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Fluticasone Propionate: Brands, Price & Uses in Bangladesh
Fluticasone Propionate is a synthetic corticosteroid used topically (intranasally, by oral inhalation, or by nebulisation) for its local anti-inflammatory effect.
About Fluticasone Propionate
Indications of Fluticasone Propionate
Fluticasone Propionate is a synthetic corticosteroid used topically (intranasally, by oral inhalation, or by nebulisation) for its local anti-inflammatory effect. In Bangladesh it is marketed as a nasal spray, a pressurized/dry powder inhaler, and a nebuliser suspension.
Established / FDA-approved and guideline-supported uses
- Allergic rhinitis (nasal spray): Prophylaxis and treatment of symptoms of seasonal and perennial allergic rhinitis (sneezing, nasal congestion, rhinorrhoea, itching) in adults and children.
- Nasal polyps (nasal spray, higher strength): Treatment of chronic rhinosinusitis with or without nasal polyps, and prevention of polyp recurrence after surgical removal.
- Asthma - maintenance/prophylaxis (inhaler and nebuliser suspension): Regular maintenance treatment of mild, moderate, and severe persistent asthma in adults and children, including patients previously controlled on bronchodilators alone or on other inhaled corticosteroids.
Uses requiring combination therapy
- In patients with more severe or poorly controlled asthma, Fluticasone Propionate is often combined with a long-acting beta-agonist (LABA, e.g. salmeterol or formoterol) as part of a step-up regimen, rather than used alone.
Important exclusion
Fluticasone Propionate inhaler/nebuliser suspension is not indicated for the relief of acute bronchospasm or as a rescue treatment for status asthmaticus or other acute asthma episodes; a fast-acting bronchodilator ("reliever" inhaler) is required for that purpose.
Dosage & Administration of Fluticasone Propionate
Allergic rhinitis / nasal polyps - Nasal spray
| Population | Strength | Dose |
|---|---|---|
| Adults and children 12 years and older | 50 mcg/spray | 2 sprays per nostril once daily (200 mcg/day); may reduce to 1 spray per nostril once controlled (max 200 mcg/day) |
| Children 4-11 years | 50 mcg/spray | 1 spray per nostril once daily (100 mcg/day); do not exceed this dose |
| Chronic rhinosinusitis/nasal polyps (adults) | 93 mcg/spray | 1-2 sprays per nostril twice daily (max 744 mcg/day) |
Administration: Shake the bottle gently before use, prime before first use, tilt head slightly forward, insert nozzle into one nostril pointing away from the nasal septum, and spray while gently breathing in through the nose; avoid spraying directly onto the septum.
Asthma maintenance - Inhaler (pMDI/DPI)
| Population | Dose range |
|---|---|
| Adults and children >16 years | 100-1000 mcg twice daily, titrated to the lowest dose that controls symptoms, according to asthma severity |
| Children 4-16 years | 50-200 mcg twice daily |
| Children 1-4 years (via spacer with face mask) | Up to 100 mcg twice daily, under specialist supervision |
Asthma maintenance - Nebuliser suspension
Typically 0.5-2 mg twice daily via jet nebuliser, dose individualised by age and asthma severity, and stepped down to the lowest effective dose once control is achieved.
Administration: Shake the inhaler before use; use a spacer device where recommended, especially in children; hold the breath for about 10 seconds after inhalation; always rinse the mouth with water (and spit it out) after each inhaled dose to reduce the risk of oral thrush and hoarseness.
Dose should be titrated to the lowest amount that maintains effective control of symptoms; do not use for immediate relief of acute bronchospasm (see Indications and Precautions).
Side Effects of Fluticasone Propionate
Local effects
- Nasal spray: Nasal dryness, irritation, unpleasant taste/smell, epistaxis (nosebleed), nasal ulceration; rarely, nasal septal perforation with prolonged use.
- Inhaler/nebuliser: Oral and throat candidiasis (thrush), hoarseness (dysphonia), throat irritation, and occasionally paradoxical bronchospasm immediately after dosing - rinse the mouth after each inhaled dose to reduce this risk.
Systemic effects (uncommon at recommended doses, more likely with high-dose or prolonged use)
- HPA-axis (adrenal) suppression, Cushingoid features
- Reduced growth velocity in children
- Reduced bone mineral density with long-term use
- Increased risk of cataracts and glaucoma with prolonged use
- Increased risk of pneumonia has been observed in patients with COPD using inhaled Fluticasone Propionate-containing products
Hypersensitivity reactions (rash, angioedema, bronchospasm, anaphylaxis) are rare but can occur.
Contraindications of Fluticasone Propionate
Fluticasone Propionate is contraindicated in patients with known hypersensitivity to fluticasone propionate or to any excipient in the formulation. Nasal and inhaled corticosteroid forms are not intended as sole therapy for status asthmaticus or other acute episodes of bronchospasm requiring intensive measures.
Frequently Asked Questions about Fluticasone Propionate
What is Fluticasone Propionate used for?
Fluticasone Propionate is a corticosteroid used as a nasal spray for allergic rhinitis (and nasal polyps) and as an inhaler or nebuliser suspension for the long-term maintenance treatment of asthma. It reduces inflammation but is not a fast-acting reliever medicine.
Can I use the Fluticasone Propionate inhaler for a sudden asthma attack?
No. Fluticasone Propionate inhaler/nebuliser suspension does not relieve acute bronchospasm or a sudden asthma attack. It is a preventer medicine that must be used regularly; for sudden symptoms, a fast-acting reliever/rescue inhaler is needed, and you should seek medical attention if symptoms do not improve.
Why do I need to rinse my mouth after using the Fluticasone Propionate inhaler?
Rinsing the mouth with water and spitting it out after each dose of the Fluticasone Propionate inhaler or nebuliser suspension helps prevent oral thrush (candidiasis) and hoarseness, which are common local side effects of inhaled corticosteroids.
Is it safe to use Fluticasone Propionate nasal spray during pregnancy or while breastfeeding?
Fluticasone Propionate should be used during pregnancy or lactation only if a physician determines that the potential benefit justifies any potential risk, since safety has not been definitively established in humans; do not start or stop use in pregnancy without consulting your physician, as uncontrolled asthma or rhinitis can also carry risks.
Can children use Fluticasone Propionate?
Yes, under medical supervision. The 50 mcg nasal spray is approved for allergic rhinitis in children 4 years and older, and the inhaler/nebuliser suspension can be used for asthma in younger children at doses set by a physician. Growth should be monitored periodically during long-term use.
What if I accidentally use more Fluticasone Propionate than prescribed?
A single accidental extra dose is unlikely to cause harm, but if a large overdose is taken or symptoms of excess corticosteroid effect appear, contact a doctor, hospital emergency department, or poison control center immediately for advice; do not attempt to treat an overdose at home.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.