corticosteroid inhaled

Fluticasone Propionate

Flovent / Flonase / Advair (with salmeterol) / Breo (with vilanterol)

Route: inhaled (MDI — HFA) · inhaled (DPI — Diskus) · nasal spray
Onset: 12–24 hours (anti-inflammatory); maximum effect 1–2 weeks
Duration: Sustained with regular use

Mechanism of action

High-potency synthetic glucocorticoid. High receptor binding affinity (approximately 3× beclomethasone). Reduces airway inflammation via glucocorticoid receptor-mediated gene regulation.

Dosing

Adult: Flovent HFA MDI: 88–440 mcg BID. Flovent Diskus DPI: 100–500 mcg BID
Pediatric: ≥4 years: 88 mcg BID (low dose); titrate up

Indications

Asthma maintenance (all severity)
COPD with frequent exacerbations (adjunct)
Allergic rhinitis (nasal formulation)

Contraindications

Acute bronchospasm
Status asthmaticus as sole therapy
Hypersensitivity to fluticasone

Side effects

Oropharyngeal candidiasis
Dysphonia
Upper respiratory infection
Adrenal suppression (high doses)
Bone mineral density loss
Pneumonia risk in COPD patients (higher with fluticasone vs. budesonide)

Monitoring parameters

Oral cavity (candidiasis)
Growth velocity in pediatric patients
Bone density with long-term high-dose use
HPA axis suppression
Pneumonia symptoms in COPD patients

Drug interactions

Strong CYP3A4 inhibitors (ritonavir — significant fluticasone accumulation)
Systemic corticosteroids (additive HPA suppression)

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