Fluticasone

Fluticasone oral inhalation is a prescription medication used to prevent difficulty breathing, chest tightness, wheezing, and coughing caused by asthma. Fluticasone is in a class of medications called corticosteroids. It works by decreasing swelling and irritation in the airways to allow for easier breathing.

Fluticasone nasal spray, available as a prescription and an over-the-counter, is a medication to treat the symptoms of allergic and nonallergic rhinitis. Fluticasone is in a class of medications called corticosteroids. It works by preventing and decreasing inflammation (swelling that can cause other symptoms) in the nose.

Fluticasone cream, ointment, and lotion are prescription medications used to reduce inflammation and relieve itching, redness, dryness, and scaling associated with various skin conditions. Fluticasone is in a class of medications called corticosteroids. It works by decreasing inflammation involved with skin diseases.

Fluticasone oral inhalation is typically used twice daily. The nasal spray is sprayed into each nostril usually once daily. The cream and lotion forms are applied to the affected area typically once or twice a day.

Common side effects of fluticasone inhalational include upper airway infection or inflammation, throat irritation, and cough.

Common side effects of fluticasone nasal spray include cough, nosebleeds, and nasal burning or irritation.

Common side effects of fluticasone topical include irritation at site of application.

Inhalational:

• Fluticasone oral inhalation is a prescription medication used to prevent difficulty breathing, chest tightness, wheezing, and coughing caused by asthma.

Topical:

• Fluticasone nasal spray is a medication used to treat the symptoms of allergic and non-allergic rhinitis in patients aged 4 years and older. Symptoms may include:
  • sneezing 
  • runny nose
  • stuffy nose
  • itchy nose
  • itchy, watery eyes
• Fluticasone cream, ointment, and lotion are prescription medications used to reduce inflammation and relieve itching, redness, dryness, and scaling associated with various skin conditions.
• This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Fluticasone may be found in some form under the following brand names:

• Advair Diskus

• Breo Ellipta

• Cutivate

• Dymista

• Flonase

• Flonase Sensimist

• Flovent HFA

• Veramyst

Inhalational:

• Common side effects of fluticasone inhalational include
  • upper airway infection or inflammation
  • throat irritation
  • sinus infection
  • hoarse voice
  • candidiasis
  • cough
  • headache

Topical:

• Common side effects of fluticasone nasal spray include
  • headache
  • nosebleeds
  • irritated or burning nose
  • runny nose
  • cough
  • nausea
  • stomach pain
  • vomiting
  • diarrhea
  • dizziness

Stinging or sneezing may occur for a few seconds right after use of fluticasone nasal spray.

• Common side effects of fluticasone lotion, ointment, and cream include
  • itching
  • burning
  • increased redness
  • hives
  • irritation
  • lightheadedness
  • an abnormal amount of hair growth over the body (hypertrichosis)

This is not a complete list of fluticasone side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• medications that block a protein in the body (CYPA4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone (Serzone)

This is not a complete list of fluticasone drug interactions. Ask your doctor or pharmacist for more information.

Inhalational:

• fungal infections (thrush) in your mouth and throat. Tell your doctor if you have any redness or white-colored coating in your mouth
• decreased adrenal function (adrenal insufficiency). Symptoms of decreased adrenal function include tiredness, weakness, nausea and vomiting, and low blood pressure. Decreased adrenal function can lead to death.
• allergic reaction (anaphylaxis). Call your doctor and stop fluticasone right away if you have any symptoms of an allergic reaction:
  • swelling of the face, throat and tongue
  • hives
  • rash
  • breathing problems
• decreased ability to fight infections. Symptoms of infection may include: fever, pain, aches, chills, feeling tired, nausea and vomiting. Tell your doctor about any signs of infection while you use fluticasone.
• slow growth in children. The growth of children using fluticasone should be checked regularly.
• eye problems including glaucoma and cataracts. Tell your doctor about any vision changes while using fluticasone. Your doctor may tell you to have your eyes checked.
• increased wheezing (bronchospasm). Increased wheezing can happen right away after using fluticasone. Always have a rescue inhaler with you to treat sudden wheezing.
• lower bone mineral density. This may be a problem for people who already have a higher chance of low bone density (osteoporosis).

