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Fluticasone Dosage

Applies to the following strength(s): 44 mcg/inh ; 110 mcg/inh ; 220 mcg/inh ; 250 mcg ; 100 mcg ; 50 mcg ; CFC free 44 mcg/inh ; CFC free 110 mcg/inh ; CFC free 220 mcg/inh ; furoate 100 mcg ; furoate 200 mcg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Asthma - Maintenance

Initial doses should be based upon previous therapy and asthma severity:

Fluticasone propionate INHALATION AEROSOL:
-For patients previously receiving bronchodilators alone:
Initial dose: 88 mcg via oral inhalation twice a day
Maximum dose: 440 mcg twice a day
-For patients previously receiving inhaled corticosteroids:
Initial dose: 88 to 220 mcg via oral inhalation twice a day
Maximum dose: 440 mcg twice a day
-For patients previously receiving oral corticosteroids:
Initial dose: 440 mcg via oral inhalation twice a day
Maximum dose: 880 mcg twice a day

Fluticasone propionate INHALATION POWDER:
-For patients previously receiving bronchodilators alone:
Initial dose: 100 mcg via oral inhalation twice a day
Maximum dose: 500 mcg twice a day
-For patients previously receiving inhaled corticosteroids:
Initial dose: 100 to 250 mcg via oral inhalation twice a day
Maximum dose: 500 mcg twice a day
-For patients previously receiving oral corticosteroids:
Initial dose: 500 to 1000 mcg via oral inhalation twice a day
Maximum dose: 1000 mcg twice a day

Fluticasone furoate INHALATION POWDER:
-For patients not previously receiving inhaled corticosteroids:
Initial dose: 100 mcg via oral inhalation once a day
-For patients with prior use of inhaled corticosteroids:
Initial dose 100 to 200 mcg via oral inhalation once a day
Maximum dose: 200 mcg once a day

Comments:
-Inhalation aerosol doses are generally intended to be given by a minimum of 2 inhalations twice a day.
-Higher initial doses may be considered in patients with poorer asthma control or those who have previously required higher doses of other inhaled corticosteroids.
-If asthma stability has not been achieved in 2 weeks, may increase dose without exceeding maximum dose; after asthma stability has been achieved, titrate to the lowest effective dose to reduce the possibility of side effects.
-For patients receiving oral corticosteroids,taper oral corticosteroids no more than once weekly beginning after the first week of inhaled therapy; patients should be carefully monitored for asthma instability during transition; once oral corticosteroid taper is complete, inhalation dose should be reduced to the lowest effective dose.
-Not indicated for the relief of acute bronchospasm.

Uses: As prophylactic therapy for the maintenance treatment of asthma and for those patients requiring oral corticosteroids for asthma who may be able to reduce or eliminate their requirement for oral corticosteroids over time.

Usual Pediatric Dose for Asthma - Maintenance

Age: 4 to 11 years:
Fluticasone propionate INHALATION POWDER:
Initial dose: 50 mcg via oral inhalation twice a day
Maximum dose: 100 mcg twice a day
Fluticasone propionate INHALATION AEROSOL:
Recommended dose: 88 mcg via oral inhalation twice a day
-A valved holding chamber and mask may be used in young patients

Age: 12 years or older:

Fluticasone propionate INHALATION AEROSOL:
-For patients previously receiving bronchodilators alone:
Initial dose: 88 mcg via oral inhalation twice a day
Maximum dose: 440 mcg twice a day
-For patients previously receiving inhaled corticosteroids:
Initial dose: 88 to 220 mcg via oral inhalation twice a day
Maximum dose: 440 mcg twice a day
-For patients previously receiving oral corticosteroids:
Initial dose: 440 mcg via oral inhalation twice a day
Maximum dose: 880 mcg twice a day

Fluticasone propionate INHALATION POWDER:
-For patients previously receiving bronchodilators alone:
Initial dose: 100 mcg via oral inhalation twice a day
Maximum dose: 500 mcg twice a day
-For patients previously receiving inhaled corticosteroids:
Initial dose: 100 to 250 mcg via oral inhalation twice a day
Maximum dose: 500 mcg twice a day
-For patients previously receiving oral corticosteroids:
Initial dose: 500 to 1000 mcg via oral inhalation twice a day
Maximum dose: 1000 mcg twice a day

Fluticasone furoate INHALATION POWDER:
-For patients not previously receiving inhaled corticosteroids:
Initial dose: 100 mcg via oral inhalation once a day
-For patients with prior use of inhaled corticosteroids:
Initial dose 100 to 200 mcg via oral inhalation once a day
Maximum dose: 200 mcg once a day

Comments:
-Inhalation aerosol doses are generally intended to be given by a minimum of 2 inhalations twice a day.
-Higher initial doses may be considered in patients with poorer asthma control or those who have previously required higher doses of other inhaled corticosteroids.
-If asthma stability has not been achieved in 2 weeks, may increase dose without exceeding maximum dose; after asthma stability has been achieved, titrate to the lowest effective dose to reduce the possibility of side effects.
-For patients receiving oral corticosteroids,taper oral corticosteroids no more than once weekly beginning after the first week of inhaled therapy; patients should be carefully monitored for asthma instability during transition; once oral corticosteroid taper is complete, inhalation dose should be reduced to the lowest effective dose.
-Not indicated for the relief of acute bronchospasm.

