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fluticasone (Nasal route)

Pronunciation

floo-TIK-a-sone

Commonly used brand name(s)

In the U.S.

  • Flonase
  • Veramyst

Available Dosage Forms:

  • Spray

Therapeutic Class: Corticosteroid, Intermediate

Pharmacologic Class: Adrenal Glucocorticoid

Uses For fluticasone furoate

Fluticasone nasal spray is used to treat sneezing, itchy or runny nose, or other symptoms caused by hay fever. This is a steroid medicine.

Slideshow: New Drug Approvals in 2013: What Was Hot, What Was Not

fluticasone furoate is available only with your doctor's prescription.

Before Using fluticasone furoate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For fluticasone furoate, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to fluticasone furoate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of fluticasone nasal spray in children. However, safety and efficacy of Veramyst® nasal spray have not been established in children younger than 2 years of age, and fluticasone propionate nasal spray in children younger than 4 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fluticasone nasal spray in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving fluticasone nasal spray.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking fluticasone furoate, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using fluticasone furoate with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Boceprevir
  • Bupropion
  • Carbamazepine
  • Ceritinib
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Dabrafenib
  • Darunavir
  • Eslicarbazepine Acetate
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Mitotane
  • Nefazodone
  • Nelfinavir
  • Piperaquine
  • Pixantrone
  • Posaconazole
  • Primidone
  • Ritonavir
  • Saquinavir
  • Siltuximab
  • Telaprevir
  • Telithromycin
  • Tipranavir
  • Voriconazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of fluticasone furoate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma or
  • Cataracts, history of or
  • Glaucoma, history of—Use with caution. May make these conditions worse.
  • Chickenpox (including recent exposure) or
  • Measles or
  • Herpes simplex (virus) infection of the eye or
  • Infections (virus, bacteria, or fungus), any type of or
  • Tuberculosis, active or history of—fluticasone furoate can reduce the body's ability to fight off these infections.
  • Injury to the nose, recent or
  • Nose surgery, recent or
  • Sores in the nose, recent—fluticasone furoate may prevent proper healing of these conditions.
  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of fluticasone furoate

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

fluticasone furoate 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 furoate away after you use 120 sprays.

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

Dosing

The dose of fluticasone furoate 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 furoate. 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 furoate, 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.

Precautions While Using fluticasone furoate

It is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by fluticasone furoate.

If your symptoms do not improve within a few days or if they become worse, check with your doctor.

fluticasone furoate may cause holes or ulcers in the cartilage of the nose and delay wound healing. Make sure your doctor knows if you have had nose surgery, a nose injury, or an infection in your nose in the last few months before using fluticasone furoate.

Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

fluticasone furoate may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using fluticasone furoate.

You may get infections more easily while using fluticasone furoate. Tell your doctor right away if you have been exposed to someone with chickenpox or measles. Also tell your doctor if you develop white patches or sores in your nose while you are using fluticasone furoate. This could be symptoms of a candida or yeast infection.

Using too much of fluticasone furoate or using it for a long time may cause may increase your risk of having adrenal gland problems. Talk to your doctor if you have more than one of these symptoms while you are using fluticasone furoate: darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

fluticasone furoate may slow down a child's growth. If you think your child is not growing properly while using fluticasone furoate, talk with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

fluticasone furoate Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Bloody nose
Less common
  • Cough
  • fever
  • headache
  • muscle aches
  • sore throat
  • sores inside the nose
  • stuffy or runny nose
  • unusual tiredness or weakness
Incidence not known
  • Difficulty with swallowing
  • dizziness
  • fast heartbeat
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • redness of the skin
  • skin rash, itching, hives or welts
  • tightness in the chest

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Back pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

See also: Side effects (in more detail)

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