Fluticasone

Fluticasone

Fluticasone is a potent corticosteroid that helps manage various respiratory conditions. This drug has gained widespread use for its effectiveness in treating allergies, asthma, and other breathing issues. Understanding fluticasone's benefits, uses, and potential side effects can help patients make better decisions about the treatment and management of the condition.

What is Fluticasone?

Fluticasone is a potent synthetic glucocorticoid that belongs to a class of medications called corticosteroids. This drug plays an elementary role in reducing inflammation in the body, making it an effective treatment for various respiratory conditions. Doctors first approved fluticasone propionate in 1990, and since then, it has become a widely used medication for managing allergic and non-allergic respiratory issues.

Fluticasone works by obstructing the release of certain natural substances that cause allergy symptoms. This action helps alleviate inflammation in the nasal passages and airways, relieving a range of symptoms associated with rhinitis and asthma.

Fluticasone Uses

Fluticasone, a versatile corticosteroid medication, has many applications in treating various respiratory and skin conditions. Doctors prescribe fluticasone in different forms, each tailored to address specific health issues.

• For respiratory conditions, fluticasone plays a crucial role in managing asthma. The Food & Drug Administration (FDA) has approved inhaled fluticasone as a maintenance and controller drug for asthma treatment. 
• Fluticasone also has significant applications in treating nasal and sinus issues. The FDA has approved nasal fluticasone for both allergic and non-allergic rhinitis. This means it helps alleviate symptoms such as sneezing, runny nose, stuffy nose, and itchy nose caused by various factors, including hay fever and other allergies. 
• In 2024, the FDA expanded its approval to include chronic rhinosinusitis without nasal polyps, using a novel drug-device combination product with an exhalation delivery system (EDS).
• For skin conditions, topical fluticasone has proven effective in treating atopic dermatitis and other corticosteroid-responsive dermatoses. It helps reduce inflammation, itching, and redness associated with these skin issues. 

How to Use Fluticasone Tablets

Proper fluticasone use depends on the specific formulation and the treated condition, such as: 

Nasal Spray:

• Shake the medicine well before each use.
• Gently blow your nose and clear your nasal passages.
• Tilt your head slightly in the backward direction. Insert the nosepiece tip into your nostril.
• Close the opposite nostril with a finger.
• Release one spray while breathing in gently through the nostril.
• Hold your breath for a few seconds, then breathe out slowly through your mouth.
• Repeat the process for the opposite nostril.
• Avoid blowing your nose or tipping your head back after using the spray.
• Clean the applicator tip with a tissue and replace the cap.

Inhaler:

• Hold the inhaler upright and open the cap fully until it clicks.
• Breathe out completely, trying to empty your lungs.
• Place the mouthpiece in your oral cavity, closing your lips around it.
• Breathe in quickly & deeply through your mouth.
• Hold your breath for about 10 seconds.
• Close the cap after each inhalation.
• Rinse your mouth with water without swallowing after fluticasone use.

Oral Tablet:

• Take the tablet at the same time each day as directed by your doctor.
• Swallow the tablet whole with water.
• Do not crush, chew, or break the fluticasone tablet.
• For eosinophilic oesophagitis, a special form is used where the medication is sprayed into the pharynx and swallowed.
• Avoid eating or drinking for 30 minutes after taking the tablet.

Side Effects of Fluticasone Tablet

Fluticasone, like all medicines, can cause several side effects, although not everyone experiences them. These may include:

• Unpleasant taste or smell
• Dry or sore nose or nosebleeds
• Dry or sore throat or hoarse voice
• Headache
• Nausea, vomiting, or diarrhoea
• Dizziness

Serious Side Effects:

Patients should go for immediate medical care if they experience:

• Breathing problems
• Damage to the nose or sores inside the nose
• Changes in eyesight, such as blurring of vision or cloudy lens (signs of glaucoma or cataracts)
• Increased susceptibility to infections
• Long-term use of fluticasone may decrease bone mineral density, potentially leading to weak bones or osteoporosis.
• Prolonged use or high doses of fluticasone may lead to adrenal gland problems. Its symptoms include darkening of the skin, diarrhoea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness, or vomiting.

