Fluticasone Propionate MEDICATION SHEET
Name &
Administration
(Generic &
brand name,
dosage, safe
dose range,
route,
frequency, rate
of admin. of IV
meds)
fluticasone
(nasal)
Trade Name(s)
Avamys [Canada]
Flonase
Veramyst
Pregnancy
Category
Category C
Ther. Class.
antiinflammatories
(steroidal)
Route/Dosage
Intranasal:
(Children 4
yr): Flonase 1
spray in each
nostril once daily
(not to exceed 2
sprays in each
nostril/day).
Intranasal:
(Children 211
Mechanism of Action
(Classification, physiologic
actions)
Action
Potent, locally acting antiinflammatory and immune
modifier.
Therapeutic Effect(s):
Decrease in symptoms of allergic
and nonallergic rhinitis.
Pharmacokinetics
Absorption: <2%; action is
primarily local following nasal
use.
Distribution: Crosses the
placenta and enters breast milk
in small amounts.
Metabolism and Excretion:
Rapidly and extensively
metabolized by the liver;
primarily excreted in feces; <5%
excreted in urine.
Half-life: 7.8 hr.
TIME/ACTION PROFILE
(improvement in symptoms)
ROUTE
ONSE
PEAK DURATION
T
Intranasa few
l
days
up to
unknown
3 wk
Side Effects
Nursing
Responsibilitie
s & Patient
Teaching
Rationale for Use
with This Patient
Contraindication/Precautions
Assessment
Indications
Contraindicated in:
Monitor
degree of nasal
stuffiness,
amount and
color of nasal
discharge, and
frequency of
sneezing.
Patients on
long-term
therapy should
have periodic
otolaryngologic
examinations to
monitor nasal
mucosa and
passages for
infection or
ulceration.
Monitor
growth rate in
children
receiving
chronic therapy;
use lowest
possible dose.
Seasonal or
perennial allergic
rhinitis.
Seasonal or
perennial nonallergic
rhinitis (Flonase only)
Hypersensitivity (Flonase
contains alcohol).
Use Cautiously in:
Active untreated infections
Diabetes or glaucoma
Underlying immunosuppression
(due to disease or concurrent
therapy)
Systemic corticosteroid therapy
(should not be abruptly
discontinued when intranasal
therapy is started)
Concurrent use of ritonavir
Recent nasal trauma, septal
ulcers, or surgery (wound healing
may be impaired by nasal
corticosteroids)
OB: Lactation: Pedi: Pregnancy,
lactation, or children <4 yr (for
Flonase) or <2 yr (for Veramyst)
(safety not established; prolonged
or high-dose therapy may lead to
yrs): Veramyst 1
spray in each
nostril daily; may
to 2 sprays if no
response; once
symptoms
controlled,
attempt to dose
to 1 spray/day.
Availability
(generic
available)
Nasal spray
(Flonase): 50
mcg/metered
spray in 16-g
bottle (delivers
120 metered
sprays)
Nasal spray
(Veramyst): 27.5
mcg/spray in a
10-g bottle
(delivers 120
sprays)
In Combination
with: azelastine
(Dymista); see
combination
drugs).
complications).
Adverse Reactions/Side
Effects
CNS: headache
EENT: epistaxis, nasal burning,
nasal irritation, nasopharyngeal
fungal infection, pharyngitis
GI: nausea, vomiting
Endo: adrenal suppression (
dose, long-term therapy only),
growth (children)
Derm: rash, urticaria
Resp: cough
Misc: ANAPHYLAXIS,
ANGIOEDEMA
* CAPITALS indicate lifethreatening.
Italics indicate most frequent.
Monitor for
signs and
symptoms of
hypersensitivity
reactions (rash,
pruritis, swelling
of face and
neck, dyspnea)
periodically
during therapy.
Lab Test
Considerations
:
Periodic adrenal
function tests
may be ordered
to assess degree
of hypothalamicpituitary-adrenal
(HPA) axis
suppression in
chronic therapy.
Children and
patients using
higher than
recommended
doses are at
highest risk for
HPA
suppression.
Patient/Family
Teaching
Advise patient
to take
medication
exactly as
directed. Take
missed doses as
soon as
remembered
unless almost
time for next
dose.
Instruct
patient in
correct
technique for
administering
nasal spray (see
medication
administration
techniques).
Shake well
before use.
Before first-time
use, prime unit
by spraying 6
times. If not
used for at least
7 days or if cap
left off for more
than 5 days,
reprime unit.
Warn patient
that temporary
nasal stinging
may occur.
Instruct
patient to stop
fluticasone and
notify health
care
professional
immediately if
signs of
anaphylaxis
(rash, hives,
difficulty
breathing,
swollen lips or
throat) occur.
Instruct
patient to notify
health care
professional of
all Rx or OTC
medications,
vitamins, or
herbal products
being taken and
consult health
care
professional
before taking
other Rx, OTC,
or herbal
products.
Advise female
patients to
notify health
care
professional if
pregnancy is
planned or
suspected or if
breastfeeding.
Instruct
patient to notify
health care
professional if
symptoms do
not improve
within 1 mo or if
symptoms
worsen.
