Fluticasone is a man-made corticosteroid. The exact mechanism of action of fluticasone is not known; however, it stimulates glucocorticoid receptors in humans that produces a potent anti-inflammatory response. Fluticasone also works on multiple cells and mediators that are responsible for the inflammatory symptoms of allergic rhinitis (sneezing, runny nose, etc). The FDA approved fluticasone in October 1994.

Fluticasone is used for the management of nasal symptoms of seasonal or perennial, allergic and non-allergic rhinitis in adults and children of 4 years of age and older. Safe and effective use of fluticasone has not been established for children under the age of 4.

Side effects of fluticasone include:

• headache,
• sore throat,
• nosebleeds,
• nasal burning or nasal irritation,
• nausea,
• vomiting,
• asthma symptoms, or
• cough.

Some children may experience growth suppression from use of inhaled steroids.

• Adults: The recommended dosing is 2 sprays per nostril daily. The maximum dose is 200 mcg/day (4 sprays). Maintenance therapy is 1 spray in each nostril daily.
• Adolescents and children 4 years of age and older: the recommended dosing is 1 spray per nostril daily (total dose 100 mcg.) Patients that do not respond adequately may increase to two sprays in each nostril once a day. The maximum dose is 200 mcg/day.

Ritonavir (Norvir) and ketoconazole (Nizoral, Extina, Xolegel, Kuric) increase fluticasone levels in the body by delaying its metabolism (elimination). It is not clear how important this effect is.

There are no adequate studies of fluticasone to determine its safety and effectiveness in pregnant women.

It is not known whether fluticasone enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

• Fluticasone propionate nasal spray is available as a 16 gm bottle, providing a total of 120 sprays. Each spray contains 50 mcg of fluticasone propionate.
• Fluticasone propionate should be store between 4 C and 30 C (39 F and 86 F).
• Brand names for fluticasone propionate are Flonase and Flonase Allergy Relief.
• Flonase is available by prescription and over-the-counter (OTC).