Topical:

• Nasal Spray
  • nose problems. Nose problems may include:
    • nose bleeds
    • sores (ulcers) in your nose
    • a certain fungal infection in your nose, mouth, and/or throat (thrush)
    • hole in the cartilage of your nose (nasal septal perforation). Symptoms of nasal septal perforation may include:

  • crusting in the nose
  • nose bleeds
  • runny nose
  • whistling sound when you breathe

  • decrease in the activity of your immune system. This will make you more likely to get an infection. Symptoms of infection may include: fever, pain, aches, chills, feeling tired, nausea and vomiting. Tell your doctor if you are exposed to chickenpox or measles.
  • slow growth in children. A child using fluticasone nasal spray should have his/her growth checked regularly.
  • eye conditions including glaucoma and cataracts. Tell your doctor about any vision changes while using fluticasone nasal spray. Be sure to have regular eye exams while you are taking this medication.
  • slow the healing of wounds. Do not use fluticasone nasal spray until your nose has healed if you have a sore in your nose, if you have surgery on your nose, or if your nose has been injured.
  • hypersensitivity reaction:  An allergic reaction to fluticasone nasal spray can occur. Tell your doctor if you experience any of the following symptoms of an allergic reaction:
    • difficulty breathing or swallowing
    • hives or rash
    • swelling
    • hoarseness

Fluticasone nasal spray can cause dizziness. Do not drive or operate machinery until you know how fluticasone nasal spray affects you.

To avoid withdrawal side effects, do not stop using fluticasone nasal spray at once. Discuss with your doctor about slowly decreasing the dose before stopping use of this medication altogether.

Do not take fluticasone nasal spray if you:

• are allergic to fluticasone nasal spray or any of its ingredients
• are taking ritonavir (Norvir)

• Lotion, ointment, or cream
  • decreased adrenal function (adrenal insufficiency). Symptoms of decreased adrenal function include tiredness, weakness, nausea and vomiting, and low blood pressure. Decreased adrenal function can lead to death.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of fluticasone, there are no specific foods that you must exclude from your diet when receiving this medication.

Before using fluticasone, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to fluticasone or any of its ingredients
• are exposed to measles or chickenpox
• have liver problems
• take ritonavir (Norvir)
• take any antifungal medication
• have an immune system problem
• have any type of viral, bacterial, or fungal infection
• have a history of glaucoma or cataracts
• have or have had nasal sores, nasal surgery, or nasal injury (fluticasone nasal spray)
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Fluticasone falls into category C. Studies in animals have shown a harmful and undesired effect on the unborn baby, yet there are no adequate and well-controlled studies in pregnant women.

This medication may be given to a pregnant woman if her healthcare provider believes that its benefits to the pregnant woman outweigh any possible risks to her unborn baby.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if fluticasone is excreted in human breast milk or if it will harm your nursing baby.

Inhalational

Flovent HFA (fluticasone aerosol inhalation):

• How do I use fluticasone aerosol inhalation?
  • It is important that you inhale each dose as your doctor has prescribed. The prescription label provided by your pharmacist will usually tell you what dose to take and how often. If it doesn’t or if you aren’t sure, ask your doctor or pharmacist. DO NOT inhale more doses or use your fluticasone aerosol inhalation more often than your doctor has prescribed.
  • It may take 1 to 2 weeks or longer for this medicine to work, and it is very important that you use it regularly. Do not stop taking Flovent HFA, even if you are feeling better, unless your doctor tells you to.
  • If you miss a dose, just take your next scheduled dose when it is due. Do not double the dose.
  • Your doctor may prescribe additional medicine (such as fast-acting bronchodilators) for emergency relief if a sudden asthma attack occurs. Contact your doctor if:
    • an asthma attack does not respond to the additional medicine
    • you need more of the additional medicine than usual
  • If you also use another medicine by inhalation, you should ask your doctor for instructions on when to use it while you are also using fluticasone aerosol inhalation.
  • Children should use fluticasone aerosol inhalation with an adult’s help, as instructed by the child’s healthcare provider. A valved holding chamber (a kind of spacer) and face mask may be used to deliver fluticasone aerosol inhalation to young patients.

Flovent Diskus (fluticasone powder for inhalation)

• How do I take fluticasone powder for inhalation?
  • An adult should always watch a child use fluticasone powder for inhalation to make sure that it is used correctly, as instructed by your doctor.
  • Fluticasone powder for inhalation comes in 3 strengths. Your doctor has prescribed the one that is best for your condition.
  • Use fluticasone powder for inhalation exactly as your doctor tells you to use it. Do not change the dose yourself. Your doctor will tell you how many times to inhale your medication and when to use your medication. Do not inhale more doses or use your medication more often than your doctor has prescribed.
  • Fluticasone powder for inhalation delivers your dose of medicine as a very fine powder that most people, but not all, can taste or feel. Whether or not you can taste or feel your dose of medicine, you should not take more than the prescribed dose. If you are not sure you are getting your dose of fluticasone powder for inhalation, contact your doctor or pharmacist.
  • It may take 1 to 2 weeks or longer after you start fluticasone powder for inhalation for your asthma symptoms to get better. You must use your medication regularly. Do not stop using your medication, even if you are feeling better, unless your doctor tells you to.
  • If you miss a dose, just take your next dose at your regular time. Do not take 2 doses at the same time unless your doctor tells you to. If you are not sure about your dosing, call your doctor.
  • Your doctor may prescribe a rescue inhaler for emergency relief of sudden asthma attacks. Contact your doctor right away if:
    • an asthma attack does not respond to your rescue inhaler
    • you need more of your rescue inhaler than usual
  • If you also use another medicine by inhalation, you should ask your doctor for instructions on when to use it while you are also using fluticasone powder for inhalation.
  • Do not use fluticasone powder for inhalation with a spacer device.

