Fluticasone Propionate is a potent, topically active synthetic trifluorinated glucocorticoid corticosteroid. The 27.5 mcg per actuation strength is specifically formulated as a nasal spray for the treatment of allergic and inflammatory conditions of the nasal mucosa. It exerts a strong anti-inflammatory and immunosuppressive effect with minimal systemic absorption due to its high first-pass metabolism and low oral bioavailability.
Adult: For Allergic Rhinitis: 2 sprays (55 mcg total) in each nostril once daily (total 110 mcg/day). May reduce to 1 spray (27.5 mcg) in each nostril once daily (total 55 mcg/day) for maintenance after symptoms are controlled. For Nasal Polyps: Starting dose is typically 2 sprays in each nostril twice daily (220 mcg/day).
Note: 1. Shake the bottle gently. 2. Prime the pump by spraying into the air until a fine mist appears (for new bottle or if not used for >7 days). 3. Blow nose gently to clear nostrils. 4. Tilt head slightly forward. 5. Insert nozzle into nostril, pointing slightly away from the nasal septum. 6. Activate spray while breathing in gently through the nose. 7. Repeat for other nostril. 8. Avoid blowing nose for 15 minutes. Clean nozzle weekly.
Fluticasone propionate acts by binding to cytoplasmic glucocorticoid receptors. The drug-receptor complex translocates to the cell nucleus, where it binds to glucocorticoid response elements (GREs) on DNA, modulating gene transcription. This leads to the synthesis of anti-inflammatory proteins (e.g., lipocortin-1) and inhibition of the synthesis of multiple pro-inflammatory mediators.
Pregnancy: Pregnancy Category C (US FDA). Animal studies show teratogenicity at high doses. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Low systemic bioavailability reduces risk, but prescribe at the lowest effective dose.
Driving: No known effects on the ability to drive or operate machinery.
| Ritonavir, Atazanavir, Clarithromycin, Itraconazole, Ketoconazole | Potent CYP3A4 inhibitors can significantly increase systemic exposure to Fluticasone, leading to increased risk of systemic corticosteroid effects and adrenal suppression. | Major |
| Other Nasal or Inhaled Corticosteroids | Additive risk of local side effects (e.g., candidiasis) and potential for increased systemic corticosteroid exposure. | Moderate |
| Live Vaccines (e.g., MMR, Varicella) | Immunosuppression may enhance the replication of the vaccine virus and increase the risk of vaccine-induced disease. Avoid administration. | Major |
Same composition (Fluticasone Propionate (27.5mcg)), different brands: