fluticasone intranasal (Rx, OTC)

Brand and Other Names:Flonase Allergy Relief, ClariSpray, more...Flonase Sensimist Allergy Relief, Children's Flonase Allergy Relief, Veramyst, Xhance, FlutiCare

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray

  • 27.5mcg/actuation (Flonase Sensimist Allergy Relief [OTC])
  • 50mcg/actuation (Flonase Allergy Relief [OTC], ClariSpray [OTC], FlutiCare [OTC])
  • 93 mcg/actuation (Xhance [Rx])

Allergic Rhinitis

Flonase Allergy Relief: 1 spray in each nostril (100 mcg/day) for maintenance therapy; OTC not for use for >6 months unless instructed by healthcare provider

ClariSpray, FlutiCare: 2 sprays in each nostril qDay x 1 wk, THEN 1-2 sprays in each nostril qDay as needed to treat symptoms for up to 6 mo unless directed by physician to use longer

Flonase Sensimist Allergy Relief: 2 sprays in each nostril qDay (ie, 110 mcg/day); after symptoms controlled, may reduce dose to 1 spray in each nostril qDay (ie, 55 mcg/day) for maintenance therapy

Nasal Polyps

Xhance: 1 spray in each nostril q12hr (372 mcg/day); not to exceed 2 sprays in each nostril q12hr (744 mcg/day)

See Administration

Dosage Forms & Strengths

nasal spray

  • 27.5mcg/actuation (Flonase Sensimist Allergy Relief [OTC])
  • 50mcg/actuation (Flonase Allergy Relief [OTC], ClariSpray [OTC])

Allergic Rhinitis

Limit duration of use of OTC nasal corticosteroids to 2 months a year in children unless otherwise directed by physician

Flonase Allergy Relief, Children's Flonase Allergy Relief

  • ≥4-11 years: 1 spray (50 mcg) in each nostril qDay; may increase up to 2 sprays/nostril qDay if not responding adequately, reduce to 1 spray in each nostril qDay once symptoms are controlled
  • >12 years: 2 sprays in each nostril qDay (ie, 200 mcg/day); reduce to 1 spray in each nostril qDay once symptoms are controlled

ClariSpray, FlutiCare

  • <4 years: Safety and efficacy not established
  • 4-11 years: 1 spray in each nostril qDay for up to 2 months annually unless directed by physician to use longer
  • ≥12 years: 2 sprays in each nostril qDay x 1 wk, THEN 1-2 sprays in each nostril qDay as needed to treat symptoms for up to 6 mo unless directed by physician to use longer

Flonase Sensimist Allergy Relief

  • 2-12 years: 1 spray (27.5 mcg) in each nostril qDay; may increase up to 2 sprays/nostril qDay if not responding adequately, reduce to 1 spray in each nostril qDay once symptoms are controlled
  • >12 years: 2 sprays in each nostril qDay (ie, 110 mcg/day); reduce to 1 spray in each nostril qDay once symptoms are controlled
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Interactions

Interaction Checker

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            Contraindicated (0)

              Serious - Use Alternative (22)

              • atazanavir

                atazanavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • clarithromycin

                clarithromycin will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • conivaptan

                conivaptan will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • darunavir

                darunavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • fosamprenavir

                fosamprenavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • imatinib

                imatinib will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • indinavir

                indinavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • isoniazid

                isoniazid will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • itraconazole

                itraconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • ketoconazole

                ketoconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • levoketoconazole

                levoketoconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • lopinavir

                lopinavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • nefazodone

                nefazodone will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • nelfinavir

                nelfinavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • nicardipine

                nicardipine will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)

                ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of fluticasone intranasal by unspecified interaction mechanism. Avoid or Use Alternate Drug. Coadministration may reduce serum cortisol concentrations; alternative corticosteroids should be considered, particularly for long term use.

              • posaconazole

                posaconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • quinidine

                quinidine will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • ritonavir

                ritonavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • saquinavir

                saquinavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • tipranavir

                tipranavir will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              • voriconazole

                voriconazole will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase systemic corticosteroid adverse effects; monitor for signs/symptoms of high corticosteroid concentrations including Cushing type signs/symptoms.

              Monitor Closely (6)

              • fedratinib

                fedratinib will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

              • letermovir

                letermovir increases levels of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ribociclib

                ribociclib will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rucaparib

                rucaparib will increase the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

              • stiripentol

                stiripentol, fluticasone intranasal. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

              • tazemetostat

                tazemetostat will decrease the level or effect of fluticasone intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              Minor (0)

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                Adverse Effects

                >10%

                Headache (17%)

                URI (15%)

                Epistaxis, Xhance 186 mcg (11.9%)

                1-10%

                Nasal congestion (8%)

                Pharyngitis (6-8%)

                Asthma symptoms (3-7%)

                Fever (1-5%)

                Dysphonia (4%)

                Cough (3-4%)

                Nasal discharge (1-3%)

                Aches and pains (1-3%)

                Flu-like syndrome (1-3%)

                Bronchitis (1-3%)

                Diarrhea (1-3%)

                Abdominal pain (1-3%)

                Nasal ulcer (1%)

                Xhance 186 mcg

                • Nasal septal ulceration (6.9%)
                • Nasal mucosal erythema (5.6%)
                • Headache (5%)
                • Nasal congestion (4.4%)
                • Acute sinusitis (4.4%)
                • Nasal mucosal ulceration (3.8%)
                • Nasal septal erythema (3.8%)
                • Nasopharyngitis (1.9%)
                • Pharyngitis (1.3%)

                Xhance 372 mcg

                • Epistaxis (9.9%)
                • Nasopharyngitis (7.5%)
                • Nasal septal ulceration (7.5%)
                • Nasal congestion (5.6%)
                • Acute sinusitis (5%)
                • Nasal mucosal erythema (5%)
                • Nasal septal erythema (4.3%)
                • Headache (3.7%)
                • Pharyngitis (3.1%)
                • Nasal mucosal ulceration (2.5%)
                • Nasal dryness (≥1%)
                • Sinusitis (≥1%)
                • Oropharyngeal pain (≥1%)
                • Toothache (≥1%)
                • Intraocular pressure increase (≥1%)

                Frequency Not Defined

                Loss of taste

                Postmarketing Reports

                Respiratory, thoracic, and mediastinal disorders: Rhinalgia, nasal discomfort (including nasal burning, nasal irritation, and nasal soreness), nasal dryness, and nasal septal perforation

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                Warnings

                Contraindications

                Hypersensitivity to fluticasone or ingredients

                Cautions

                May mask acute infection, including fungal infection, exacerbate viral infections or limit response to vaccines; not for use in untreated localized infection involving nasal mucosa; administer antimicrobial therapy if bacterial infection of sinuses suspected or confirmed; respiratory tract fungal or bacterial infections, parasitic infections, ocular herpes simplex may occur

                Persons who are using drugs that suppress the immune system, such as corticosteroids, are more susceptible to infections than healthy individuals and may experience a worsening of existing infections

                Chickenpox and measles: Serious or fatal course in susceptible individuals; unvaccinated or immunologically unexposed children or adults should avoid exposure

                Delays wound healing of nasal septal ulcers, trauma, or surgery; best to administer after healing has occurred

                May increase risk of hypercorticism or hypothalamic-pituitary adrenal (HPA) axis suppression, especially in younger patients receiving high doses for prolonged periods; HPA suppression may lead to adrenal crisis; withdraw or discontinue slowly; pediatric patients may be more susceptible to systemic toxicity

                Nasal corticosteroids, including fluticasone propionate, may result in the development of glaucoma and/or cataracts; closely monitor vision changes or patients with a history of increased intraocular pressure (IOP), glaucoma, and/or cataracts

                Systemic corticosteroids has shown to cause a reduction in growth velocity in children and adolescents; monitor growth while taking intranasal corticosteroids

                Decreases in bone mineral density (BMD) have been observed with long-term oral inhalation of products containing corticosteroids into lungs; monitor and appropriately treat patients with major risk factors for decreased bone mineral content (eg, prolonged immobilization, family history of osteoporosis, postmenopausal status, tobacco use, advanced age, poor nutrition, or chronic use of drugs that can reduce bone mass [eg, anticonvulsants, oral corticosteroids])

                Avoid in patients with known hypersensitivity to fluticasone or any ingredient; see Contraindications

                Avoid concomitant use with strong CYP3A4 (eg, ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, ketoconazole, telithromycin, conivaptan, lopinavir, voriconazole)

                Local nasal effects

                • Epistaxis, nasal erosions, and nasal ulcerations were reported
                • Nasal septal perforations have been reported; patients treated over several months or longer should be examined periodically for possible changes in the nasal mucosa
                • If a septal perforation is noted, discontinue treatment; avoid spraying directly on septum
                • Localized Candida albicans infections have been observed; if such an infection develops, consider appropriate local therapy and discontinuation treatment; periodically examine for evidence of candidal infection in the nasal and oropharyngeal mucosa
                • Avoid use in patients who have experienced recent nasal ulcerations, nasal surgery, or nasal trauma
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                Pregnancy & Lactation

                Pregnancy

                Available data on inhaled or intranasal fluticasone propionate use in pregnant women have not reported a clear association with adverse developmental outcomes

                Fluticasone propionate crossed the placenta following subcutaneous administration to mice and rats and oral administration to rabbits

                Lactation

                There are no available data on fluticasone propionate in human milk, effects on breastfed child, or effects on milk production

                Developmental and health benefits of breastfeeding should be considered and adverse effects on breastfed child from treatment or from an underlying maternal condition

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Potent anti-inflammatory corticosteroid with vasoconstrictive properties

                Available in 2 salt forms, fluticasone propionate (Flonase, Xhance) and fluticasone furoate (Veramyst)

                Absorption

                Peak plasma concentration, 186 mcg dose: 17.2 pg/mL

                Peak plasma concentration, 372 mcg dose: 25.3 pg/mL

                AUC, 186 mcg dose: 111.7 pg·h/mL

                AUC, 372 mcg dose: 171.7 pg·h/mL

                Bioavailability: ≤2%

                Onset of action: May take several days to achieve optimum benefit

                Distribution

                Vd: 4.2 L/kg

                Protein binding: 99%

                Metabolism

                Metabolized by CYP3A4 pathway; only circulating metabolite detected in humans is 17β-carboxylic acid derivative of fluticasone propionate

                Elimination

                Half-life: 7.8 hr

                Clearance: 1093 mL/min

                Renal clearance: <0.02% of total clearance

                Excretion: Urine (<5%); feces (remaining amount excreted as parent drug and metabolites)

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                Administration

                Nasal Spray Preparation

                ClariSpray

                • Gently shake bottle
                • Prime spray when starting new bottle; have not used spray in a week, or just cleaned nozzle
                • Aim away from face; grasp spray bottle and pump until fine mist appears
                • Blow nose gently to clear nostrils

                Flonase Allergy Relief

                • Gently shake bottle
                • Remove green cap
                • Blow your nose gently to clear nostrils

                Flonase Sensimist Allergy Relief

                • Shaken vigorously with the cap on
                • Prime spray when starting a new bottle, using a bottle you haven't used in 30 days, when cap has been left off for ≥5 days, or when device doesn't seem to be working correctly
                • Aim away from face and grasp spray bottle on either side
                • Pump until fine mist appears
                • Blow nose gently to clear nostrils

                Xhance

                • Avoiding spraying directly on the nasal septum
                • Shake before each use
                • Before initial use, prime by first gently shaking and then press bottle until a fine mist appears (≥7 times)
                • Direct the spray into the air, away from the face
                • If nasal spray has not been used ≥7 days, prime pump again by shaking and releasing 2 sprays into the air, away from face

                Nasal Spray Administration

                Flonase Allergy Relief and Clarispray

                • Aim slightly away from center of nose
                • Spray once or twice; breathe out through mouth
                • Repeat in other nostril

                Flonase Sensimist Allergy Relief

                • Aim tip of spray nozzle into a nostril and tilt head forward while keeping bottle upright
                • Press button in all the way once or twice (according to proper dosing) Breathe out through your mouth
                • Repeat in other nostril
                • Wipe spray nozzle with clean tissue and replace cap

                Xhance

                • Administer intranasal route only
                • Insert tapered tip of cone-shaped nosepiece into one nostril and form a tight seal between nosepiece and nostril
                • Next, place flexible mouthpiece into the mouth, bending it as necessary to maintain a tight seal
                • Blow into mouthpiece, and while continuing to blow, push the bottle up to actuate the spray pump
                • Continuing to blow through mouth, but not inhaling/exhaling through the nose, at time of actuation is important to achieve intended drug deposition
                • Repeat process in other nostril for a full dose

                Storage

                ClariSpray, Flonase, Flonase Allergy Relief: Store at 4-30°C (39-86°F)

                Flonase Sensimist: Store at 15-30°C (59-86°F); do not refrigerate or freeze

                Xhance: Store at room temperature 15-25°C (59-77°F), excursions permitted from 15-30°C (59-86°F); avoid exposure to extreme heat, cold or light

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.005 % ointment
                fluticasone propionate topical
                -
                0.005 % ointment
                fluticasone propionate topical
                -
                0.005 % ointment
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % lotion
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.005 % ointment
                fluticasone propionate topical
                -
                0.005 % ointment
                fluticasone propionate topical
                -
                0.005 % ointment
                fluticasone propionate topical
                -
                0.05 % lotion
                fluticasone propionate topical
                -
                0.05 % cream
                fluticasone propionate topical
                -
                0.05 % lotion
                Children's Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Children's Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                ArmonAir Digihaler inhalation
                -
                113 mcg/actuation aerosol
                fluticasone propionate inhalation
                -
                110 mcg/actuation aerosol
                fluticasone propionate inhalation
                -
                44 mcg/actuation aerosol
                Beser topical
                -
                0.05 % lotion
                Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Flonase Allergy Relief nasal
                -
                50 mcg/actuation suspension
                Xhance nasal
                -
                93 mcg/actuation aerosol
                Xhance nasal
                -
                93 mcg/actuation aerosol
                Flovent Diskus inhalation
                -
                100 mcg/actuation aerosol
                Flovent Diskus inhalation
                -
                250 mcg/actuation aerosol
                Flovent Diskus inhalation
                -
                100 mcg/actuation aerosol
                Flovent Diskus inhalation
                -
                250 mcg/actuation aerosol
                Flovent Diskus inhalation
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation suspension
                fluticasone propionate nasal
                -
                50 mcg/actuation suspension
                fluticasone propionate nasal
                -
                50 mcg/actuation suspension
                fluticasone propionate nasal
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation suspension
                fluticasone propionate nasal
                -
                50 mcg/actuation suspension
                fluticasone propionate nasal
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation aerosol
                fluticasone propionate nasal
                -
                50 mcg/actuation suspension
                ClariSpray nasal
                -
                50 mcg/actuation suspension
                Flovent HFA inhalation
                -
                220 mcg/actuation aerosol
                Flovent HFA inhalation
                -
                44 mcg/actuation aerosol
                Flovent HFA inhalation
                -
                110 mcg/actuation aerosol

                Copyright © 2010 First DataBank, Inc.

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                Patient Education
                fluticasone propionate topical

                FLUTICASONE - TOPICAL

                (floo-TIK-a-sone)

                COMMON BRAND NAME(S): Cutivate

                USES: This medication is used to treat a variety of skin conditions (such as eczema, psoriasis, rash). Fluticasone reduces swelling (inflammation), itching, and redness. This medication is a medium-strength corticosteroid. It is available in several forms, including cream, ointment, and lotion. Your doctor will choose the type of product based on your skin condition and the area of your body to be treated.Fluticasone ointment is not recommended for use by children because of the risk of serious side effects.

                HOW TO USE: Use this medication on the skin only. However, do not use it on the face, groin, or underarms, or for diaper rash, unless directed to do so by your doctor.Wash and dry your hands before using. Clean and dry the affected area. Apply a thin film of medication to the affected area and gently rub in as directed by your doctor, usually once or twice daily. Do not bandage, cover, or wrap the area unless directed to do so by your doctor.Wash your hands after each use, unless you are using this medication to treat the hands. Avoid getting this medication in your eyes because it may worsen or cause glaucoma. Also avoid getting it in your nose or mouth. If medication gets in these areas, rinse with plenty of water.Use this medication only for the condition prescribed. Do not apply large amounts of this medication, use it more often, or use it for longer than prescribed. Your condition will not improve any faster, and your risk of side effects may increase.Tell your doctor if your condition does not improve in 2 weeks or if it worsens.

                SIDE EFFECTS: Burning, itching, stinging, or dryness may occur when you apply this medication, but usually only lasts a short time. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: stretch marks, skin thinning/discoloration, acne, excessive hair growth, small red bumps on the skin (folliculitis).Rarely, it is possible this medication will be absorbed from the skin into the bloodstream. This can lead to side effects of too much corticosteroid. These side effects are more likely in children, and in people who use this medication for a long time or over large areas of the skin. Tell your doctor right away if any of the following side effects occur: unusual/extreme tiredness, weight loss, headache, swelling ankles/feet, increased thirst/urination, vision problems.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using fluticasone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as formaldehyde), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: poor blood circulation, diabetes, immune system problems.Corticosteroids can make skin infections worse and more difficult to treat. Tell your doctor if you have a skin infection or if your condition does not improve.Rarely, using corticosteroid medications for a long time or over large areas of skin can make it more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past few months.Though it is unlikely, this medication may temporarily slow down a child's growth if used for a long time. See the doctor regularly so your child's height can be checked.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

                OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for other skin problems unless told to do so by your doctor. A different medication may be necessary in those cases.Lab and/or medical tests (such as adrenal gland function) may be done while you are using this medication, especially if you use this drug for a long time or apply it over large areas of the body. Keep all medical and lab appointments. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

                Information last revised April 2023. Copyright(c) 2023 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.