![]() Hypersensitivity: Hypersensitivity reactions (including anaphylaxis, angioedema, rash, contact dermatitis, hypotension, bronchospasm, and urticaria) have been reported discontinue for severe reactions.Delayed wound healing: Avoid use in patients with recent nasal septal ulcers, nasal surgery, or nasal trauma until healing has occurred.Concurrent use of ritonavir (and potentially other strong inhibitors of CYP3A4) may increase fluticasone levels and effects on HPA suppression. Adult patients receiving ≥20 mg per day of prednisone (or equivalent) may be most susceptible. Particular care is required when patients are transferred from systemic corticosteroids to inhaled products due to possible adrenal insufficiency or withdrawal from steroids, including an increase in allergic symptoms. Pediatric patients may be more susceptible to systemic toxicity. Withdrawal and discontinuation of a corticosteroid should be done slowly and carefully. HPA axis suppression may lead to adrenal crisis. Adrenal suppression: May cause hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods.<1%, postmarketing, and/or case reports: Altered sense of smell, anaphylactoid reaction, anaphylaxis, angioedema, blurred vision, bronchospasm, cataract, conjunctivitis, contact dermatitis, dry eye syndrome, dry throat, dysgeusia, dyspnea, esophageal candidiasis, eye irritation, facial edema, glaucoma, growth suppression, hoarseness, hypersensitivity reaction, intestinal candidiasis, nasal candidiasis, nasal septum perforation, pharyngeal candidiasis, pruritus, skin rash, sore throat, throat irritation, tongue edema, urticaria, voice disorder, wheezing Warnings/Precautions Respiratory: Epistaxis (6% to 12%), nasal mucosa ulcer (3% to 8% includes nasal septal ulceration), pharyngitis (3% to 8%), nasopharyngitis (8%), acute asthma (7%), nasal congestion (6%), acute sinusitis (5%), cough (4%), blood in nasal mucosa (1% to 3%), bronchitis (1% to 3%), flu-like symptoms (1% to 3%), rhinorrhea (1% to 3%), dry nose (1% to <3%), oropharyngeal pain (1% to <3%), sinusitis (1% to <3%) Ophthalmic: Increased intraocular pressure (1% to <3%) Gastrointestinal: Nausea and vomiting (3% to 5%), abdominal pain (1% to 3%), diarrhea (1% to 3%), abdominal distress (1% to <3%), toothache (1% to <3%) Oral: Feces (as parent drug and metabolites) Urine (10%: Central nervous system: Headache (4% to 16%)Ĭentral nervous system: Body pain (1% to 3%), dizziness (1% to 3%), generalized ache (1% to 3%)Įndocrine & metabolic: Weight gain (1% to <3%) Hepatic via CYP3A4 to 17 beta-carboxylic acid (negligible activity) Excretion Fluticasone belongs to a group of corticosteroids which utilizes a fluorocarbothioate ester linkage at the 17 carbon position extremely potent vasoconstrictive and anti-inflammatory activity Pharmacokinetics/Pharmacodynamics Distributionįluticasone propionate: 4.2 L/kg Fluticasone furoate: V d,ss: 608 L Metabolism
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