Fluticasone

Indications
 Nasal
Treatment and prophylaxis of allergic rhinitis
Adult: 100 mcg into each nostril once daily, increased to 100 mcg bid.
Child: >4 yr: 50 mcg into each nostril once daily, increased to 50 mcg bid.
Nasal
Nasal polyps
Adult: As propionate: 200 mcg to be instilled into each nostril 1-2 times daily for at least 4-6 wk.
Inhalation
Asthma prophylaxis
Adult: As powder or aerosol: 100-250 mcg bid in mild cases, up to 500-1000 mcg bid in severe cases.
Child: As powder or aerosol: >4 yr: Initially, 50-100 mcg bid. May increase to 200 mcg, if necessary.
Inhalation
Severe asthma
Adult: As nebuliser: 0.5-2 mg bid.
Child: As nebuliser: 4-16 yr: 1 mg bid.
Inhalation
Chronic obstructive pulmonary disease
Adult: As powder or aerosol: 500 mcg bid.
Topical/Cutaneous
Corticosteroid-responsive dermatoses
Adult: As propionate: Apply a 0.05 or 0.005% cream/ointment onto affected area.
Contraindications
 Hypersensitivity. Acne vulgaris, rosacea, perioral dermatitis, skin atrophy; hypersensitivity. Primary cutaneous viral infections (e.g. herpes simplex, chicken pox), perianal and genital pruritus, primary fungal or bacterial skin infections. Inhalation: Status asthmaticus.
Warnings / Precautions
 Children, pregnancy, lactation, concomitant skin infections. Concomitant skin/lung/systemic infections. Advised to rinse mouth with water every time after inhalation. Application to large areas, broken skin or under occlusive dressings.
Adverse Reactions
 Topical: Pruritus, hypertrichosis, dryness, numbness of fingers, burning, eruptions, hypopigmentation, allergic contact dermatitis, secondary infection, skin atrophy, Cushing's syndrome, reversible HPA-axis suppression. Inhalation: Oropharyngeal candidiasis, pharyngitis, dysphoria, cough, rhinitis, nasal congestion and headache. Systemic absorption may be seen when applied to large areas, when skin is broken or under occlusive dressings.
Potentially Fatal: Suppression of immune system.
Drug Interactions
 May lead to increased plasma concentrations of fluticasone when used with CYP4503A4 inhibitors such as ritonavir.
See Below for More fluticasone Drug Interactions
Mechanism of Actions
 Fluticasone utilises a fluorocarbothioate ester linkage at the C17 position. It has potent vasoconstrictive and anti-inflammatory activity, but weak HPA inhibitory effect when applied topically.
Absorption: Poorly absorbed from the GI tract (oral).
Distribution: Protein-binding: 91%.
Metabolism: Extensively hepatic; converted to 17β-carboxylic acid.
Excretion: Faeces (as unchanged drug and metabolites), urine (as metabolites).
Storage Conditions
 Inhalation: Store at 25°C. Nasal: Store at 4-30°C. Topical/Cutaneous: Store at 15-30 °C.
ATC Classification
 D07AC17 - fluticasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
R01AD08 - fluticasone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
R03BA05 - fluticasone ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.
Storage
 Inhalation: Store at 25°C. Nasal: Store at 4-30°C. Topical/Cutaneous: Store at 15-30 °C.
Available As
  • Fluticasone 0.005%
  • Fluticasone Propionate 0.005% w/w
  • Fluticasone 0.005% w/w
  • Fluticasone 0.05%
  • Fluticasone Propionate 0.05%
  • Fluticasone 0.05% v/v
  • Fluticasone Propionate 0.05% w/v
  • Fluticasone 0.05% w/v
  • Fluticasone Propionate 0.05% w/w
  • Fluticasone 0.05% w/w
  • Fluticasone 0.5 mg
  • Fluticasone Propionate 0.5%
  • Fluticasone Propionate 100 mcg
  • Fluticasone 100 mcg
  • Fluticasone 125 mcg
  • Fluticasone Propionate 125 mcg
  • Fluticasone 2 mg
  • Fluticasone 25 mcg
  • Fluticasone 250 mcg
  • Fluticasone Propionate 250 mcg
  • Fluticasone 27.5 mcg
  • Fluticasone 50 mcg
  • Fluticasone Propionate 50 mcg
  • Fluticasone Propionate 500 mcg
  • Fluticasone 500 mcg

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