Fluticasone

Drug Overview

Fluticasone is a synthetic corticosteroid primarily used to suppress inflammatory responses and regulate the immune system. This medication can be administered via different routes (such as nasal spray, inhalers, topical creams) to treat diseases caused by hyperactive immune responses.

Its pharmacological actions include reducing airway swelling, decreasing the release of allergic mediators, and inhibiting immune cell activity. Common applications include allergic rhinitis, asthma, dermatitis, etc., but it must be used under medical supervision to avoid long-term side effects.

Brand Names and Generic Name

The generic name of Fluticasone is "Fluticasone." Common brand names for different formulations include:

• Flixonase (nasal spray)
• Dovonex (topical cream)
• Seretide (inhaler combined with salmeterol)

Drug Classification

This medication belongs to the class of "synthetic corticosteroids," which can be subdivided based on the route of administration:

• Topical: such as skin creams, nasal sprays
• Inhalation: such as asthma inhalers
• Injectable or oral: less common, usually used for severe inflammatory conditions

Different formulations have distinct pharmacokinetic properties; topical use can reduce the risk of systemic side effects.

Indications

Primarily used for the following chronic inflammatory or allergy-related diseases:

• Asthma: as a long-term control medication to reduce bronchial constriction
• Allergic rhinitis: to relieve nasal congestion and sneezing
• Atopic dermatitis: topical treatment for skin redness and swelling

In some cases, it can also be used for immunosuppressive therapy post-organ transplantation, which requires evaluation by a specialist physician.

Common Side Effects

When used topically, common side effects include:

• Nasal spray: nasal dryness, throat irritation
• Inhaler: oral thrush, hoarseness
• Topical cream: skin atrophy, capillary dilation

Long-term high-dose use may lead to systemic side effects such as:

• Immunosuppression
• Reduced bone mineral density
• Blood sugar fluctuations

Serious side effects require immediate medical attention: fever, difficulty breathing, skin ulceration, etc.

Warnings and Precautions

The following patients should use with caution:

• Active tuberculosis or latent tuberculosis infection
• Uncontrolled diabetes or hypertension
• History of gastrointestinal ulcers

Use during pregnancy should be limited to necessary cases, and breastfeeding requires risk assessment for the infant. Long-term use in children may affect growth and development; regular monitoring of height and bone density is recommended.

Drug Interactions

Concurrent use with the following medications may affect drug metabolism:

• CYP3A4 inhibitors (such as ritonavir, clarithromycin): may increase blood concentration
• Oral anticoagulants: may enhance anticoagulant effects

Before using traditional Chinese herbal supplements (such as ginkgo, ginseng), consult a physician to avoid overlapping steroid use.

Dosage and Administration

The dosage should be adjusted based on disease severity and route of administration:

• Asthma inhaler: 1-2 times daily, 100-500 micrograms per dose
• Nasal spray: 2 sprays per nostril, 1-2 times daily
• Skin cream: apply a thin layer to affected area, 1-2 times daily

Inhalers should be cleaned before use, and rinsing the mouth after use can reduce oral side effects. Do not stop medication abruptly; treatment adjustments should be made by a physician.

Missed Dose Management

If a dose is missed:

• Inhaler: take immediately, but skip if close to the next dose
• Topical cream: apply immediately, but avoid double dosing

Long-term missed doses may worsen symptoms; continuous monitoring of disease progression is recommended.

Overdose Management

Overdose may cause:

• Dizziness, nausea, muscle tremors
• Severe cases may present with hypotension or mental disturbances

If overdose occurs, seek immediate medical attention, providing details of the medication type, dose, and timing. Supportive treatment may be administered based on symptoms.

 

Frequently Asked Questions

Does long-term use of inhaled fluticasone suppress the immune system?

Inhaled fluticasone has a strong local anti-inflammatory effect with minimal systemic absorption, thus having little impact on overall immune function. However, patients with severe immune deficiency or those requiring high-dose long-term use should regularly consult their physician to evaluate the need for immune function monitoring.

How can I reduce the risk of oral thrush after using fluticasone nasal spray?

After using the nasal spray, rinse the mouth with water and spit out to prevent swallowing. If symptoms such as dry mouth, sore throat, or white oral patches occur, seek medical attention promptly. The doctor may prescribe topical antifungal medication and instruct proper nasal spraying techniques to minimize mucosal contact.

What drug interactions should I be aware of when combining fluticasone with other steroids?

When used with CYP3A4 inhibitors like ketoconazole or rifampicin, metabolism may be affected, requiring dose adjustments. Always inform your doctor of all medications you are taking, including prescription drugs, over-the-counter medications, and herbal supplements, to avoid excessive or insufficient effects.

Can I use inhaled fluticasone while breastfeeding?

The drug and its metabolites are present at very low concentrations in breast milk. Current studies suggest minimal risk to the infant. However, consult your physician before use, considering the mother's condition and alternative options to determine the safest medication strategy.

What should I do if I forget to take my dose of fluticasone?

If missed within half an hour of the scheduled time, take the dose immediately and continue with the original schedule. If close to the next dose, skip the missed dose and do not double the dose. Setting reminders and marking medication times on the packaging can help prevent missed doses.