
GENERIC NAME: fluticasone propionate oral inhaler
BRAND NAMES: Flovent
DRUG CLASS AND MECHANISM: Fluticasone propionate is a
man-made
steroid of the glucocorticoid family which is related to the
naturally-occurring steroid hormone, cortisol or
hydrocortisone, produced
by the adrenal glands. Glucocorticoid steroids have potent anti-
inflammatory actions. When used as an inhaler, fluticasone
propionate goes
directly to the airways of the lung. In asthmatic patients, the
suppression of inflammation within the airways reduces the
spasm that
narrows the airways and makes getting air into and out of the
lungs
difficult. When used in lower doses, very little fluticasone
propionate is
absorbed into the body. When higher doses are used, fluticasone
is
absorbed and may cause side effects elsewhere in the body.
PRESCRIPTION: yes
GENERIC AVAILABLE: no
PREPARATIONS: Inhalation aerosol unit in
44 µg,
110 µg
or 220 µg per actuation.
STORAGE: Fluticasone propionate should be kept at room
temperature, 4-30°C (39-86°F) and should be shaken
well before
each use.
PRESCRIBED FOR: Fluticasone propionate is used for the
control
of asthma in persons requiring continuous treatment. Such
patients may
include those with frequent asthmatic episodes requiring
medications to
dilate (expand) airways or those with asthmatic episodes at
night.
DOSING: Doses vary from patient to patient, but
recommendations
for inhalation are similar for most corticosteroids including
fluticasone
propionate. The canister containing the fluticasone propionate
should be
shaken well before administering. The lungs are emptied of air
by
breathing out completely. The mouthpiece is placed between the
open lips,
and the lips are closed firmly around the mouthpiece. The
canister's
actuating valve is depressed one time while breathing in deeply
and
slowly. The breath is held for a count of 10, and then normal
breathing is
resumed. If more than a single inhalation is prescribed, a
minute should
pass between inhalations.
A tube acting as a spacer, which can be attached to the
canister, may be
helpful for persons who are unable to coordinate breathing in
and pressing
down on the canister's valve. Following administration,
the mouth
should be rinsed thoroughly with water or mouthwash which is
then spit out
to minimize dry mouth, irritation of the throat, and
hoarseness. The
inhaler must be cleaned frequently by removing the canister and
cap from
the inhaler and then rinsing the inhaler with warm water and
drying it.
If a bronchodilator aerosol spray (a spray that causes the
airways to
expand), for example, albuterol (Proventil; Ventolin), is used,
it should
be used first, and then 5 - 15 minutes later the fluticasone
propionate
should be used.
DRUG INTERACTIONS: No drug interactions have been
described
with inhaled fluticasone propionate.
PREGNANCY: Adequate and well-controlled studies
regarding the
use of fluticasone during pregnancy have not been done.
Fluticasone use
during pregnancy should be avoided unless the potential benefit
justifies
the potential but unknown risk to the fetus.
NURSING MOTHERS: It is not known if fluticasone
propionate is secreted in breast milk. Other medications in the same class as
fluticasone propionate are secreted into breast milk. It is not
known
whether the small amounts that may appear in the milk are of
consequence
to the infant.
SIDE EFFECTS: The most commonly noted side effects
associated
with inhaled fluticasone propionate are mild cough or wheezing;
these
effects may be minimized by using a bronchodilator inhaler
(e.g. albuterol
or Ventolin) first. Oral candidiasis or thrush (a fungal
infection) may
occur in between 1 in 50 and 1 in 20 persons who use fluticasone
propionate (without a spacer), the risk being higher with
higher doses.
The risk for candidiasis in children is lower than in adults.
Using a
spacer and washing the mouth out with water following each use
reduces the
risk of candidiasis. Hoarseness may also occur, and here also,
a spacer
and washing the mouth out with water following each use reduces
the risk.
High doses of inhaled glucocorticoids may decrease formation
and
increase break-down of bone thereby weakening bones and
promoting
fractures. Still higher doses may cause suppression of the
body's ability
to make its own natural glucocorticoid in the adrenal gland. It
is
possible that these effects are shared by higher-dose
fluticasone
propionate. People with suppression of their adrenal glands
(which can be
diagnosed by a doctor) would need increased amounts of
glucocorticoids,
probably by the oral or intravenous route, during periods of
high physical
stress when glucocorticoids are particularly important.
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From the Doctors at MedicineNet.com  |
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Back to Medications IndexLast Editorial Review: 7/23/1998