Uses: As prophylactic therapy for the maintenance treatment of asthma and for those patients requiring oral corticosteroids for asthma who may be able to reduce or eliminate their requirement for oral corticosteroids over time.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Use with caution; monitor for signs of increased drug exposure

Dose Adjustments

Abrupt discontinuation after prolonged use is not recommended

Inhalation doses should be reduced to the lowest effective dose once asthma stability has been achieved.

Concomitant use with strong CYP450 3A4 inhibitors is not recommended.

Oral Corticosteroids:
-Allow at least 1 week before initiating a taper with oral corticosteroid
-Prednisone should be reduced in increments not exceeding 2.5 mg to 5 mg per day on a weekly basis
-Monitor for signs of asthma instability including serial objective measure of airflow
-Monitor for signs of adrenal insufficiency

Precautions

Safety and efficacy of fluticasone propionate have not been established in patients younger than 4 years.

Safety and efficacy of fluticasone furoate have not been established in patients younger than 12 years

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-For oral inhalation only
-Patients should rinse mouth with water (without swallowing) after each use
-Patients should receive instruction on proper use; children may need assistance to ensure proper use

Storage requirements:
INHALATION AEROSOL:
-Store with mouthpiece down. Contents under pressure; do not puncture or store near heat or open flame
-Discard when counter reads "000" even though the canister is not completely empty
INHALATION POWDER:
-Prior to use: Store in dry place away from direct heat or sunlight
-In use (fluticasone propionate): Remove from pouch immediately before use: Discard 6 weeks (50 mcg) or 2 months (100 and 250 mcg) after opening foil pouch or when counter reads "0"; whichever comes first; the inhaler is not reusable.
-In use (fluticasone furoate): Remove from pouch immediately before use: Discard 6 weeks after opening foil pouch or when counter reads "0"; whichever comes first; the inhaler is not reusable.

Preparation techniques: The manufacturer product information should be consulted for complete instructions.
Fluticasone propionate: INHALATION AEROSOL: Shake well before each spray
Fluticasone propionate INHALATION POWDER: Do no use with a spacer device

General:
-This drug is not intended for acute asthma exacerbations; patients should treat acute asthma symptoms with an inhaled, short-acting beta 2-agonist, such as albuterol.
-Use with caution, if at all, in patients with active or quiescent tuberculosis infection, untreated fungal, bacterial, systemic viral or parasitic infections, or ocular herpes simplex.
-Patients switching from oral corticosteroid treatment should do so gradually while monitoring HPA axis functions regularly; oral corticosteroid supplementation may be needed during periods of stress.

Monitoring:
-Monitor asthma signs and symptoms including serial objective measures of airflow
-Monitor bone mineral content in patients at high risk of decreased bone mineral density
-Monitor growth regularly in pediatric patients
-Regular eye examinations should be considered, especially in patients with a history of ocular changes or those experiencing visual changes
-Periodically assess oral cavity for signs and symptoms of Candida albicans infection
-Monitor for signs and symptoms of adrenal insufficiency
-Monitor adrenocortical function in patients transferring from corticosteroids with higher systemic effects.

Patient advice:
-Patients should understand that this drug is a corticosteroid; they should know the signs and symptoms of hypercorticism and adrenal suppression.
-Patients should understand that during times of stress, such as surgery or infection, additional oral supplementation may be necessary; they should discuss with their healthcare professional whether they need to carry a medical identification card identifying their corticosteroid use.
-Patients on immunosuppressant doses of corticosteroids should understand that a greater risk of infection exists; they should avoid exposure to chickenpox or measles and if exposed, they should consult their healthcare professional promptly.
-Patients should check with their healthcare provider before taking any new medications, including herbal supplements and over the counter products.
-Patients should be instructed on proper inhaler technique and the importance of regular use.
-Patients should understand this drug is not intended to relieve acute asthma symptoms and a short acting bronchodilator should be used for that; if asthma symptoms do not respond to a short acting bronchodilator, or require higher or more frequent dosing, they should contact their healthcare professional for reevaluation of therapy.
-Patients should be instructed to rinse and spit after oral inhalation use to avoid infection; if infection develops, they should contact their healthcare professional.

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