Fluticasone is a potent corticosteroid that helps treat respiratory and skin conditions of all types. The World Health Organisation has recognised its importance and included it in their List of Essential Medicines. This anti-inflammatory medicine comes in various forms. These include inhalers, nasal sprays & topical creams. This article explains how this medicine works, its usage instructions and common side effects.

How Does Fluticasone Work?

The medication binds to human glucocorticoid receptors with impressive strength (18 times stronger than dexamethasone and 3 times more than budesonide). The binding process reduces inflammation by lowering inflammatory cells. The medicine also stops the release of inflammatory mediators such as histamine, cytokines, and leukotrienes. These actions help calm the overactive immune response that causes symptoms.

Uses of Fluticasone

Doctors prescribe fluticasone to treat several conditions. 

• Nasal spray to treat allergic and non-allergic rhinitis, which helps with sneezing, itching, and nasal congestion

• Inhaled version for asthma and COPD

• Topical version to manage eczema, atopic dermatitis and other inflammatory skin conditions. 

• Treatment of chronic rhinosinusitis without nasal polyps

How & When to Take or Use Fluticasone?

Each fluticasone form needs specific handling:

For nasal spray:

• Shake gently before each use

• Keep the bottle upright while using

• Adults typically use 1-2 sprays in each nostril once daily

• Children aged 4-11 usually need 1 spray per nostril daily

For inhaler:

• Breathe out before you use the inhaler

• Inhale the medicine slowly through the mouthpiece

• Hold your breath for a few seconds to allow the medicine to settle in your lungs

• Rinse your mouth after each use to avoid irritation or fungal infection

For topical cream:

• Dry your affected skin area

• Apply a thin layer of the ointment and gently rub it

• Wash your hands after applying medicine

• Do not apply to broken skin, face, and eyes

What Are the Side Effects of Fluticasone?

Common side effects:

• Headache

• Nasal irritation or burning

• Nosebleeds

• Sore throat

• Nausea

Serious side effects:

• Allergic reactions

• Glaucoma

• Cataracts

• Adrenal suppression

Can I Use Fluticasone Daily?

Patients get the best results when they keep taking fluticasone. The medication might take several days to show maximum effectiveness, and response times vary between individuals. Users should not use an over-the-counter nasal spray for more than one month without asking their doctor. Prescription versions allow longer use under medical supervision.

Precautions 

• People with recent nasal injuries, ulcers, or surgery should wait until healing finishes before using a nasal spray. 

• People with liver problems, infections, or osteoporosis need extra care when taking fluticasone.

• Regular eye checkups are important for patients with eye problems since extended use might increase their risk of glaucoma or cataracts. 

• Doctors should monitor children's growth while using fluticasone as it may affect their growth rate. 

• The medication requires careful use by patients with active infections because it might make them more susceptible to infections.

Dosage for Fluticasone

For nasal spray:

• Adults: 1-2 sprays (50 mcg/spray) in each nostril once daily

• Children aged 4-11: 1 spray (50 mcg/spray) in each nostril once daily

• Children aged 2-11 using fluticasone furoate: 1 spray (27.5 mcg/spray) in each nostril daily

For asthma inhalers:

• Adults and children 12+: Usually 88-232 mcg twice daily

• Children 4-11: Typically 30-88 mcg twice daily

You should shake your nasal spray gently before each use. The spray needs priming before first use by releasing 6 sprays into the air.

What If I Missed a Dose?

Take the missed dose when you remember it. Skip the forgotten dose if it's almost time for your next scheduled one. Your results won't improve by doubling up - it only increases your risk of side effects.

What If I Overdose?

Fluticasone overdose can happen, though it's rare with nasal sprays. Watch for these symptoms:

• Darkening of skin

• Loss of appetite

• Unusual tiredness

• Mental depression

Get emergency medical help if you suspect an overdose.

Drug Interactions

Fluticasone can interact with some drugs. Strong CYP3A4 inhibitors pose the biggest concern, including:

• Ketoconazole and similar antifungals

• Certain HIV medications

• Clarithromycin and other antibiotics

Let your doctor know about everything you take, including vitamins and supplements.

