Fluticasone Propionate

PAEDIATRIC (this page's primary use) — typical starting doses for children over 4 years of age: 50 to 100 micrograms twice daily. Many children's asthma will be well controlled on the 50 to 100 microgram twice-daily regimen; for those not sufficiently controlled, additional benefit may be obtained by increasing the dose up to 200 micrograms twice daily, which is the maximum licensed paediatric dose. The starting dose should be appropriate to the severity of the disease and should then be titrated down to the lowest dose at which effective control of asthma is maintained. If the Flixotide 50 microgram Evohaler presentation does not offer the exact paediatric dose prescribed, see the data sheets of the alternative Flixotide presentations (Accuhaler, Nebules). The retrieved posology gives doses only for adults and children over 16 years and for children over 4 years of age — no dose is stated for children aged 4 years and under, and no per-kg dosing is given anywhere. Paediatric dosing is safety-critical: verify against a children's formulary. POTENCY EQUIVALENCE: fluticasone propionate is as effective as other inhaled steroids at approximately half the microgram daily dose — 100 micrograms of fluticasone propionate is approximately equivalent to a 200 microgram dose of beclometasone dipropionate (CFC-containing) or budesonide. NOT A RELIEVER: Flixotide Evohaler is not designed to relieve acute symptoms, for which an inhaled short-acting bronchodilator is required; patients should be advised to have rescue medication available. If relief with short-acting bronchodilator treatment becomes less effective, or more inhalations than usual are needed, medical attention must be sought. SYSTEMIC EFFECTS: possible at high doses given for prolonged periods — Cushing's syndrome, Cushingoid features, adrenal suppression, growth retardation in children and adolescents, decreased bone mineral density, and psychological/behavioural effects (psychomotor hyperactivity, sleep disorders, anxiety, depression, aggression — particularly in children); review the dose regularly and reduce to the lowest effective dose. Check inhaler technique regularly. SPECIAL GROUPS: there is no need to adjust the dose in elderly patients or in those with hepatic or renal impairment. US SOURCE NOTE: the openFDA record in this bundle is an over-the-counter fluticasone propionate NASAL SPRAY (adults and children 12 years and over, 2 sprays in each nostril once daily; children 4 to 11 years, 1 spray in each nostril once daily; children under 4 years, do not use) — a different formulation, route and indication. None of its figures have been used for this inhaled-asthma page.