Fluticasone propionate
Fluticasone propionate (Flonase)
Fluticasone propionate
(flu- TIH-kah-sohn)
Pregnancy Category: C Cutivate Flonase Flovent (Rx)

Classification: Corticosteroid

See Also: See also Corticosteroids.

Action/Kinetics: Following intranasal use, a small amount is absorbed into the general circulation. Onset: Approximately 12 hr. Maximum effect: May take several days. t 1/2: About 7.8 hr. Absorbed drug is metabolized in the liver and excreted in the urine.

Uses: Nasal/Inhalation. Prevention and maintenance treatment of asthma in adults and children over four years of age. To manage seasonal and perennial allergic and nonallergic rhinitis in adults and children over four years of age. Topical. Relief of inflammatory and pruritic corticosteroid-responsive dermatoses in adults. Atopic dermatitis in clients as young as 3 months.

Contraindications: Use for relief of acute bronchospasm. Use following nasal septal ulcers, nasal surgery, or nasal trauma until healing has occurred.

Special Concerns: Clients on immunosuppressant drugs, such as corticosteroids, are more susceptible to infections. Use with caution, if at all, in active or quiescent tuberculosis infections; untreated fungal, bacterial, or systemic viral infections; or ocular herpes simplex. Use with caution during lactation.

Side Effects: Allergic: Rarely, immediate hypersensitivity reactions or contact dermatitis. Respiratory: Epistaxis, nasal burning, blood in nasal mucus, pharyngitis, irritation of nasal mucous membranes, sneezing, runny nose, nasal dryness, sinusitis, nasal congestion, bronchitis, nasal ulcer, nasal septum excoriation. CNS: Headache, dizziness. Ophthalmologic: Eye disorder, cataracts, glaucoma, increased intraocular pressure. GI: N&V;, xerostomia. Miscellaneous: Unpleasant taste, urticaria. High doses have resulted in hypercorticism and adrenal suppression.

Drug Interactions: Ketoconazole may fluticasone plasma levels due to liver breakdown.

How Supplied: Aerosol (Flovent): 44 mcg/inh, 220 mcg/inh, 440 mcg/inh; Cream: 0.05%; Nasal spray: 50 mcg/inh; Ointment: 0.005% Powder for Inhalation (Flovent Rotadisk): 50 mcg/inh, 100 mcg/inh, 250 mcg/inh;

Dosage
?Aerosol (Flovent) Treatment of asthma.
Adults and children over 4 years of age, initial: 88 mcg b.i.d. (maximum: 440 mcg b.i.d.) if previous therapy was bronchodilators alone; 88-220 mcg b.i.d. (maximum: 440 mcg b.i.d.) if previous therapy was inhaled corticosteroids; and, 880 mcg b.i.d. (maximum: 880 mcg b.i.d.) if previous therapy was oral corticosteroids.
?Powder (Flovent Rotadisk) Prevention of asthma.
Adults and adolescents: 100 mcg b.i.d. (maximum: 500 mcg b.i.d.) if previous therapy was bronchodilators alone; 100-250 mcg b.i.d. (maximum: 500 mcg b.i.d.) if previous therapy was inhaled corticosteroids; and, 1,000 mcg b.i.d. (maximum: 1,000 mcg b.i.d.) if previous therapy was oral corticosteroids. Children, 4-11 years: 50 mcg b.i.d. (maximum: 100 mcg b.i.d.) if previous therapy was bronchodilators alone or inhaled corticosteroids.
?Nasal Spray Allergic rhinitis.
Adults and children over 4 years of age, initial: One 50-mcg spray in each nostril once a day, for a total daily dose of 100 mcg/day. Maximum dose is two sprays (200 mcg) in each nostril once a day.
?Ointment, Cream
Apply sparingly to affected area 2-4 times daily. For Cutivate Cream, apply a thin film to the affected areas 1-2 times/day.