fluticasone furoate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
fluticasone furoate: clinical details
Prescribing considerations
- Confirm symptoms are consistent with allergic rhinitis and review technique if response is inadequate.
- Consider cumulative exposure when other corticosteroid formulations are prescribed.
- Avoid ritonavir; avoid potent CYP3A inhibition unless benefit outweighs risk and appropriate monitoring is arranged.
- Prolonged exposure can cause systemic corticosteroid effects despite normally low intranasal bioavailability.
Contraindications and cautions
- Hypersensitivity to fluticasone furoate or any product excipient.
Monitoring
- Monitor growth in children receiving prolonged intranasal corticosteroid treatment.
- Assess new blurred vision or other visual disturbance and consider ophthalmology referral.
- Monitor for systemic corticosteroid effects where exposure is increased by interacting medicines or concurrent steroids.
- Review persistent nasal ulceration, bleeding or mucosal swelling.
Clinical pharmacology
A high-affinity glucocorticoid-receptor agonist with local anti-inflammatory activity. Intranasal systemic bioavailability is very low; absorbed fluticasone furoate is extensively metabolised by CYP3A4 to an inactive metabolite.
Formulation and product differences
- The selected product is a white intranasal suspension delivered by a primed spray device.
- It contains benzalkonium chloride, which may cause swelling of the nasal lining with long-term use.
- Do not assume it is interchangeable with another fluticasone ester or products intended for inhaled, dermatological or other routes.
fluticasone furoate preparations and strengths
Nasal preparation
Route: Nasal
Strengths: 27.5 micrograms
fluticasone furoate interactions
Interactions mainly arise when other medicines increase fluticasone exposure or add to the total corticosteroid burden.
Ritonavir
Concomitant use is not recommended because systemic fluticasone exposure and corticosteroid adverse effects may increase.
Cobicistat-containing medicines
These can increase systemic corticosteroid exposure; avoid the combination unless benefit outweighs risk and monitor if used.
Potent CYP3A inhibitors, including ketoconazole or itraconazole
They may reduce fluticasone metabolism and increase systemic corticosteroid effects.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.