination.
Olopatadine:
No interactions between olopatadine and other drugs are expected (see section 5.2).
Mometasone Furoate:
Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side-effects. The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid side-effects.
Pregnancy
Mometasone Furoate:
There are no or limited amount of data from the use of mometasone furoate in pregnant women. Studies in animals have shown reproductive toxicity (see section 5.3).
Olopatadine:
There are no or limited amount of data from the use of intranasal olopatadine in pregnant women.
Studies in animals have shown reproductive toxicity following systemic administration (see section 5.3).
Ryaltris should not be used in pregnancy unless the potential benefit to the mother justifies any potential risk to the mother, foetus or infant. Infants born of mothers who received corticosteroids during pregnancy should be observed carefully for hypoadrenalism.
Breast-feeding
Mometasone Furoate:
It is unknown whether mometasone furoate is excreted in human milk
Olopatadine:
Available data in animals have shown excretion of olopatadine in milk following oral administration (for details see section 5.3). A risk to the newborn/infants cannot be excluded.
A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Ryaltris therapy taking into account the benefit of breast feeding for the child and the benefit of therapy for the woman.
Fertility
There are only limited data with regard to fertility.
There are no clinical data concerning the effect of mometasone furoate on fertility. Animal studies have shown reproductive toxicity, but no effects on fertility.
There are no clinical data concerning the effect of olopatadine on fertility.
In isolated cases dizziness, lethargy, fatigue and somnolence may occur when using Ryaltris. In these cases, the ability to drive and use machines may be impaired. Alcohol may enhance this effect.
Summary of the safety profile
The most commonly reported adverse reaction during treatment with Ryaltris was dysgeusia (a substance-specific unpleasant taste), epistaxis and nasal discomfort.
Tabulated list of adverse reactions
The following adverse reactions have been reported during clinical studies and post-marketing data and are classified according to the following convention: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1000), very rare (<1/10,000) or not known (cannot be estimated from the available data).
Frequency
Common
Uncommon
Rare
Not known
System Organ Class
Infection and infestations
Bacterial vaginosis
Pharyngitis*
Upper respiratory tract infection*
Immune system disorders
Hypersensitivity including anaphylactic reactions, angioedema, bronchospasm, and dyspnoea*
Psychiatric disorders
Anxiety
Depression
Insomnia
Nervous system disorder
Dysgeusia (unpleasant taste)
Dizziness
Headaches
Somnolence
Lethargy
Migraine
Eye disorders
Blurred vision
Dry eye
Eye discomfort
Cataracts*
Glaucoma*
Increased intraocular pressure*
Ear and labyrinth disorder
Ear pain
Respiratory, thoracic and mediastinal disorders
Epistaxis
Nasal discomfort
Nasal dryness
Nasal inflammation
Nasal mucosal disorder
Oropharyngeal pain
Sneezing
Throat irritation
Nasal septum perforation*
Gastrointestinal disorders
Dry mouth
Abdominal pain
Nausea
Constipation
Sore tongue
General disorders and administration site conditions
Fatigue
Injury, poisoning and procedural complications
Laceration
*reported with the use of corticosteroids.
Systemic effects of some nasal corticosteroids may occur, particularly when administered at high doses for prolonged periods (see section 4.4).
Growth retardation has been reported in children receiving nasal corticosteroids. Growth retardation may be possible in adolescents, too (see section 4.4).
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme, website: yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store.
With the nasal route of administration overdose reactions are not anticipated.
No data are available in humans regarding overdose by accidental or deliberate ingestion.
Inhalation or oral administration of excessive doses of corticosteroids may lead to suppression of HPA axis function.
There is no known specific antidotes to Ryaltris active components.
In the case of overdose, appropriate monitoring and supportive management of the patient should be implemented.
Medicines sold in Romania with the same active substance: Cunoscut în România ca
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
Medicines sold in Poland with the same active substance: W Polsce znany jako
⚠ Not the same combination. This medicine contains Mometasone furoate monohydrate, Olopatadine hydrochloride. The products below do not contain exactly the same set of active substances — they are not direct substitutes.
Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
Ask anything about Ryaltris 25 micrograms/actuation + 600 micrograms/actuation Nasal Spray, suspension. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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