Fluticasone: Difference between revisions
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Latest revision as of 10:43, 23 May 2026
Fluticasone
Flonase (intranasal, OTC); Flovent (inhaled, asthma); Cutivate (topical)
Experience
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Problems
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Effects
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Summary
Pharmacy
Starting dose
Inhaled (Flovent HFA) 88 mcg BID; intranasal (Flonase) 2 sprays/nostril daily; topical (Cutivate) 0.05% cream BID
Preparations
Inhaled MDI 44/110/220 mcg per actuation; DPI (Diskus) 50/100/250 mcg; nasal spray 50 mcg/actuation; cream/ointment 0.005%, 0.05%
US FDA Max
ICS 880 mcg/d (asthma); intranasal 200 mcg/d
Pharmacology
Routes
Inhaled, intranasal, topical
Onset
Inhaled: bronchial effect 1-2 weeks; nasal: symptom relief 12-24 hours; topical: hours
Duration
12-24 hours per dose
Half-life
~7.8 hours (fluticasone propionate, inhaled systemic exposure)[1]
Bioavailability
<1% oral (extensive first-pass via CYP3A4); ~30% inhaled lung deposition[1]
Pregnancy
Inhaled and intranasal generally considered safe; widely used in asthma in pregnancy.[citation needed]
Legal status
OTC (intranasal Flonase) and Rx-only (inhaled, topical) in US
Purported mechanism
Fluticasone is a potent topical glucocorticoid receptor agonist designed for high local receptor affinity and extensive hepatic first-pass to minimize systemic glucocorticoid exposure.0 Suppresses inflammatory gene transcription (NF-κB, AP-1), induces lipocortin, downregulates mast cells and eosinophils. CYP3A4 substrate; strong CYP3A4 inhibitors (ritonavir, ketoconazole) can raise systemic levels enough to produce iatrogenic Cushing's[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Flovent HFA (fluticasone propionate), GlaxoSmithKline, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020548s055lbl.pdf