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Fluticasone propionate

Uses|Precautions + Warnings|Side Effects|Interactions|Dosage

Uses

What is fluticasone propionate used for?

Fluticasone propionate is part of a class of drugs known as corticosteroids. Corticosteroids, or steroids, are synthetic drugs that are modeled after the naturally occurring hormone cortisol, which is produced in the adrenal glands located above the kidneys. Corticosteroids are used to reduce inflammation, pain, itchiness, and other effects mediated by the immune system response.

Each corticosteroid is formulated to be used in a specific dosage form, either parenteral, oral, topically, or otherwise. Fluticasone as propionate is available as an inhalational powder, nebule of inhalation, nasal spray, drops, and topical cream or ointment.

Fluticasone propionate is mainly indicated to treat the following conditions:

  • Asthma
  • Allergic rhinitis
  • Nasal polyps
  • Dermatoses

How should I take fluticasone propionate?

Fluticasone as propionate is available as an inhalational powder, nasal spray, drops, and topical cream or ointment.

Inhalational dosage forms require an inhaler or nebulizer for administration. Follow the instructions carefully to administer each dose. Take a deep breath and hold it for a few seconds to allow the medication to enter the airways. Swish and spit with clean water after using a dry powder inhaler to get rid of residual powder and prevent the development of opportunistic infections of the mouth.

Nasal spray and drops should only be administered through the nose. Clean and cover the tip of the nozzle after each use.

The topical dosage forms should be applied as a thin layer on the affected areas of skin. Wash your hands thoroughly before and after application.

Never share any corticosteroids, inhalers, etc. with others, even if they have the same symptoms or are prescribed the same medication.

How do I store fluticasone propionate?

This drug should be stored at room temperature (15-30°C) and be protected from light and moisture. Do not store it in the refrigerator or freezer. Always check the label before using this product. For safety, keep out of the reach of children and pets.

Do not use if the printed expiration date has passed, the product seal has been broken, or the product has changed in color, odor, or consistency.

Do not dispose of this product by pouring it down the drain, toilet, or into the environment. Ask your pharmacist regarding the proper way and location of disposal.

Precautions + Warnings

What should I know before using fluticasone propionate?

Corticosteroids, including fluticasone, are associated with an increased risk of infection, bone demineralization, weight gain, water retention, and various other effects. This risk is further increased in elderly patients, young patients, immunocompromised patients, and those undergoing chronic treatment with steroids.

Because fluticasone as propionate is not generally used as a systemic dosage dorm, these effects are less likely and less severe. For orally administered doses, the mouth should be rinsed with water by using a swish, gargle, and spit method. This is to prevent the occurrence of oral candidiasis or thrush.

Never stop taking corticosteroids suddenly. If side effects are being experienced or you have completed your therapy, your doses must be tapered gradually until it is safe to stop taking corticosteroids. Abruptly stopping the use of steroids can result in adrenal insufficiency, which is potentially life-threatening.

Some groups of people with conditions like osteoporosis, diabetes mellitus, hypertension, hypothyroidism, myopathy, glaucoma, and myasthenia gravis may experience an exacerbation of symptoms after using corticosteroids.

Before using this medication, inform your doctor if:

  • You have ever had an allergic reaction to fluticasone propionate or other corticosteroids
  • You have a history of allergy to other medications, food, or other substances
  • You are taking other medications, especially other corticosteroids
  • You have underlying health conditions

Is it safe during pregnancy or breastfeeding?

This drug is a pregnancy category C drug. There is insufficient evidence from human studies that shows it can cause fetal harm when taken during pregnancy. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as determined by your doctor.

This drug may be excreted in breast milk. This drug should be used while breastfeeding only if the potential benefit justifies the potential risk to the child, as determined by your doctor.

Side Effects

What side effects can occur when using fluticasone propionate?

All drugs have the potential to elicit side effects even with normal use. Many side effects are route and dose-related and will likely resolve when it is adjusted or at the end of therapy.

Potential side effects while using this drug include:

  • Adrenal suppression
  • Immunosuppression
  • Pneumonia
  • Oropharyngeal candidiasis (thrush)
  • Nose bleeds
  • Nasal perforation or ulceration
  • Visual disturbances
  • Increased intraocular pressure
  • Decreased bone density
  • Growth retardation in children
  • Hyperglycemia
  • Delayed wound healing
  • Skin atrophy
  • Rebound dermatoses
  • Withdrawal symptoms

Seek medical attention immediately if you experience any of these serious, potentially fatal drug reactions:

  • Adrenal insufficiency
    • Extreme fatigue
    • Weight loss
    • Decreased appetite
    • Nausea, vomiting, diarrhea,
  • Paradoxical bronchospasm

You may experience some, none, or other side effects not mentioned above. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.

