Fluticasone Propionate

How it works

A potent glucocorticoid that, after delivery to the airways, binds glucocorticoid receptors to suppress airway inflammation, reduce mucosal oedema and decrease bronchial hyper-responsiveness.

Prescribing in practice

• Inhaled corticosteroids can cause growth retardation in children, so use the lowest effective dose, monitor height and review the need for treatment regularly.
• Use an age-appropriate spacer (with facemask in young children) and correct inhaler technique to maximise lung deposition and reduce oropharyngeal effects.
• It is a preventer, not a reliever, and must be taken regularly even when the child is well.

Monitoring

Monitor the child's height and growth, asthma control and inhaler technique at routine reviews.

Counselling the patient

• Rinse the mouth and spit out after each dose to reduce the risk of oral thrush and hoarseness.
• Use every day as a preventer, not for sudden breathlessness.
• Always use the prescribed spacer device and bring it to reviews so technique can be checked.

Evidence & guidelines

Inhaled corticosteroids are first-line preventer therapy in paediatric asthma per NICE/BTS-SIGN guidance.