Fluticasone Nasal

Name: Fluticasone Nasal

Proper Use of fluticasone

fluticasone comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

fluticasone is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away.

To use the spray:

  • When you use the fluticasone nasal spray for the first time, you must prime the spray. Press down fully the top of the pump 6 times or until a fine spray comes out. Prime the spray if it has not been used for more than 7 days (fluticasone propionate) or 30 days (Veramyst®) or if the cap has been left off the bottle for 5 days or longer. Shake the medicine well before each use.
  • Gently blow your nose before using the spray. Tilt your head back slightly and insert the tip of the nose piece into your nostril.
  • Close the opposite nostril with a finger. Release 1 spray and at the same time, breathe in gently through the nostril.
  • Hold your breath for a few seconds then breathe out slowly through your mouth.
  • Spray the opposite nostril using the same steps.
  • Do not blow your nose or tip your head back after using the spray.
  • Wipe the tip of the outside of the nose piece with a clean, dry tissue or cloth and put the cap back on.
  • Throw fluticasone away after you use 120 sprays.

You may need to use fluticasone for a few days before you start to feel better.

Dosing

The dose of fluticasone will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of fluticasone. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For symptoms of hay fever:
    • For nasal dosage form (spray):
      • Fluticasone propionate:
        • Adults—At first, 2 sprays in each nostril once a day. Some patients may need 1 spray in each nostril two times a day (morning and evening). Your doctor may adjust your dose as needed.
        • Children 4 years of age and older—At first, 1 spray in each nostril once a day. Some patients may need 200 mcg or 2 sprays in each nostril once a day.
        • Children younger than 4 years of age—Use is not recommended.
      • Veramyst®:
        • Adults and children 12 years of age and older—At first, 2 sprays in each nostril once a day. Your doctor may decrease your dose to 55 mcg or 1 spray in each nostril once a day.
        • Children 2 to 11 years of age—At first, 1 spray in each nostril once a day. Your child's doctor may need to increase the dose up to 2 sprays in each nostril once a day depending on your child's condition.
        • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of fluticasone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Consumer Information Use and Disclaimer

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take fluticasone or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to fluticasone (nasal). This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Review Date: October 4, 2017

Index Terms

  • Flonase Sensimist
  • Fluticasone Furoate
  • Fluticasone Propionate

Brand Names U.S.

  • Flonase Allergy Relief [OTC]
  • Flonase Sensimist [OTC]
  • Flonase [DSC]
  • GoodSense Nasoflow [OTC]
  • Ticaspray
  • Veramyst [DSC]

Pharmacologic Category

  • Corticosteroid, Nasal

Pharmacology

Fluticasone belongs to a group of corticosteroids which utilizes a fluorocarbothioate ester linkage at the 17 carbon position; extremely potent vasoconstrictive and anti-inflammatory activity

Distribution

Fluticasone propionate: 4.2 L/kg; Fluticasone furoate: Vd,ss: 608 L

Metabolism

Hepatic via CYP3A4 to 17 beta-carboxylic acid (negligible activity)

Excretion

Oral: Feces (as parent drug and metabolites); Urine (<5% as metabolites)

Use Labeled Indications

Rx products:

Allergic rhinitis (Veramyst, Avamys [Canadian product], Flonase [Canadian product]): Management of seasonal and perennial allergic rhinitis in adults and children ≥2 years of age (Veramyst, Avamys) and in patients 4 to 17 years of age (Flonase)

Nonallergic rhinitis (Flonase): Management of the nasal symptoms of perennial nonallergic rhinitis in adults and pediatric patients ≥4 years of age

OTC products:

Upper respiratory allergies: Relief of hay fever or other upper respiratory allergies (eg, itchy and watery eyes, nasal congestion, runny nose, sneezing, itchy nose) in adults and children ≥4 years of age (Clarispray, Flonase Allergy Relief, Good Sense Nasoflow) or children ≥2 years of age (Flonase Sensimist)

Dosing Adult

Allergic rhinitis (fluticasone furoate): Intranasal:

Veramyst (Rx): Initial: Two sprays (27.5 mcg/spray) per nostril once daily (110 mcg/day); once symptoms are controlled, may reduce dosage to 1 spray per nostril once daily (55 mcg/day) for maintenance therapy.

Avamys (Rx) [Canadian product]: Two sprays (27.5 mcg/spray) in each nostril once daily (110 mcg/day). Total daily dosage should not exceed 2 sprays in each nostril (110 mcg/day).

Nonallergic rhinitis (fluticasone propionate): Intranasal:

Flonase (Rx): Initial: Two sprays (50 mcg/spray) per nostril once daily (200 mcg/day); alternatively, the same total daily dosage may be divided and given as 1 spray per nostril twice daily (200 mcg/day). After the first few days, dosage may be reduced to 1 spray per nostril once daily for maintenance therapy (100 mcg/day) (maximum: 2 sprays in each nostril [200 mcg]/day).

Upper respiratory allergies (OTC): Intranasal:

ClariSpray, Flonase Allergy Relief, Good Sense Nasoflow (fluticasone propionate): Initial: Two sprays (50 mcg/spray) per nostril once daily (200 mcg/day); after 1 week, may adjust to 1 or 2 sprays per nostril once daily (100 to 200 mcg/day). Do not use for more than 6 months unless instructed by health care provider.

Flonase Sensimist (fluticasone furoate): Initial: Two sprays (27.5 mcg/spray) per nostril once daily (110 mcg/day); after 1 week, may adjust to 1 or 2 sprays per nostril once daily (55 to 110 mcg/day). Do not use for more than 6 months unless instructed by healthcare provider.

Dosing Geriatric

Refer to adult dosing.

Upsides

  • Fluticasone relieves nasal symptoms such as a runny, stuffy nose, sneezing and nasal itching.
  • Suitable for adults and children aged four years and older (Flonase); or adults and children aged two years and older (Veramyst).
  • Fluticasone has a strong affinity for the glucocorticoid receptor. This means it is less likely to cause salt and water retention (and therefore less likely to cause high blood pressure, low potassium levels, or high sodium levels).
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