Fluticasone Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Asthma - Maintenance

Inhalation aerosol:

Patients previously treated with bronchodilators only: Initial dose: 88 mcg twice daily; maximum dose: 440 mcg twice daily.

Patients treated with an inhaled corticosteroid: Initial dose: 88 to 220 mcg twice daily; maximum dose: 440 mcg twice daily; may start at doses above 88 mcg twice daily in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.

Patients previously treated with oral corticosteroids: Initial dose: 880 mcg twice daily; maximum dose: 880 mcg twice daily.

Inhalation powder:

Patients previously treated with bronchodilators only: Initial dose: 100 mcg twice daily; maximum dose: 500 mcg twice daily.

Patients treated with an inhaled corticosteroid: Initial dose: 100 to 250 mcg twice daily; maximum dose: 500 mcg twice daily; may start at doses above 100 mcg twice daily in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.

Patients previously treated with oral corticosteroids: Initial dose: 1000 mcg twice daily; maximum dose: 1000 mcg twice daily.

Usual Pediatric Dose for Asthma - Maintenance

4 to 11 years:

Inhalation powder:

Patients previously treated with bronchodilators or inhaled corticosteroids: Initial dose: 50 mcg twice daily; maximum dose: 100 mcg twice daily. May start at higher dose in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.

Inhalation aerosol:

Patients previously treated with inhaled or oral corticosteroids: Initial dose: 88 mcg twice daily; maximum dose: 88 mcg twice daily. May start at higher dose in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.


12 years or older:

Inhalation powder:

Patients previously treated with bronchodilators alone: Initial dose: 100 mcg twice daily; maximum dose: 500 mcg twice daily.

Patients previously treated with inhaled corticosteroids: Initial dose: 100 to 250 mcg twice daily. Maximum dose: 500 mcg twice daily. May start doses above 100 mcg twice daily in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.

Patients previously treated with oral corticosteroids: Initial dose: 1000 mcg twice daily. Maximum dose: 1000 mcg twice daily.

13 years or older:

Inhalation aerosol:

Patients previously treated with bronchodilators only: Initial dose: 88 mcg twice daily; maximum dose: 440 mcg twice daily.

Patients treated with an inhaled corticosteroid: Initial dose: 88 to 220 mcg twice daily; maximum dose: 440 mcg twice daily; may start at doses above 88 mcg twice daily in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.

Patients previously treated with oral corticosteroids: Initial dose: 880 mcg twice daily; maximum dose: 880 mcg twice daily.

Inhalation powder:

Patients previously treated with bronchodilators only: Initial dose: 100 mcg twice daily; maximum dose: 500 mcg twice daily.

Patients treated with an inhaled corticosteroid: Initial dose: 100 to 250 mcg twice daily; maximum dose: 500 mcg twice daily; may start at doses above 100 mcg twice daily in poorly controlled patients or those who previously required higher doses of inhaled corticosteroids.

Patients previously treated with oral corticosteroids: Initial dose: 1000 mcg twice daily; maximum dose: 1000 mcg twice daily.

Usual Pediatric Dose for Eosinophilic Esophagitis

Not an FDA approved indication. Optimal dose and dosing regimen are not established.

Oral (swallowed): Note: Patients use an oral inhaler without a spacer and swallow the medication.
1 year to 10 years: 220 mcg orally 4 times daily for 4 weeks, 220 mcg orally 3 times daily for 3 weeks, 220 mcg orally twice daily for 3 weeks, 220 mcg orally daily for 2 weeks.
11 years and older: 440 mcg 4 times daily for 4 weeks, 440 mcg 3 times daily for 3 weeks, 440 mcg twice daily for 3 weeks, 440 mcg daily for 2 weeks.

Usual Pediatric Dose for Bronchopulmonary Dysplasia

Older than 28 days: Some centers have used 2 to 4 puffs (44 mcg/puff) every 12 hours via a face mask and a spacer. One trial used fixed doses administered via a spacer and neonatal anesthesia bag (into ventilator, directly into nasopharyngeal endotracheal tube, or with a face mask) in 16 former preterm neonates (GA: less than 32 weeks; Post Natal Age: 28 to 60 days); chest radiograph score was improved compared to placebo; the treatment group had increased blood pressure compared to baseline; the authors conclude that the trial results do not support the use of fluticasone in oxygen dependent patients with moderate BPD; exact dosing cannot be replicated in the U.S. with available products. (Body weight: 0.5 to 1.2 kg: 125 mcg every 12 hours for 3 weeks, followed by 125 mcg once daily for the 4th week; greater than 1.2 kg: 250 mcg every 12 hours for 3 weeks, followed by 250 mcg once daily for the 4th week)

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Inhalation aerosol: If adequate response is not seen after 2 weeks of initial dosage, increase dose. Doses should be reduced to the lowest effective dose once asthma is controlled.

Precautions

Fluticasone inhalation is used also used to reduce or discontinue oral corticosteroid therapy for asthma. Do not decrease prednisone faster than 2.5 mg/day on a weekly basis, beginning after at least 1 week of fluticasone inhalation therapy. Monitor for signs of asthma instability and adrenal insufficiency. Decrease fluticasone to lowest effective dose after prednisone reduction is complete. If bronchospasm with wheezing occurs after oral inhalation use, a fast acting bronchodilator may be used.

Dialysis

Data not available

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