Generic & Brand Names
Generic: Fluticasone Propionate / Fluticasone Furoate
Common Brands: Flixotide®, Flixonase®, Arnuity®
Drug Class
Inhaled Corticosteroid Anti-inflammatory Respiratory Agent Mechanism of Action
Fluticasone binds to glucocorticoid receptors, inhibiting inflammatory cell activation, cytokine release, and edema in airways. This reduces bronchial hyperresponsiveness and improves airflow.
Indications
- Maintenance therapy of asthma (all ages)
- Chronic obstructive pulmonary disease (COPD) with frequent exacerbations
- Allergic rhinitis (nasal spray)
Dosage (General)
- Adults (inhalation): 100–500 mcg twice daily (propionate), 110–200 mcg once daily (furoate)
- Children 4–11 years: 50–200 mcg twice daily (propionate), 50–100 mcg once daily (furoate)
- Nasal spray: 50–200 mcg per nostril once or twice daily, depending on product
Rinse mouth after inhalation to prevent oral candidiasis.
Side Effects
- Oral thrush (candidiasis)
- Hoarseness / dysphonia
- Throat irritation
- Cough
- Rare systemic corticosteroid effects at high doses
Contraindications & Precautions
- Hypersensitivity to fluticasone
- Active untreated infections
- Use caution in tuberculosis or immunocompromised patients
Drug Interactions
- CYP3A4 inhibitors (e.g., ketoconazole) may increase systemic exposure
- Concurrent systemic corticosteroids increase risk of adverse effects
Pregnancy & Lactation
Generally considered safe; use only if benefits outweigh risks.
Key Notes
- Not for relief of acute asthma attacks
- Regular use improves asthma control and reduces exacerbations
- Preferred inhaled corticosteroid in many guidelines due to potency
References
- British National Formulary (BNF). Inhaled corticosteroids – Fluticasone.
- British National Formulary for Children (BNFc). Asthma and allergic rhinitis.
- Kliegman RM, St. Geme JW. Nelson Textbook of Pediatrics, 22nd ed. Elsevier; Respiratory pharmacology.
- Katzung BG, Trevor AJ. Basic & Clinical Pharmacology, 15th ed. McGraw-Hill.