b'44 Not your fathers fluticasoneExhaled \x1f uticasone, using the EXHALATION DELIVERY SYSTEM (EDS), and inhaled \x1f 1uticasone, using standard nasal sprays, are not the same when it comes to nasal sprays.XHANCE is the only FDA-approved prescription nasal spray that uses the EDS to treat nasal polyps in adults. 2XHANCE is different. Heres why:1. Deposition Is Different with the EDSXHANCE uses the EXHALATION DELIVERY SYSTEM, designed to deliver medication high anddeep in the nasal passages to regions where nasal polyps originate. 1,22. XHANCE and Flonase Are Not BioequivalentA pharmacokinetic study evaluated the systemic exposure of a single dose of XHANCE 186 mcgor 372 mcg versus Flonase 400 mcg in healthy subjects. Results showed systemic exposure was higher with both XHANCE 186 mcg and 372 mcg than with Flonase 400 mcg. 3Given these differences, dispense XHANCE as written.Scan to learn more about XHANCE, including the EXHALATION DELIVERY SYSTEM, or visit https://www.xhancehcp.com/exhalation-delivery-systems.INDICATIONS AND USAGE:Patients with major risk factors for decreased bone mineral XHANCE is a corticosteroid indicated for the treatment ofcontent should be monitored and treated with established nasal polyps in patients 18 years of age or older. standards of care.IMPORTANT SAFETY INFORMATION ADVERSE REACTIONS:The most common adverse reactions (incidence 3%) are CONTRAINDICATIONS: epistaxis, nasal septal ulceration, nasopharyngitis, nasal Hypersensitivity to any ingredient in XHANCE. mucosal erythema, nasal mucosal ulcerations, nasal congestion, WARNINGS AND PRECAUTIONS: acute sinusitis, nasal septal erythema, headache, and pharyngitis. Local Nasal Effects: epistaxis, erosion, ulceration, septalDRUG INTERACTIONS:perforation, Candida albicans infection, and impairedStrong cytochrome P450 3A4 inhibitors (e.g., ritonavir, wound healing. Monitor patients periodically for signsketoconazole): Use not recommended. May increase risk of of possible changes on the nasal mucosa. Avoid use insystemic corticosteroid effects.patients with recent nasal ulcerations, nasal surgery, orUSE IN SPECIFIC POPULATIONS:nasal trauma until healing has occurred. Hepatic impairment. Monitor patients for signs of increasedClose monitoring for glaucoma and cataracts is warranted. drug exposure. Hypersensitivity reactions (e.g., anaphylaxis, angioedema, urticaria, contact dermatitis, rash, hypotension, andPlease see accompanying Brief Summary of full bronchospasm) have been reported after administrationPrescribing Information on following page.ofuticasone propionate. Discontinue XHANCE if such reactions occur. All brand names are registered trademarks of their respective owners. Immunosuppression: potential increased susceptibility to or worsening of infections (e.g., existing tuberculosis;References: 1. Djupesland PG. Nasal drug delivery devices: characteristics fungal, bacterial, viral, or parasitic infection; ocular herpesand performance in a clinical perspectivea review. Drug Deliv Transl Res.simplex). Use with caution in patients with these infections.2013;3(1):42-62. 2. Full Prescribing lnformation for XHANCE ( uticasone More serious or even fatal course of chickenpox orpropionate). OptiNose US, Inc.; 2021. 3. Messina JC, Offman E, Carothers JL, measles can occur in susceptible patients. Mahmoud RA. A randomized comparison of the pharmacokinetics and Hypercorticism and adrenal suppression may occur withbioavailability ofuticasone propionate delivered via Xhance Exhalation Delivery very high dosages or at the regular dosage in susceptibleSystem versus Flonase Nasal Spray and Flovent HFA Inhalational Aerosol. Clin individuals. If such changes occur, discontinue XHANCE slowly. Ther. 2019;41(11):23432356.XHANCE, OPTINOSE, EXHALATION DELIVERY SYSTEM and EDSare trademarks of OptiNose AS. EDS-FLU=exhalation delivery system with \x1f uticasone.2022 OptiNose US, Inc. All rights reserved. XHA-22-10061 04/2022XHA-22-10061_Pharmacy Differentiation Ad-US Medicine Compendia_DR.indd 1 5/4/22 1:18 PM'