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Fluticasone information from DrugsUpdate  

See Available Brands of Fluticasone in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Fluticasone is a synthetic glucocorticoid.
Both the furoate and propionate forms are used as topical anti-inflammatories:

    * Fluticasone propionate
    * Fluticasone furoate

Pharmacodynamics

Pharmacokinetics

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).

Fluticasone Indications / Fluticasone Uses

Information Not Available

Fluticasone Adverse Reactions / Fluticasone Side Effects

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.

Precautions

Monitor
Assess patient's symptoms before initiating therapy and periodically during treatment. Monitor patients for any evidence of systemic corticosteroid effect. Since glaucoma and/or cataracts can occur with use of nasal and inhaled fluticasone, closely monitor patients with vision changes or with history of increased IOP, glaucoma, and/or cataracts.

Special 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.

Other Drug Interactions

May lead to increased plasma concentrations of fluticasone when used with CYP4503A4 inhibitors such as ritonavir.

Other Interactions

Information Not Available

Dosage

Topical/Cutaneous
Corticosteroid-responsive dermatoses
Adult: As propionate: Apply a 0.05 or 0.005% cream/ointment onto affected area.

Nasal
Treatment and prophylaxis of allergic rhinitis
Adult: 100 mcg into each nostril once daily, increased to 100 mcg bid.
Child: >4 years: 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 weeks.

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 years: 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 years: 1 mg bid.

Inhalation
Chronic obstructive pulmonary disease
Adult: As powder or aerosol: 500 mcg bid.

Food(before/after)

Information Not Available

List of Contraindications

Fluticasone and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Fluticasone and Lactation

Caution when used during lactation

Fluticasone and Children

Cutivate Cream
Safety and efficacy not established in children younger than 3 months of age.

Cutivate Lotion
Safety and efficacy not established in children younger than 1 years of age.

Cutivate Ointment
Safety and efficacy not established.

Flonase
Safety and efficacy not established in children younger than 4 years of age.

Flovent Diskus
Safety and efficacy not established in children younger than 4 years of age.

Flovent HFA Inhalation Aerosol
Safety and efficacy not established for children younger than 4 years of age.

Veramyst
Safety and efficacy not established in children younger than 2 years of age.

Fluticasone and Geriatic

Flovent HFA , Veramyst
Use with caution, usually starting at the low end of the dosage range, because of the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant diseases or other drug therapy.

Flovent Diskus
No difference in safety and efficacy between patients 65 yr of age and older compared with younger patients.

Fluticasone and Other 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.

Storage

Inhalation
Store at 25°C.

Nasal
Store at 4-30°C.

Topical/Cutaneous

Store at 15-30 °C.

Lab interference

Inhalation
Store at 25°C.

Nasal
Store at 4-30°C.

Topical/Cutaneous

Store at 15-30 °C.

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