fluticasone (Flonase, Veramyst, Flovent, Arnuity Ellipta)

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Introduction

Tradenames: Flonase (fluticasone propionate), Veramyst (fluticasone furoate) - intranasal, Flovent, Flovent Diskus, Flovent Rotadisk (inhaler)

Indications

Contraindications

pregnancy category = c

safety in lactation = -

safety in lactation = ?

Dosage

  • nasal spray:
    • 2 sprays QD
    • 0.05%, 50 ug/actuation, 16 g = 120 actuations.
  • hydrofluoroalkane inhaler:
    • 2 puffs BID,
    • 110 & 220 ug/actuation, 13 g = 120 actuations
    • 90% of maximum benefit at 250 ug/day
    • no increased benefit of doses > 500 ug/day[5]
  • Arnuity Ellipta: 100 or 200 mg QD (dry powder inhaler)
  • topical: 0.05% ointment/cream BID/TID

Pharmacokinetics

elimination via liver

Adverse effects

oral inhalation

nasal administration

Drug interactions

* if ritonavir is required, use low-dose budesonide or beclomethasone[10][11]

Test interactions

Laboratory

More general terms

More specific terms

Component of

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 743
  4. Prescriber's Letter 8(2):supplement 2001
  5. Jump up to: 5.0 5.1 Journal Watch 21(19):153, 2001 Holt et al, BMJ 323:253, 2001
  6. Jump up to: 6.0 6.1 Journal Watch 22(5):41, 2002 Eid et al, Pediatrics 109:217, 2002
  7. Prescriber's Letter 14(6): 2007 New Nasal Steroids: Veramyst and Omnaris Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230610&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. Jump up to: 8.0 8.1 Prescriber's Letter 17(7): 2010 Clarithromycin Interaction with Salmeterol and Inhaled Corticosteroids Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260701&pb=PRL (subscription needed) http://www.prescribersletter.com
  9. Jump up to: 9.0 9.1 9.2 Deprecated Reference
  10. Jump up to: 10.0 10.1 Foisy MM, Yakiwchuk EM, Chiu I, Singh AE. Adrenal suppression and Cushing's syndrome secondary to an interaction between ritonavir and fluticasone: a review of the literature. HIV Med. 2008 Jul;9(6):389-96. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18459946 Free article
  11. Jump up to: 11.0 11.1 11.2 NEJM Knowledge+ Complex Medical Care

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