← Search & browse all drugs
RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS › Glucocorticoids
fluticasone
R03BA05
Forms & Strengths
- Inhalation aerosol (HFA): 44 mcg, 110 mcg, 220 mcg per actuation
- Inhalation powder (Diskus): 50 mcg, 100 mcg, 250 mcg, 500 mcg per blister
- Nasal spray: 50 mcg per actuation
- Topical cream: 0.05%
- Topical ointment: 0.005%
Adult Dosing
- Asthma (Inhalation aerosol): 88 to 220 mcg twice daily
- Asthma (Inhalation powder): 100 to 250 mcg twice daily, up to 500 mcg twice daily in severe cases
- Allergic rhinitis (Nasal): 2 sprays (100 mcg) in each nostril once daily
- Atopic dermatitis / Inflammatory dermatoses (Topical): Apply thin film to affected area 1-2 times daily
Pediatric Dosing
- Asthma in children 4-11 years (Inhalation aerosol): 44 mcg twice daily
- Asthma in adolescents >=12 years: Refer to adult dosing
- Allergic rhinitis in children >=4 years (Nasal): 1 spray (50 mcg) in each nostril once daily
- Topical formulations in pediatric patients: Use lowest effective dose; avoid prolonged use on face, groin, or axillae
Indications
- Maintenance treatment of asthma as prophylactic therapy
- Nasal symptoms of seasonal and perennial allergic rhinitis
- Inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses
Mechanism of Action
- Synthetic trifluorinated corticosteroid with potent anti-inflammatory and vasoconstrictive activity
- Binds to cytosolic glucocorticoid receptors, inhibiting multiple inflammatory cell types and mediator release
Contraindications
- Primary treatment of status asthmaticus or other acute episodes of asthma requiring intensive measures
- Hypersensitivity to fluticasone propionate or any excipient (e.g., lactose in Diskus)
- Untreated localized fungal infections involving the oral cavity (for inhaled formulations)
Adverse Reactions
- Pharyngitis, nasal burning, epistaxis, and headache (nasal spray)
- Oral candidiasis (thrush), dysphonia, upper respiratory tract infection (inhalation)
- Local skin atrophy, striae, telangiectasia, contact dermatitis (topical)
- Hypothalamic-pituitary-adrenal (HPA) axis suppression, reduction in growth velocity in pediatric patients, glaucoma, cataracts (systemic effects with high doses)
Drug Interactions
- Strong CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, clarithromycin) significantly increase systemic fluticasone exposure and risk of systemic corticosteroid effects
- Ritonavir: Coadministration is generally not recommended due to risk of Cushing syndrome and adrenal suppression
Curated Content: Needs Vetting Before Put to Clinical Use