Fluticasone
FLOVENT
Pronunciation: floo-TIK-a-soen (FLOE-vent)
“Flo’s ventilated Flute case”
What it isInhaled or intranasal glucocorticoid agonist; asthma control and allergic rhinitis.
Why this oneIts unusually high CYP3A4 dependence lets ritonavir turn a nominally local steroid into systemic Cushing syndrome.
What limits itRinse after inhalation to limit candidiasis and dysphonia; high exposure can suppress growth and the adrenal axis.
FDA-approved for
- asthma/rhinitis (1994)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Allergic rhinitis | Adult | 2 sprays/nostril QD (200 mcg/day) | 1 spray/nostril QD (maintenance) | 2 sprays/nostril/day (200 mcg/day) |
| Allergic rhinitis | Adolescents/children ≥4 y | 1 spray/nostril QD (100 mcg/day) | 1 spray/nostril QD | 2 sprays/nostril/day (200 mcg/day) |
Renal Undefined
Hepatic Monitor for signs of increased drug exposure
Instructions
- Intranasal use only
- Prime before first use or after ≥1 week non-use (shake, release 6 sprays away from face)
- Shake gently before each use
- Use at regular intervals; max effect may take several days
- After first few days may reduce to 1 spray/nostril QD for maintenance
Available strengths
- powder 0.05, 0.1, 0.2, 0.25 mg/inh
- inhaler 44, 110, 220 mcg/inh
- cream 0.05 %
- lotion 0.05 %
- nasal spray 27.5, 50, 93 mcg/spray
- ointment 0.005 %
Cautions
- Epistaxis, nasal ulceration, Candida albicans infection, nasal septal perforation, impaired wound healing
- Glaucoma and cataracts
- Hypersensitivity reactions (anaphylaxis, angioedema, urticaria)
- Immunosuppression
- Hypercorticism and adrenal suppression
- Effect on growth in children
Adverse reactions
- Headache
- Pharyngitis
- Epistaxis
- Nasal burning/irritation
- Nausea/vomiting
- Asthma symptoms
- Cough
Pregnancy Insufficient human data; animal studies show corticosteroid-characteristic teratogenicity and decreased fetal weight at maternally toxic doses.
Lactation No data on presence in human milk; low concentrations of other corticosteroids detected in human milk.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 44 mcg/inh | inhaler | per unit | $11.82/g | offered |
| 110 mcg/inh | inhaler | per unit | $13.59/g | offered |
| 220 mcg/inh | inhaler | per unit | $21.79/g | offered |
| 0.05 mg/inh | powder | per unit | $3.07/ea | offered |
| 0.1 mg/inh | powder | per unit | $3.17/ea | offered |
| 0.2 mg/inh | powder | per unit | $5.71/ea | not offered |
| 0.25 mg/inh | powder | per unit | $2.69/ea | offered |
Other forms: Fluticasone nasal (FLONASE)
Available combined with: fluticasone / salmeterol · fluticasone / salmeterol / hfa · fluticasone / umeclidinium / vilanterol · fluticasone / vilanterol
Generic entry2031 est.
NO BOXED WARNINGS
Principal riskOral candidiasis; systemic effects with a strong CYP3A4 inhibitor
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
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