Fluticasone Propionate Nasal prep

Indications

Fluticasone Propionate Nasal prep is used for: Seasonal and Perennial allergic and nonallergic, rhinitis, Nasal polyps

Adult Dose

Nasal Allergic rhinitis Adults: 2 sprays(100mcg) in each nostril once a day, preferably in the morning. In some cases 2 sprays into each nostril twice daily, not exceeding 4 sprays. Nasal polyps Adult: 4 sprays (200 mcg) into each nostril 1-2 times daily for at least 4-6 wk.

Child Dose

Nasal Allergic rhinitis Children over 12 years: 2 sprays(100mcg) in each nostril once a day, preferably in the morning. In some cases 2 sprays into each nostril twice daily, not exceeding 4 sprays. Children under 12 years (4 - 11 Years): 1 spray (50mcg) in each nostril once a day. The maximum total daily dosage should not exceed 4 sprays. Nasal polyps Child: >16 yr 4 sprays (200 mcg) into each nostril 1-2 times daily for at least 4-6 wk.

Renal Dose

Administration

Contra Indications

Hypersensitivity.

Precautions

Rarely, immediate hypersensitivity reactions or contact dermatitis may occur after the administration of Fluticasone Propionate nasal spray. Rare instances of wheezing, nasal septum perforation, cataracts, glaucoma and increased intraocular pressure have been reported following the intranasal application of corticosteroids, including Fluticasone Propionate. Although systemic effects have been minimal with recommended doses of Fluticasone Propionate nasal spray, potential risk increases with larger doses. Therefore, larger than recommended doses of Fluticasone Propionate nasal spray should be avoided. Lactation: Unknown whether distributed in breast milk; caution advised

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

Interactions

May lead to increased plasma concentrations of fluticasone when used with CYP4503A4 inhibitors such as ritonavir.

Adverse Effects

Side effects of Fluticasone Propionate Nasal prep : >10% Headache (17%), URI (15%) 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%) Frequency Not Defined Loss of taste With the nasal spray, drying of the nose and an increase in the incidence of nosebleeds may occur. Potentially Fatal: Paradoxical bronchospasm.

Mechanism of Action

Fluticasone utilises a fluorocarbothioate ester linkage at the C17 position. It has potent vasoconstrictive and anti-inflammatory activity, but weak HPA inhibitory effect when applied topically.