Fluticasone

Flovent,Arnuity Ellipta, Advair Diskus

Asthma and COPD

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Classification:

Corticosteroids

Uses:

Fluticasone is an inhaled corticosteroid that is used to prevent the symptoms of asthma. Two main causes of asthma are bronchoconstriction and inflammation. When used on a regular basis, fluticasone decreases the severity and number of asthma attacks. This medication must be used with a short-acting medication such as albuterol (SAMA). Fluticasone is also used in patients with COPD. Fluticasone will not relieve an asthma attack once it has already started. This product is available in a powder,disk,or aerosol powder.

Routes/Dosages:

Recommended Starting Dosage: Administered by the orally inhaled route in patients 4 years and older. Pediatric patients (4-11): 88 mcg b.i.d

Adult and adolescents (12 yrs and older): 88 mcg b.i.d, 88-220 mcg b.i.d, 440mcg b.i.d


Highest Recommended Dosage: Adults and adolescents (12 yrs and older): 440-880 mcg b.i.d

Pediatric patients (4-11 yrs): 88 mcg b.i.d


Flovent should be primed before using for the first time by releasing 4 test puffs into the air away from the face. Shake well for 5 seconds before each spray. If inhaler has not been used for more than 7 days or when it has been dropped, prime the inhaler again by shaking well for 5 seconds and release 1 test puff into the air. Each container is a 12-g pressurized aluminum canister and provides 120 metered inhalations.

Pharmokinetics:

When administered as a single dose by dry powder inhaler, fluticasone is reported to have total systemic bioavailability of approximately 17%. It has a low GI tract absorption and a high hepatic first-pass metabolism,therefore any systemic effects arise from lung absorption. Fluticasone has a half-life of about 5 hours,therefore totally eliminated from the body in just a few days.

Adverse/Side effects:

  • Increased trouble breathing right after using (paradoxical bronchospasm)
  • Low bone mineral density,which can lead to osteoporosis
  • Cataracts, glaucoma, or other vision problems
  • Slow growth in children
  • Problems with adrenal glands
  • A weakened immune system and increase the risk for infections, such as fungus infection in the mouth (thrush). Always rinse mouth with water when using corticosteroids to prevent thrush. Inform your doctor if you have TB, chickenpox, or measles.
  • This medication may need to be taken for a period of 1-2 weeks before asthma symptoms improve.
  • Tell your doctor if you are pregnant or breastfeeding, or if you have a liver disease.

Drug Interactions :

  1. Clarithromycin (Biaxin)
  2. Delavirdine
  3. Indinavir
  4. Fortovase


* There are currently 34 major drug interactions with fluticasone.

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References :

Integrated Cardiopulmonary Pharmacology 4th ed

Erj.ersjournals.Com

Drugs.Com

U.S.Nationa Library of Medicine

The Journal of Allergy and Clinical Immunology