fluticasone inhalation

Pronunciation

Generic Name: fluticasone inhalation (floo TIK a zone)
Brand Name: Flovent Diskus, Flovent HFA, Flovent, Flovent Rotadisk

What is fluticasone inhalation?

Fluticasone is a steroid. It prevents the release of substances in the body that cause inflammation.

Fluticasone inhalation is used to prevent asthma attacks. It will not treat an asthma attack that has already begun.

Fluticasone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about fluticasone inhalation?

Do not use fluticasone inhalation to treat an asthma attack that has already begun.

Before using this medication, tell your doctor if you have been sick or had an infection of any kind. You may not be able to use fluticasone inhalation until you are well.

Contact your doctor if your asthma symptoms do not improve after using fluticasone inhalation for 2 weeks.

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Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.

Your dosage needs may change if you have surgery, are ill, are under stress, or have recently had an asthma attack. Talk with your doctor if any of your asthma medications do not seem to work as well in treating or preventing asthma attacks.

If you were switched from an oral (taken by mouth) steroid to fluticasone inhalation, you may need to go back to taking the oral medicine if you are under stress or have an asthma attack or other medical emergency. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency.

What should I discuss with my healthcare provider before using fluticasone inhalation?

You should not use this medication if you are allergic to fluticasone.

Before using this medication, tell your doctor if you have been sick or had an infection of any kind. You may not be able to use fluticasone inhalation until you are well.

FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Before using fluticasone inhalation, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether fluticasone passes into breast milk or if it could harm a nursing baby. Do not use fluticasone inhalation without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 4 years old without the advice of a doctor. Fluticasone can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis.

How should I use fluticasone inhalation?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Do not use fluticasone inhalation to treat an asthma attack that has already begun. It will not work fast enough. Use only a fast-acting inhalation medication.

Flovent is a liquid form of fluticasone that is used with an inhaler device. This device creates a spray that you inhale through your mouth and into your lungs. Your doctor or pharmacist can show you how to use an inhaler.

Flovent Diskus is a powder form of fluticasone that comes with a special inhaler device preloaded with blister packs containing measured doses of fluticasone. The device opens and loads a blister of fluticasone each time you use the inhaler. The disk device is not to be used with a spacer. Follow the patient instructions provided with the Diskus.

To reduce the chance of developing a yeast infection in your mouth, rinse with water after using fluticasone inhalation products. Do not swallow. Pay special attention to your dental hygiene. This medicine can cause cavities or tooth discoloration.

Asthma is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Get your prescription refilled before you run out of medicine completely. Do not change your doses or medication schedule without advice from your doctor.

Contact your doctor if your asthma symptoms do not improve after using fluticasone inhalation for 2 weeks.

Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.

Your dosage needs may change if you have surgery, are ill, are under stress, or have recently had an asthma attack. Talk with your doctor if any of your asthma medications do not seem to work as well in treating or preventing asthma attacks.

If you were switched from an oral (taken by mouth) steroid to fluticasone inhalation, you may need to go back to taking the oral medicine if you are under stress or have an asthma attack or other medical emergency. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency.

Store at room temperature away from moisture and heat. Keep the medicine canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

An overdose of fluticasone is not expected to produce life threatening symptoms. However, long term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid while using fluticasone inhalation?

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using fluticasone inhalation.

Fluticasone inhalation side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using fluticasone and call your doctor at once if you have a serious side effect such as:

  • weakness, tired feeling, nausea, vomiting, feeling like you might pass out;

  • skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

  • blurred vision, eye pain, or seeing halos around lights;

  • signs of infection such as fever, chills, sore throat, ear pain, flu symptoms;

  • wheezing or breathing problems after using this medication; or

  • worsening asthma symptoms.

Less serious side effects may include:

  • headache;

  • dryness in your mouth, nose, or throat;

  • white patches or sores inside your mouth or on your lips;

  • stuffy nose, sinus pain, cough; or

  • hoarseness or deepened voice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Fluticasone inhalation dosing 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)

What other drugs will affect fluticasone inhalation?

Tell your doctor about all other medicines you use, especially:

  • conivaptan (Vaprisol);

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);

  • antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

  • an antidepressant such as nefazodone;

  • heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan); or

  • HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra).

This list is not complete and other drugs may interact with fluticasone. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about fluticasone inhalation.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 12.01. Revision Date: 2011-11-07, 5:48:04 PM.

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