Fluticasone vs Budesonide 

Comparison Factor	Fluticasone	Budesonide
Pneumonia Risk	Higher risk	Lower risk
Effectiveness for Asthma	Slightly better lung function improvement at equivalent doses	Effective but may require higher doses for similar effects
Side Effects Profile	More likely to cause hoarseness and a sore throat	Less likely to cause vocal side effects
Half-life	8 hours	2.8 hours
Drug Interactions	Antifungals, HIV medicines, certain antibiotics	Aspirin, antifungals, blood pressure medicine
Nasal Allergy Treatment	Faster reduction in nasal blockage; shows the most important improvement within 36 hours[	Somewhat similar effect in reducing nasal blockage at 4 weeks
Eosinophil Count Reduction	Greater reduction at 8 weeks	Moderate reduction at 8 weeks
Cost-effectiveness	Generally budget-friendly	Lower healthcare costs

These medications belong to the same drug class and pregnancy category C. Fluticasone shows more potency at equivalent doses, so patients and doctors need to weigh its greater effectiveness against the possibility of increased side effects, especially when treating respiratory conditions.

FAQs

1. What is fluticasone used for?

   We used fluticasone to treat respiratory and allergic conditions. It helps manage asthma symptoms such as wheezing & shortness of breath and hay fever symptoms. This medication also helps patients with chronic rhinosinusitis, especially those with nasal polyps.

2. How does fluticasone work in the body?

   Fluticasone acts as a corticosteroid that binds to glucocorticoid receptors and reduces inflammation. The medication attaches to these receptors and decreases inflammatory cells like eosinophils, monocytes, and mast cells. It stops the release of substances that cause allergy symptoms. Your breathing becomes easier because this action reduces swelling in the nasal passages and airways.

3. What are the common side effects of fluticasone?

   Common side effects are:

   • Unpleasant taste or smell

   • Dry or sore nose and occasional nosebleeds

   • Hoarseness or sore throat

   • Headache

   • Nausea or vomiting

4. How should I use the Fluticasone nasal spray or inhaler correctly?

   The nasal spray needs a gentle shake first. You should tilt your head slightly backward and insert the tip into one nostril. Block the other nostril with your finger and spray once while breathing gently through your nose. You can then repeat this process for the other nostril. The inhaler requires you to breathe out completely before placing the mouthpiece in your mouth. Take a deep breath in, hold it for about 10 seconds, and then exhale slowly.

5. Can fluticasone be used for both allergies and asthma?

   Fluticasone works effectively for both conditions. Different forms target specific issues - nasal sprays help with allergies while inhalers treat asthma. The medication reduces inflammation in affected areas similarly for both conditions.

6. Is fluticasone safe for long-term use?

   Doctors must monitor long-term fluticasone usage carefully. Parents should track their children's development since the medication might slow growth. The medication could reduce bone mineral density in adults as time passes. Extended treatment requires regular eye checkups because fluticasone might raise the risk of glaucoma or cataracts.

7. What precautions should I follow while using fluticasone?

   Your doctor needs to know about any recent nasal injuries, surgeries or sores. You should mention existing conditions such as glaucoma, cataracts, osteoporosis, liver disease, or infections. The medication could make you more prone to infections, so watch out for fever, chills, or sore throat.

8. Can I use fluticasone during pregnancy or breastfeeding?

   Pregnant women can use fluticasone nasal spray since very little reaches the baby. The medication passes minimally through breast milk, so nursing mothers can use fluticasone. You should still check with your doctor first.

9. What happens if I miss a dose of fluticasone?

   You should take it right away unless your next dose is coming up soon. The medication should never be doubled up to make up for a missed dose.

10. Are there any drug interactions with Fluticasone I should know about?

    The medication has many drug interactions. Strong CYP3A4 inhibitors like ketoconazole or ritonavir should not be combined with fluticasone.