Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND
MECHANISM: Fluticasone is a synthetic steroid of the glucocorticoid family of
drugs that is used for treating allergic conditions involving the nose.
Fluticasone mimics the naturally-occurring hormone produced by the adrenal
glands, cortisol or hydrocortisone. The exact mechanism of action of fluticasone
is unknown. Fluticasone has potent anti-inflammatory actions. It is believed
that fluticasone exerts its beneficial effects by inhibiting several types of
cells and chemicals involved in allergic, immune and inflammatory responses.
When used as a nasal inhaler or spray, the medication goes directly to the
lining within the nose, and very little is absorbed into the rest of the body.
The FDA approved fluticasone in October 1994.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Intranasal spray: 50 or 27.5 mcg per actuation
STORAGE: Fluticasone should be stored at 4°-30°C (39°-86°F) and shaken well
before each use.
PRESCRIBED FOR: Fluticasone is used for the control of symptoms of allergic
and non-allergic rhinitis, a condition in which the lining of the nose swells
and releases fluid that results in a stuffy and
runny nose.
DOSING: Fluticasone usually is administered as two sprays in each nostril
once daily, or one spray in each nostril twice daily. After a few days of
continuous use, one spray in each nostril once daily may be sufficient.
DRUG INTERACTIONS:Ritonavir (Norvir) and ketoconazole (Nizoral) may increase the blood
concentrations of fluticasone and potentially increase its side effects.
PREGNANCY: Fluticasone has not been adequately evaluated in pregnant women.
Fluticasone should be used during
pregnancy when it is absolutely necessary.
NURSING MOTHERS: It is not known if fluticasone is secreted in breast milk.
Other medications in the same class as fluticasone are secreted into breast
milk. Fluticasone should be used only while
breastfeeding if it is absolutely
necessary.
SIDE EFFECTS: The most common side effects associated with fluticasone are
headache, throat infection, nasal irritation, sneezing,
cough, nausea,
vomiting,
and nosebleeds. Hypersensitivity reactions such as skin rash, itching, facial
swelling, and anaphylaxis may occur. Some children may experience growth
suppression when using fluticasone.
Hay fever (allergic rhinitis) is an irritation of the nose caused by pollen and is associated with the following allergic symptoms: nasal congestion, runny nose, sneezing, eye and nose itching, and tearing eyes. Avoidance of known allergens is the recommended treatment, but if this is not possible, antihistamines, decongestants, and nasal sprays may help alleviate symptoms.
Although they are the cornerstone of allergy treatment,
avoidance measures are not always enough to manage all of
the symptoms. When the symptoms of nasal allergies are
mild or intermittent, antihistamines with or without
decongestants can help. Very often, some relief can be
found in taking over-the-counter (OTC) drugs and this is
usually the first step an allergy sufferer will take.
Self-medication, though, is frequently inadequate since OTC
drugs cannot adequately treat the inflammation that
develops in the nose. At this stage, anti-inflammatory
medications are required, usually in the form of intra-
nasal steroid sprays (sprayed into the nose).
The combination of an antihistamine (with or without a
decongestant) and a topical nasal steroid spray will
usually afford good relief with minimal side effects. The
addition of ipratropium bromide nasal spray (Atrovent - an
anticholinergic medication) is also very effec...
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