Fluticasonum

Description: Inhaled glucocorticoid.

Indications: Used for long-term treatment of asthma and chronic obstructive pulmonary disease (COPD).

Contraindications: Increased sensitivity to any component of the medication.

Dosage:

• For adults:
  • Aerosol (Aer.) per inhalation (inh.), powder (pulv.) per inhalation (inh.):
    • Bronchial asthma: Initial dose ranges from 100 μg twice a day to 1,000 μg twice a day, depending on disease severity, later reduced to the minimum effective dose. Maximum daily dose: usual dose is 500 μg twice a day.
  • Suspension (Susp.) per inhalation (inh.):
    • Severe bronchial asthma or severe exacerbation: Initial dose of 500-2,000 μg twice a day, later adjusted to the minimum effective dose. The medication is inhaled using a metered dose inhaler.
• For children:
  • Ages 1-4 years:
    • Bronchial asthma: Usual dose is 100 μg twice a day.
  • Ages over 4 years:
    • Aerosol (Aer.) per inhalation (inh.), powder (pulv.) per inhalation (inh.): Bronchial asthma: Usual dose is 50-100 μg, up to 200 μg twice a day if needed, later adjusted to the minimum effective dose.
    • Suspension (Susp.) per inhalation (inh.): Severe exacerbation of bronchial asthma: Initial dose is 1,000 μg twice a day, later adjusted to the minimum effective dose. The medication is inhaled using a metered dose inhaler.
• For elderly:
  • Same as adults.
• In case of IFN (impaired hepatic function):
  • No need to reduce the dose.
• In case of KFN (impaired renal function):
  • No need to reduce the dose.

Adverse Reactions:

• Common: Hoarse voice, throat irritation, cough, oral and upper respiratory tract candidiasis.
• Others: Paradoxical bronchospasm, skin rash, urticaria, angioedema; with prolonged use of very high doses: latent adrenal insufficiency, latent bone metabolism disorder, delayed growth in children, cataracts, glaucoma.

Pregnancy
Limited experience in treating pregnant women. Fluticasone has very weak systemic effects, so it can be used if effective before pregnancy. Only prescribe during pregnancy if the benefit to the mother outweighs the potential risk to the fetus.

Breastfeeding
No data on use during breastfeeding. Consider the expected benefit of treatment and potential harm to the mother and baby when prescribing fluticasone propionate to nursing mothers.

Warnings:

• Use with caution in cases of pulmonary tuberculosis, pregnancy, and breastfeeding.
• Use regularly and discontinue gradually.
• Not suitable for relieving acute asthma attacks.
• Rinse mouth after each inhalation to avoid potential oral infections.
• In cases of severe disease exacerbation, trauma, surgery, or other stress, systemic glucocorticoids may be needed.
• Gradually replace systemic glucocorticoids with inhaled ones to prevent adrenal insufficiency and worsening of other allergic diseases.

Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė