What you need to know about Flovent (fluticasone propionate)

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Flovent (fluticasone propionate) is an inhaled corticosteroid that people with asthma use regularly to maintain long-term symptom control and prevent asthma attacks. Like other types of corticosteroids , Flovent suppresses the immune response, which in turn reduces the inflammation that causes hyperresponsiveness of the airways.

The two FDA-approved forms of Flovent, Flovent HFA (fluticasone spray) and Flovent Diskus (powder form), are available by prescription only. There are no general forms in the United States.

Other FDA-approved fluticasone inhalants used to treat asthma include ArmonAir RespiDisk, ArmonDisk Digihaler, and Arnuity Ellipta.

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Applications

Flovent, called preventive therapy, has long been used to prevent asthma symptoms.

Flovent should not be used to relieve sudden seizures and is not a substitute for a rescue inhaler . Rather, it is prescribed as an adjunct to treatment when an emergency inhaler alone is not effective in controlling asthma symptoms.

Flovent can be used alone, but it is more common to combine it with a long-acting beta agonist (LABA) .

In the past, inhaled corticosteroids were tried before LABAs, but current guidance from the Global Asthma Initiative (GINA) recommends starting them together for better long-term control.

For Flovent to work, it must be used on a regular schedule as directed by your doctor.

There are two types of Flovent approved by the FDA for adults and children over 4 years of age:

  • Flovent HFA is an aerosolized form of fluticasone that is given in a conventional metered dose inhaler . It uses an aerosol propellant to deliver medicine to the lungs.
  • Flovent Diskus is a powder that does not require a propellant for the medicine to reach the lungs. Instead, you should inhale the dust yourself.

While neither is inherently better than the other at treating asthma symptoms, there are factors that can make one more attractive to you than the other.

Flovent HFA

  • Manual coordination is required, which may seem inconvenient to new users.

  • Familiar feature for experienced inhaler users

  • It can be used with a spacer to reduce the amount of drug in the mouth.

  • Before use, it is necessary to prime; if used irregularly, it can become clogged.

  • Expiration date 12 months.

Flovent disc

  • Requires a simple inhalation (no manual coordination required)

  • Cannot be used with spacer

  • It does not require primer and generally does not clog.

  • It should be used for six weeks to two months, depending on the strength of the action.

  • Does not require regular washing

Before drinking

Flovent HFA and Flovent Diskus are generally prescribed when a short-acting reliever inhaler such as albuterol cannot effectively control asthma symptoms.

If you use an emergency inhaler more than twice a week, the American Academy of Allergy, Asthma, and Immunology (AAAAI) recommends adding inhaled medications daily for better long-term control. These include inhaled corticosteroids such as inhaled Flovent and LABA. such as Serevent (salmeterol).

The decision to start Flovent is based on the frequency and severity of the asthma attacks. Although pulmonary function tests (PFTs) play a central role in the diagnosis of asthma , the administration of inhaled steroids does not affect an asthma treatment plan as much.

Precautions and contraindications.

People with a known allergy to fluticasone propionate or fluticasone furoate (a similar medicine) should not take Flovent.

People with a known milk allergy should not take Flovent Diskus as it contains lactose powder, which in rare cases may be contaminated with milk protein.

People with certain medical conditions should also be careful when taking Flovent:

Although Flovent is not contraindicated in people with these conditions, taking it for a long period of time can accelerate the progression of the disease. Special care should be taken to monitor anyone taking Flovent who has vision problems, adrenal dysfunction, or osteoporosis .

Caution should also be exercised when considering prescribing Flovent to adults over 65, as they are more likely to have these health problems and / or take multiple medications, some of which may interact with Flovent.

Both Flovent HFA and Flovent Diskus have been found to be potentially harmful to the fetus in animal studies, but well-controlled human studies are not available. The benefits of treatment may outweigh the risks to the pregnant woman, but the situation should be carefully considered under the guidance of a physician or healthcare provider.

Other corticosteroid options

There are other types of inhaled corticosteroids available if fluticasone does not provide adequate control or causes excruciating side effects. These include combination inhalers that use both inhaled steroids and LABAs.

Inhaled steroids and FDA-approved steroid / LABA combinations for moderate to severe asthma include:

Dose

Flovent HFA is available in doses of 44 mcg (mcg), 110 mcg, and 220 mcg. Flovent Diskus is available in doses of 50, 100 and 250 mcg.

The recommended dose depends on the age of the person. As a general rule, the lowest dose should be used when starting for the first time and increased if necessary, never exceeding the recommended daily dose.

This is especially important for children, as Flovent's action on the adrenal glands can slow growth, although the risk is considered low because the drug is administered by inhalation rather than by injection or ingestion. However, children should receive the lowest possible dose and monitor their growth during treatment.

Recommended dose
Flovent HFA Flovent disc
Adults and adolescents over 12 years of age. Start with 88 mcg twice a day.
Never exceed 880 mcg twice a day.
Start with 100 mcg twice a day.
Never exceed 100 mcg twice a day.
Children from 4 to 11 years old Limit intake to 88 mcg twice a day.
Never exceed 88 mcg twice a day.
Start with 50 mcg twice a day.
Never exceed 100 mcg twice a day.
All doses must be divided into 12 hours.

It takes one to two weeks from the start of Flovent treatment to experience the full benefits. Most people need to take Flovent every day. However, according to the National Institutes of Health (NIH) Asthma Management updated December 2020, this may not be necessary for patients with mild to moderate persistent asthma. If you use an asthma inhaler on a daily basis, talk to your doctor about how the new recommendations could affect your treatment.

If you feel like you have good control of your asthma, you can talk to your doctor about reducing the concentration of your daily dose.

If Flovent cannot control your symptoms, tell your doctor. A long-acting beta agonist may be added to your daily treatment plan as needed, or an oral corticosteroid may be recommended if your asthma attacks are severe and recurring.

How to take and store

Both Flovent HFA and Flovent Diskus can be stored at room temperature between 68 and 77 degrees F. Keep Flovent HFA away from open flames or other heat sources and do not pierce the container. Keep both medicines out of the reach of children.

Since Flovent HFA and Flovent Diskus are supplied differently, the instructions for use are different. Talk to your doctor or pharmacist if you are not sure whether you are using the Flovent inhaler correctly.

Using Flovent HFA:

  1. When you first use the inhaler (or if you haven't used it for four weeks), fill it by spraying it into the air four times. You only need to spray it once if you haven't used it for one to three weeks.
  2. Shake the inhaler vigorously for five seconds.
  3. Remove the cap and, if you use one, place a spacer over the end.
  4. Exhale fully and place the mouthpiece in your mouth at the lowest position, closing your lips tightly to form a seal.
  5. Inhale deeply through your mouth while pressing the inhaler all the way in at the same time.
  6. Hold your breath for about 10 seconds and breathe out slowly.
  7. If additional doses are needed, wait 30 seconds, shake the inhaler, and start again.
  8. When done, rinse your mouth. Do not swallow it.
  9. Replace the cap.

Clean the mouthpiece and spacer at least once a week. When the dose counter reads "020", it is time to recharge.

Using Flovent Diskus:

  1. Push the handle up and down until it stops to open the disc.
  2. Hold the disc at the level of the mouthpiece with it towards you.
  3. Slide the lever next to the nozzle down until it clicks. This loads a precise dose onto the disk drive.
  4. Keep the puck away from your face and breathe out fully.
  5. Press your mouth firmly against the mouthpiece and inhale as deeply as possible.
  6. Remove your mouth from the mouthpiece, holding your breath for about 10 seconds.
  7. Exhale slowly and completely.
  8. If additional doses are needed, repeat the steps above.
  9. Close the mouthpiece cap when done.

When the dose counter on the disk reads "5", refill the prescription. Do not rinse the inhaler. Keep it dry at all times.

If you miss a dose of Flovent HFA or Flovent Diskus, take it as soon as possible. However, if it is nearing time for your next dose, skip the missed dose and go back to your normal dosing schedule. Never double your dose.

Side effects

While Flovent is generally safe to use, Flovent does carry some risk of side effects, most of which decrease as you use it. If side effects persist or get worse, tell your doctor.

general

The side effects of Flovent HFA and Flovent Diskus are similar. While Flovent Diskus has fewer constitutional symptoms, comparatively Flovent HFA has a much lower risk of oral yeast infection (thrush) due to the use of spacers.

The most common side effects of Flovent HFA and Flovent Diskus (in order of frequency) are:

Flovent HFA
Flovent disc

Severe form

Although Flovent is considered safe with relatively few excruciating side effects, it can cause problems with long-term use. Some of these may be associated with the development of cataracts, glaucoma, loss of bone minerals, or adrenal dysfunction, which can occur, albeit infrequently, in Flovent users.

Call your doctor if you experience any of the following symptoms while using Flovent HFA or Flovent Diskus:

  • Blurry vision
  • Eye pain
  • Loss of sight
  • erectile dysfunction
  • Irregular or missed periods
  • Difficulty breathing or wheezing
  • Hot
  • Bone fractures
  • Severe weakness
  • Confusion or disorientation

When to call 911

Seek emergency help if you experience symptoms of anaphylaxis after using Flovent:

  • Rash or hives
  • Difficulty breathing
  • Wheezing
  • Fast or irregular heartbeat
  • Dizziness or lightheadedness
  • Swelling of the face, tongue, or throat
  • Feeling of impending doom

If left untreated, anaphylaxis can lead to shock, coma, suffocation, heart or respiratory failure, or death.

Warnings and interactions

Because Flovent can suppress the immune system, children may also be at higher risk for infectious diseases, so parents should try to avoid diseases such as measles or chickenpox. If your child's school has an outbreak or your child becomes infected, speak to your healthcare provider right away for advice on what to do.

Stop taking Flovent if you develop thrush because the medicine can make it worse. You should call your asthma doctor if you develop a respiratory infection, especially a lower respiratory infection , as you may also need to temporarily stop treatment.

Drug concentration problems

In the body, Flovent HFA and Flovent Diskus are metabolized by the enzyme cytochrome P450 (CYP450). Because of this, it can interact with other drugs that are metabolized by the same enzyme. In this case, the concentration of one or both drugs may increase or decrease.

Lowering the concentration of the drug may reduce the effectiveness of the drug, and increasing it may increase the risk of side effects.

Potentially dangerous drugs include:

Some interactions may require changing the medication, reducing the dose, or dividing each dose over several hours to avoid interactions. Others may not require any adjustments.

Due to the wide range of possible interactions, it is important that your healthcare provider9 is aware of any medications you are taking, whether they are prescription, over-the-counter, herbal, nutritional, or recreational medications.

Get the word of drug information

Flovent HFA and Flovent Diskus are valuable medications for managing asthma symptoms, but they only work if you take them as directed. If you are having trouble sticking with your asthma treatment plan, talk to your doctor about how to make it easier for you to adhere to this protocol.

If your symptoms are not controlled, you may have been taking the medicine the wrong way. In other cases, your healthcare provider may choose a one-time daily inhaler for you, such as the Breo Ellipta, if needed.

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