Topical:

Nasal spray

• Use fluticasone nasal spray exactly as prescribed.
• This medication comes in a nasal spray.
• Fluticasone is usually sprayed in each nostril once daily. Do not spray fluticasone nasal spray into your eyes.
• Discard fluticasone nasal spray after 120 sprays.
• Children should use fluticasone nasal spray with an adult’s help, as instructed by the child’s healthcare provider.
• Flonase may take several days of regular use for your rhinitis symptoms to get better. If your symptoms do not improve or get worse, call your healthcare provider.
• To avoid withdrawal side effects, do not stop using fluticasone nasal spray at once. Discuss with your doctor about slowly decreasing the dose before stopping use of this medication altogether.
• If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of fluticasone nasal spray at the same time.

Prescription Form:

Use fluticasone nasal spray exactly as your healthcare provider tells you. Do not use fluticasone nasal spray more often than prescribed.

You will get the best results if you keep using fluticasone nasal spray regularly each day without missing a dose. After you begin to feel better, your healthcare provider may decrease your dose. Do not stop using fluticasone nasal spray unless your healthcare provider tells you to do so.

Over-the-Counter Form:

If your symptoms do not get better within 7 days of starting use or you get new symptoms such as severe facial pain or thick nasal discharge. You may have something more than allergies, such as an infection.

Stop use and ask your doctor if you you notice any vision changes, get a constant whistling sound from your nose, or you have severe or frequent nosebleeds.

Priming and Using Your fluticasone nasal spray

Your fluticasone nasal spray must be primed before you use it for the first time and when you have not used it for a week or more.

How to prime your fluticasone nasal spray:

• Shake the bottle gently and then remove the dust cover
• Hold the bottle with the nasal applicator pointing away from you and with your forefinger and middle finger on either side of the nasal applicator and your thumb underneath the bottle.
• Press down and release 6 times until a fine spray appears. The pump is now ready for use.

Using your fluticasone nasal spray:

Step 1. Blow your nose to clear your nostrils.

Step 2. Close 1 nostril. Tilt your head forward slightly and, keeping the bottle upright, carefully insert the nasal applicator into the other nostril.

Step 3. Start to breathe in through your nose, and while breathing in press firmly and quickly down 1 time on the applicator to release the spray. To get a full dose, use your forefinger and middle finger to spray while supporting the base of the bottle with your thumb. Avoid spraying in eyes. Breathe gently inwards through the nostril.

Step 4. Breathe out through your mouth.

Step 5. If a second spray is required in that nostril, repeat steps 2 through 4.

Step 6. Repeat steps 2 through 5 in the other nostril.

Step 7. Wipe the nasal applicator with a clean tissue and replace the dust cover.

Do not use this bottle for more than the labeled number of sprays even though the bottle is not completely empty. Before you throw the bottle away, you should talk to your healthcare provider to see if a refill is needed. Do not take extra doses or stop taking Flonase without talking to your healthcare provider.

Cleaning your fluticasone nasal spray:

Your nasal spray should be cleaned at least 1 time each week.

1. Remove the dust cover and then gently pull upwards to free the nasal applicator.

2. Wash the applicator and dust cover under warm tap water. Allow to dry at room temperature.

3. Place the applicator and dust cover back on the bottle.

4. If the nasal applicator becomes blocked, it can be removed and left to soak in warm water. Rinse the nasal applicator with cold tap water. Dry the nasal applicator and place it back on the bottle. Do not try to unblock the nasal applicator by inserting a pin or other sharp object.

Lotion, cream, ointment

• Fluticasone is to be used as directed by your doctor. It is for external use only. Avoid contact with the eyes.
• Fluticasone should not be used for any disorder other than that for which it was prescribed.
• The treated skin area should not be bandaged or otherwise covered or wrapped so as to be occlusive unless directed by your doctor.
• Report any signs of local adverse reactions as well as non-healing or worsening of skin condition.
• Do not to use this medication in the treatment of diaper dermatitis unless directed by your doctor. Fluticasone should not be applied in the diaper areas as diapers or plastic pants may constitute occlusive dressing.
• Fluticasone should not be used on the face, underarms, or groin areas unless directed to do so by your doctor.
• If you are instructed by your doctor to apply fluticasone to exposed portions of the body, avoid excessive or unnecessary exposure to either natural or artificial sunlight (such as sunbathing, tanning booths, sun lamps, etc.).

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Keep this and all medicines out of the reach of children.