Drinking alcohol may cause rhinitis as well as worsen asthma (see alcohol-induced respiratory reactions ). In certain populations, particularly those of East Asian countries such as Japan, these reactions have a nonallergic basis.  In other populations, particularly those of European descent, a genetic variant in the gene that metabolizes ethanol to acetaldehyde, ADH1B, is associated with alcohol-induced rhinitis. It is suggested that this variant metabolizes ethanol to acetaldehyde too quickly for further processing by ALDH2 and thereby leads to the accumulation of acetaldehyde and rhinitis symptoms.   In these cases, alcohol-induced rhinitis may be of the mixed rhinitis type and, it seems likely, most cases of alcohol-induced rhinitis in non-Asian populations reflect true allergic response to the non-ethanol and/or contaminants in alcoholic beverages, particularly when these beverages are wines or beers.  Alcohol-exacerbated rhinitis is more frequent in individuals with a history of rhinitis exacerbated by aspirin. 
Although the risk of developing hypothalamic-pituitary-adrenal (HPA) suppression is very low with inhaled budesonide; formoterol, patients should, nevertheless, be monitored for this possibility. Particular care is needed for patients who are transferred from systemic to inhaled corticosteroids because deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic to less systemically absorbed inhaled corticosteroids. Patients previously maintained on doses equivalent to greater than or = 20 mg/day of prednisone may be at increased risk. After withdrawal from systemic corticosteroids, a number of months are required for recovery of HPA-axis function.
A one-year placebo-controlled clinical growth study was conducted in 229 pediatric patients (ages 4 through 8 years of age) to assess the effect of RHINOCORT AQUA (single-daily dose of 64 mcg, the recommended starting dose for children ages 6 years and above) on growth velocity. From a population of 141 patients receiving RHINOCORT AQUA Nasal Spray and 67 receiving placebo, the point estimate for growth velocity with RHINOCORT AQUA Nasal Spray was cm/year lower than that noted with placebo (95% confidence interval ranging from cm/year lower than placebo to cm/year higher than placebo).