Interactions

What drugs may interact with fluticasone propionate?

This drug may interact with other medications. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and inform your doctor and pharmacist.

Known drugs and their interactions with fluticasone propionate include:

  • CYP3A4 inhibitors
    • Increased risk of systemic exposure and side effects of fluticasone propionate

If you experience an adverse drug interaction, do not stop taking this drug. Inform your doctor immediately to reevaluate your treatment plan. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

Does food or alcohol interact with fluticasone propionate?

This medication can be taken with or without meals. This medication does not have any significant interaction with alcohol.

Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

What health conditions may interact with fluticasone propionate?

This drug should be taken with caution if you have any of the following conditions or risk factors:

  • Broken skin or overly thin skin (for topical creams/ointments)
  • COPD
  • Diabetes mellitus
  • Cataracts or glaucoma
  • Osteoporosis
  • Postmenopausal status
  • Active infections
  • Psoriasis
  • Hepatic impairment

Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult your doctor or pharmacist before using fluticasone propionate.

What is the dose of fluticasone propionate for an adult?

As asthma prophylaxis

  • Dry powder or metered-dose inhaler:
    • Mild asthma: Administer 100 mcg twice a day.
    • Moderate to severe asthma: Administer 250 to 500 mcg twice a day, increasing the dose up to 1000 mcg twice a day depending on response.
  • Nebulizer: Administer 500 to 2000 mcg twice a day.

For allergic rhinitis

  • Spray: Administer 100 mcg into each nostril one to two times a day, preferably in the morning.
  • Maintenance dose: 50 mcg into each nostril once a day.

For nasal polyps

  • Drops: Instill 200 mcg into each nostril one to two times per day for 4 to 6 weeks.

For corticosteroid-responsive dermatoses

  • Topical: (as 0.05% cream or 0.005% ointment):Aapply thinly and gently rub onto the affected areas 1-2 times per day for up to 4 weeks. Reduce the frequency or switch to a lower-potency preparation after improvement occurs.

What is the dose of fluticasone propionate for a child?

As asthma prophylaxis

  • Dry powder or metered-dose inhaler
    • Age 4 to 16 years: Administer 50 to 100 mcg twice a day, increasing the dose up to 200 mcg if necessary.
  • Nebulizer:
    • Age 4 to 16 years: Administer 1000 mcg twice a day.

For allergic rhinitis

  • Spray
    • Age 4 to 12 years: Administer 50 mcg into each nostril one to two times per day, preferably in the morning. Maximum daily dose: 100 mcg into each nostril.
    • Age over 12 years: same as the adult dose.

For nasal polyps

  • Drops:
    • Age 16 and over: same as the adult dose.

For atopic dermatitis that is unresponsive to lower potency corticosteroids

  • Topical
    • Age 3 months and over: Apply a thin layer and rub gently onto the affected areas one to two times per day for 1-2 weeks. If the condition improves, reduce the frequency to the lowest effective dose for the shortest possible time.
    • Withdraw treatment and reassess the diagnosis if there is no significant improvement within 1-2 weeks.

How is fluticasone propionate available?

This drug is available in the following brands, dosage forms, and strengths:

Inhalants

  • Flixotide metered-dose inhaler 50 mcg, 125 mcg (per actuation)
  • Flixotide nebule 250 mcg/mL

Topicals

  • Cutivate 0.05% cream

Nasal sprays and drops

  • Avamys 27.5 mcg (per actuation)
  • Flixotide 50 mcg (per actuation)
  • Flusort 50 mcg (per actuation)
  • Flutiair 500 mcg/mL
  • Nasoflo 50 mcg (per actuation)

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of this drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Fluticasone, https://www.mims.com/philippines/drug/info/fluticasone, Accessed Aug 6, 2020

Nasoflo, https://assets.unilab.com.ph/uploads/Common/Products/Nasoflo/nasoflo.pdf, Accessed Aug 6, 2020

Flixotide, https://www.mims.com/philippines/drug/info/flixotide, Accessed Aug 6, 2020

Avamys, https://www.mims.com/philippines/drug/info/avamys, Accessed Aug 6, 2020

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Written by Stephanie Nicole Nera, RPh, PharmD Updated Aug 13, 2020
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