Fluticasone: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 6, 2023.

1. How it works

• Fluticasone inhalation may be used to treat asthma or COPD (chronic obstructive pulmonary disease).
• Fluticasone reduces inflammation and is thought to work by controlling the release of prostaglandins and other substances that promote inflammation. Fluticasone can also help constrict (narrow) blood vessels. Inhaled fluticasone acts directly on the bronchial tubes to improve breathing, reduce inflammation, and reduce congestion.
• Fluticasone belongs to a group of medicines known as corticosteroids.

2. Upsides

• Fluticasone for inhalation is used to prevent and control the symptoms of asthma.
• May be used in combination with salmeterol to prevent the symptoms of COPD or to reduce exacerbations of COPD.
• May also be used in the treatment of some other conditions as directed by a doctor.
• 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. Overall systemic absorption is low.
• Generic fluticasone for inhalation is available.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Oral candidiasis (thrush of the mouth), infections, nasal congestion, diarrhea, hoarseness, throat irritation, or voice changes.
• Fluticasone inhalation will not stop an asthma attack once it has started. The combination of fluticasone and salmeterol should not be used to relieve acute bronchospasm.
• May not be suitable for some people including those with a bacterial, viral, fungal, parasitic, or any other type of infection. May also not be suitable for people with glaucoma or cataracts, liver disease, low bone mineral density, or a weakened immune system.
• Long-term use of inhaled corticosteroids can lead to osteoporosis (bone loss). The risk is higher in people who smoke, do not exercise, or whose diets are lacking in vitamin D or calcium.
• Cannot be used by children aged less than four. Some preparations are only recommended for children older than twelve.
• May affect the growth rate of children. Talk to your doctor if you think your child is not growing at a normal rate.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Fluticasone inhalation prevents and controls the symptoms of asthma and is used for the maintenance treatment of asthma. Oral candidiasis and throat irritation are the most common side effects, which may be reduced by rinsing the mouth with water after use.

5. Tips

• Remember that fluticasone inhalation does not relieve an acute attack of asthma. Use a reliever inhaler (for example, albuterol) instead.
• Use a fluticasone inhaler exactly as directed by your doctor. Do not take more or less than you have been advised to take.
• Talk to your doctor if you are having surgery, are unwell, are under stress, or have recently had an asthma attack. Also, talk to your doctor if you think your asthma medications are not working as well as they used to or your symptoms get worse. Your dose may need to be changed.
• Flovent is a form of fluticasone that comes as a liquid and is used with an inhaler device. Talk to your doctor or pharmacist if you are having difficulty using this device.
• Store the Flovent HFA canister mouthpiece down away from high heat or flame. The canister may explode if it gets too hot. Shake the canister thoroughly for five seconds before each inhalation. Allow 30 seconds between inhalations. Contact your pharmacy for a refill when the dose counter reads "20". Discard the device when the dose counter reads "000". Wipe the inside of the mouthpiece at least once weekly and use a cotton swab dampened with water to wipe the opening of the metal canister.
• Flovent Diskus or Arnuity Ellipta come as preloaded blisters containing measured doses of fluticasone. Talk to your doctor or pharmacist if you are having difficulty using this device. Store the blister packs unopened, and discard any unused medicine six weeks after opening the foil. Do not take more than one dose of Arnuity Ellipta per day.
• Rinse your mouth out with water straight after using any fluticasone inhalation product, then spit the water out, do not swallow.
• Keep good oral hygiene. Brush your teeth twice a day and floss. Fluticasone may increase the risk of cavities or tooth discoloration.
• See your doctor for regular asthma checks. Your vision may need to be checked regularly as well.
• The powder in some fluticasone inhalation powders contains milk proteins. Do not use it if you have allergies to milk proteins.
• Do not use or give this medication to anybody who has not been prescribed it by a doctor.
• Using corticosteroids may make you more susceptible to viral infections such as chickenpox, measles, or other types of infection.
• May take one to two weeks or longer of regular use for maximal benefit to be apparent.
• Do not spray fluticasone near your eyes.
• See your doctor if you notice a change in your vision, or experience a rash or an allergic-type reaction while using fluticasone.

6. Response and effectiveness

• Although fluticasone inhalation is rapidly absorbed through the bronchial tissues it does not have an immediate effect on asthma symptoms. It may take one to two weeks or longer for the maximal benefits of fluticasone to be seen.
• The effectiveness of inhaled fluticasone is due to its direct local effect on bronchial and lung tissue. Systemic absorption (into the bloodstream) is approximately 18% for products such as Flovent Diskus. Absorption via the gastrointestinal tract is minimal (less than 1%).

7. Interactions

Medicines that interact with fluticasone inhalation may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with fluticasone inhalation. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with fluticasone inhalation include:

• amphotericin B
• aprepitant
• baricitinib
• cobicistat
• CYP3A4 inhibitors, such as clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole, ritonavir, verapamil, goldenseal, or grapefruit
• denosumab
• desmopressin
• echinacea
• fingolimod
• fusidic acid
• hyaluronidase
• inactivated vaccines such as poliovirus (IPV) vaccine, whole-cell pertussis (whooping cough) vaccine, rabies vaccine, and the hepatitis A vaccine
• ketoconazole
• leflunomide
• loop diuretics, such as furosemide
• loxapine
• mifepristone
• pimecrolimus or tacrolimus
• ritonavir
• simeprevir
• sipuleucel-T
• tobacco (smoked).

Note that this list is not all-inclusive and includes only common medications that may interact with fluticasone inhalation. You should refer to the prescribing information for fluticasone inhalation for a complete list of interactions.

References

• Fluticasone (oral inhalation) 05/2023. Prasco Laboratories https://www.drugs.com/pro/fluticasone-hfa-aerosol.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use fluticasone only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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