Fluticasone

Fluticasone - Nasal spray 50 mg | Dose

Fluticasone is a medicine from corticosteroid group of drugs intended for inhalation use in the prophylaxis of asthma. It can be administered via oral and nasal inhalation.

Precautions

Fluticasone can be absorbed into the systemic circulation and cause systemic side effects, such as:

  • Cushing's syndrome (rapid weight gain in the stomach and chest area)
  • Psychomotor hyperactivity
  • Anxiety
  • Depression
  • Loss of appetite
  • Anorexia
  • Weight loss
  • Hypoglycemia
  • Weakening of the immune system
  • Loss of consciousness

If you notice any of these side effects, contact your doctor immediately.

It should be administered with caution in patients with diabetes because it can cause hypoglycemia.

Use in children should be generally avoided because it can slow the growth of children.

Fluticasone should be administered with caution in the following conditions:

  • Severe impairment of hepatic function
  • Increased levels of cortisol in the blood
  • Active infection
  • Osteoporosis
  • Eye condition or vision problems

Fluticasone, pregnancy and breastfeeding

Manufacturer claims that there are limited data on its use during pregnancy. Use of this drug to about 200 pregnant women has not led to any adverse effects on the fetus. One study has examined its use in 5362 pregnant woman and it has been established that Fluticasone does not increase the risk of congenital malformations.1 However, the use of corticosteroids during pregnancy is associated with an increased incidence of cleft palate in newborns. Also, corticosteroids can slow down the development of the fetus.

Fluticasone is excreted into breast milk at very low concentrations, and caution is required if used during breastfeeding.

How to use

Fluticasone nasal spray 50 mg / dose

Dosage in adult patients:

Initial dose: Two doses in each nostril once a day, preferably in the morning immediately after getting up.

Maintenance dose: One dose in each nostril once a day in the morning.

Maximum daily dose: Four doses in each nostril.

The starting dose in children aged 4 - 11 years is one dose in each nostril. If necessary, dose can be increased up to two doses in each nostril.

Fluticasone oral spray (125 mcg / dose and 250 mg / dose)

Dosage in patients older than 16 years: 100 - 1000 micrograms (mcg) twice a day.

Dose of 1000 mg per day should be used only for the prophylaxis of severe asthma because such a high dose increases the risk of systemic side effects.

Use of Fluticasone oral spray is not recommended in patients younger than 16 years.

Interactions

Fluticasone should not be administered concurrently with the following drugs:

  • Ritonavir (antiretroviral drug used for the treatment of AIDS). Ritonavir may cause several hundred-fold increase in the concentration of Fluticasone in the blood, which results in severe side effects.
  • Antibiotics, such as: clarithromycin and telithromycin. These drugs also increase its concentration in the blood.
  • Protease inhibitors (e.g. amprenavir, atazanavir and indinavir) which are used for the treatment of AIDS. These drugs cause a significant increase in its blood levels.
  • Boceprevir - a drug used to treat hepatitis C.
  • Cobicistat (drug used for the treatment of AIDS)
  • Antifungal drugs, such as: ketoconazole, itraconazole and voriconazole. These drugs increase its absorption in the blood thus increasing the risk of systemic side effects.

Side effects

Fluticasone may cause the following side effects:

  • Fungal infections in the mouth caused by a fungus called Candida
  • Increased levels of cortisol in the blood and Cushing's syndrome
  • Suppression of the adrenal gland
  • Mood disorders (anxiety, aggressiveness and depressed mood)
  • Increased levels of glucose in the blood
  • Paradoxical bronchial spasm
  • Increased bone resorption and osteoporosis
  • Glaucoma
  • Cataracts
  • Eye irritation
  • Nausea
  • Stomach pain
  • Shortness of breath
  • Difficulty breathing
  • Impotence
  • Paraesthesia

References

  1. NCBI link