fluticasone propionate
Flixonase§, Flonase
Pregnancy Risk Category C
How supplied
Nasal spray: 50 mcg/metered spray (9-g, 16-g bottles)
Action
Exact mechanism unknown. Decreases nasal inflammation.
Indications & dosage
Seasonal and perennial allergic rhinitis--
Adults: Initially, 2 sprays (100 mcg) in each nostril once daily. Or, 1 spray in each nostril b.i.d. After few days, dose may be reduced to 1 spray in each nostril daily. Maximum daily dose is 2 sprays in each nostril.
Children age 4 and older: Initially, 1 spray (50 mcg) in each nostril once daily. If patient doesn't respond or symptoms are severe, increase to 2 sprays in each nostril daily. Depending on patient's response, may decrease dose to 1 spray in each nostril daily. Maximum daily dose is 2 sprays in each nostril.
Adverse reactions
CNS: headache.
EENT: epistaxis, nasal burning, blood in nasal mucus, pharyngitis, nasal irritation.
Interactions
None significant.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients hypersensitive to drug or its components. Don't use drug in patients with recent nasal septal ulcers, nasal surgery, or nasal trauma until healing has occurred.
Nursing considerations
- Use cautiously, if at all, in patients with active or quiescent tuberculous infections; glaucoma; untreated fungal, bacterial, or systemic viral infections; or ocular herpes simplex. Also use cautiously in patients already receiving systemic corticosteroids and in breast-feeding women.
- Although occurrence is rare, watch for signs of immediate hypersensitivity or contact dermatitis after intranasal administration.
Patient teaching
- Urge patient to read instruction sheet before using drug for first time.
- To instill drug, tell patient to shake container gently before use, blow nose to clear nasal passages, and tilt head slightly forward and insert nozzle into nostril, pointing away from septum. Tell him to hold other nostril closed; then inspire gently and spray. Next, have patient shake container and repeat procedure in other nostril.
- Stress importance of adhering to a schedule for instillation because drug effectiveness depends on regular use. Caution patient not to exceed recommended dose; doing so may lead to hyperadrenocorticism, hypothalamic-pituitary-adrenal axis suppression, or suppression of growth in children or teenagers.
- Tell patient to notify prescriber if symptoms don't improve or condition worsens.
- Warn patient to avoid exposure to chickenpox and measles and, if exposed, to obtain medical advice.
- Instruct patient to watch for and report signs and symptoms of nasal infection.
- Tell patient that sugarless gum, hard candy, and water will help to relieve dry mouth.
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING