Fluticasone propionate (Flonase, Xhance)
Matt Kauflin, Pharm.D., BCPS

Fluticasone propionate – Flonase®, Xhance®

Drug Class – Intranasal Corticosteroid

Mechanism of Action – Fluticasone has anti-inflammatory, antipruritic, and vasoconstrictive properties. It has been shown to have a wide range of inhibitory effects on multiple cell types (e.g. mast cell, eosinophil, neutrophil, macrophages, and lymphocytes) and mediators (i.e. histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation.

Dosage Forms – Nasal spray 50 mcg/actuation.  Nasal exhaler suspension 93 mcg/actuation

Dosing/Indications:

  1. 1.Allergic rhinitis – Kids > 4 and adults – 2 sprays/nostril daily or 1 spray/nostril bid 

  2. 2.Nonallergic rhinitis – Kids > 4 and adults – 2 sprays/nostril daily of 1 spray/nostril bid 

  3. 3.Nasal polyps – Adults 1 spray/nostril bid, may increase to max 2 sprays/nostril bid (744 mcg/day) 

 

Fluticasone propionate – Flonase®

Dosage adjustment

  • •No dosage adjustment required in hepatic impairment 

  • •No dosage adjustment required in renal impairment 

Contraindications

  • •Hypersensitivity to fluticasone 

Warnings

  • •None 

Pregnancy

  • •Fluticasone propionate nasal spray is considered safe during pregnancy and breastfeeding 

 

Fluticasone propionate – Flonase®

Drug Interactions

  • •CYP 3A4/5 inhibitors 

  • •Desmopressin 

Adverse Effects

  • •Headache, nasal irritation and burning, sore throat, epistaxis and cough 

Monitoring Parameters

  • •Control of symptoms of rhinitis 

Therapeutic Pearls

  • •Advise patients on proper administration technique 

  • •May take several days for effect 

  • •Nasal spray is available OTC 

 

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