Precautions

Patients should be aware of several essential precautions when using fluticasone to ensure safe and effective treatment, including:

• Fluticasone may cause holes or ulcers in the nasal cartilage and delay wound healing. 
• Before using fluticasone, tell your doctor about recent nasal and sinus issues, infections (eye infection, herpes, chicken pox, measles, flu, or tuberculosis), and eye issues (glaucoma or cataract).
• People with liver issues may exercise caution while using fluticasone.
• Pregnant women 
• Fluticasone may slow down a child's growth. Parents should monitor their child's growth and consult a doctor for concerns.

How Fluticasone Tablet Works

The primary mechanism of action of fluticasone involves the activation of glucocorticoid receptors. Once activated, these receptors trigger a cascade of cellular responses that suppress inflammatory processes. This activation impacts various cell types involved in inflammation, including eosinophils, monocytes, mast cells, macrophages, and dendritic cells. Fluticasone not only reduces the number of these inflammatory cells but also decreases the production of cytokines (signaling molecules that promote inflammation).

Fluticasone also has a direct local effect on the nasal passages and airways. It causes vasoconstriction, which narrows blood vessels and exerts anti-inflammatory activity. These actions help to reduce swelling and congestion in the nasal passages, alleviating breathing problems in individuals with allergic rhinitis or other nasal conditions.

Can I Take Fluticasone with Other Medicines?

Commonly checked interactions with fluticasone include:

• Acetaminophen
• Albuterol
• Alprazolam
• Apixaban
• Aspirin (both regular and low strength)
• Atorvastatin
• Budesonide / formoterol
• Cetirizine
• Diphenhydramine
• Escitalopram
• Metoprolol (both succinate ER and tartrate forms)
• Montelukast
• Levothyroxine
• Loratadine

Dosing Information

For adults and children 12 years and older with rhinitis, the usual dose of fluticasone furoate nasal spray is two sprays (27.5 mcg/spray) in each nostril once a day. Fluticasone propionate nasal spray is typically administered as one or two sprays (50 mcg/spray) in each nostril once daily as needed.

Conclusion

Fluticasone has an impact on various respiratory conditions, providing relief to millions of people worldwide. Its versatility in treating allergies, asthma, and other breathing issues makes it a valuable tool in managing respiratory health. As we've seen, fluticasone reduces inflammation in the airways and nasal passages, helping patients breathe easier and enjoy a better quality of life. While fluticasone offers significant benefits, it's crucial to use it as prescribed and be aware of potential side effects and interactions. 

FAQ's

1. What is fluticasone mainly used for?

Fluticasone has an impact on various respiratory conditions. Doctors prescribe it primarily to treat allergy symptoms such as sneezing, itching, and runny or stuffy nose. 

2. Who needs to take fluticasone?

Doctors prescribe fluticasone for individuals experiencing:

• Allergic rhinitis symptoms
• Non-allergic rhinitis
• Chronic rhinosinusitis with or without nasal polyps
• Asthma (for maintenance treatment)

3. Is it bad to use fluticasone every day?

Using fluticasone daily as prescribed by a doctor is generally safe for most people. 

4. Is fluticasone safe?

Fluticasone impacts various conditions and is generally considered safe when used as directed. However, like all medications, it carries potential risks and side effects. Most people who use fluticasone nasal spray do not experience severe or long-term side effects.

5. Who Cannot use fluticasone?

Fluticasone can affect various body systems, and it's not suitable for everyone. Individuals should avoid using fluticasone if they:

• Had an allergic reaction to fluticasone or any other medicine
• Have a skin infection
• Have acne or severe flushing of skin on and around the nose, cheeks, forehead, and chin that comes and goes (rosacea)
• Have itching around the bottom (anus) or genital area.

6. Is fluticasone safe for kidneys?

While the available information does not explicitly address the safety of fluticasone for kidneys, it's always important for patients to discuss their complete medical history, including any kidney issues, with their doctor before starting fluticasone treatment.

Disclaimer: The information provided here is not meant to substitute an advice from a healthcare professional. The information is not intended to cover all the possible uses, side-effects, precautions, and drug interactions. This information is not intended to suggest that using a specific drug is suitable, safe, or efficient for you or anyone else. The absence of any information or warning regarding the drug should not be interpreted as an implicit guarantee from the organisation. We strongly advise you to consult a doctor if you have any concerns about the drug and never use the medication without a doctor’s prescription.