Amprenavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Drug reference
Fluticasone
Inhaled corticosteroid (ICS) / Glucocorticoid · Corticosteroid
Also known as Fluticasone propionate, Fluticasone furoate
START
Asthma: Start at appropriate dose for severity; use spacer with MDI; rinse mouth after each use to prevent thrush
TYPICAL MAX
Inhaled FP: 1000 mcg BD; FF: 200 mcg OD (specialist supervision if >500 mcg/day)
STOP IF
Severe paradoxical bronchospasm, signs of adrenal insufficiency, pneumonia (COPD patients)
WATCH
Asthma control (ACT score), oral thrush, voice changes, growth velocity (children), bone density (long-term high dose), eye exam (annual if high dose)
CDSCO approvedSchedule HJan AushadhiATC R03BA05 (inhaled); D07AC17 (topical)
KDIGO 2024 + manufacturer label
- ONSET
- 23min · absorption onset
- PEAK
- 1.5h · Systemic peak (minimal)
- t½
- 20h · Furoate: 15-24h; Propionate: 7-8h
- DURATION
- 1d · 24-hour coverage (furoate OD or propionate BD)
EXCRETION
Fecal (major)
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Compatible with pregnancy at standard inhaled doses; benefits of controlled asthma outweigh risks; use lowest effective dose
FDA category + note
Top interactionssee all 12 →
- AmprenavirSevereDatabaseDDInter
- AtazanavirSevereDatabaseDDInter
- BoceprevirSevereDatabaseDDInter
- Brexucabtagene AutoleucelSevereDatabaseDDInter
Available in India
144 branded formulations and 142 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
High-affinity binding to intracellular glucocorticoid receptors, translocating to nucleus where it upregulates anti-inflammatory gene transcription (lipocortin, IL-10) and suppresses pro-inflammatory gene expression (cytokines, chemokines, adhesion molecules). First-pass hepatic metabolism minimizes systemic exposure.
Indications
Asthma (maintenance therapy, all severities)Chronic obstructive pulmonary disease (COPD) - as combinationAllergic rhinitis (intranasal)Inflammatory skin conditions (topical)Nasal polyps
Dosing
- Adult
- Asthma (propionate): 100-500 mcg BD via MDI or DPI. COPD (furoate): 100 mcg OD. Rhinitis (nasal): 1-2 sprays per nostril OD (50 mcg/spray)
- Pediatric
- Asthma: 50-100 mcg BD (age 4-16). Rhinitis: 1 spray per nostril OD (>/=4 years)
- Renal adjustment
- No adjustment needed
- Hepatic adjustment
- Use with caution in severe hepatic impairment (reduced clearance may increase systemic exposure)
- Geriatric
- Standard dosing; monitor for systemic effects with high doses/long-term use
- Max dose
- Inhaled: 1000 mcg BD (propionate); 200 mcg OD (furoate). Nasal: 2 sprays/nostril/day
Pharmacokinetics
Onset
Days to weeks (anti-inflammatory effect)
Peak effect
1-2 hours (Tmax systemic); clinical effect builds over 1-2 weeks
Duration
12-24 hours
Half-life
Fluticasone propionate: 7-8 hours; Fluticasone furoate: 15-24 hours
Bioavailability
Oral: <1% (extensive first-pass metabolism); Systemic from lung: ~15%
Protein binding
91%
Metabolism
Hepatic CYP3A4 to inactive metabolite fluticasone 17-beta-carboxylic acid
Excretion
Fecal (major); renal (<5%)
Contraindications
- Hypersensitivity to fluticasone or any excipient
- Untreated respiratory infection
- Status asthmaticus (not for acute relief)
Side effects
Common
Oral candidiasis (thrush)Hoarse voice / dysphoniaCoughHeadacheNasal irritation (intranasal)Epistaxis (intranasal)Skin atrophy (topical, prolonged use)
Serious
- Adrenal suppression (high doses, prolonged use)
- Growth retardation in children
- Osteoporosis and fractures (long-term high dose)
- Cataracts and glaucoma
- Pneumonia (increased risk in COPD patients)
- Paradoxical bronchospasm (rare)
- Cushing's syndrome (very high doses or CYP3A4 inhibitors)
Pregnancy & lactation
Pregnancy
Compatible with pregnancy at standard inhaled doses; benefits of controlled asthma outweigh risks; use lowest effective dose
Lactation
Excretion in breast milk is minimal at standard inhaled doses; compatible with breastfeeding
Drug interactions
Atazanavir
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Boceprevir
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Brexucabtagene Autoleucel
Severe
Database
Drug interaction classified as: others
Source: DDInter
Ceritinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Cladribine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clarithromycin
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Cobicistat
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Conivaptan
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Delavirdine
Severe
Database
Clinical effect not specified
Source: DDInter
Desmopressin
Severe
Database
Clinical effect not specified
Source: DDInter
Dinutuximab
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Chronic obstructive pulmonary disease
GOLD · Pulmonology · 2025
Chronic obstructive pulmonary disease
ICS · Pulmonology · 2022
Inflammatory bowel disease
OTHER · Gastroenterology · 2015
Extrapulmonary tuberculosis
ICMR · Infectious Diseases · 2022
Chronic obstructive pulmonary disease
NICE · Pulmonology · 2019
Ask House about Fluticasone
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Katzung, BNF, Nelson, Harriet Lane·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19