API: Fluticasone Propionate

What Is Fluticasone Propionate and How Does It Work?

Fluticasone Propionate is a manufactured corticosteroid that acts as a glucocorticoid to help regulate the body’s immune system. The drug selectively binds to the glucocorticoid receptor and shows both anti-inflammatory and vasoconstrictive properties. Although the exact mechanism of action of the drug is not fully known, fluticasone propionate inhibits the effects of various cells involved in the immune system, such as mast cells, eosinophils, neutrophils, macrophages, and lymphocytes. The drug also manages a variety of immune response mediators, such as histamine and cytokines response.1

For more information, including a MSDS sheet, please see PNA’s Fluticasone Propionate page.

Approved Indications

  • Nasal Conditions (Spray and Aerosol): Fluticasone Propionate is used to treat allergies and allergic rhinitis, nasal polyps. The drug can also be used alone, or in conjunction with salmeterol, to treat asthma and chronic obstructive pulmonary disease (COPD).
  • Skin Conditions (Topical): Fluticasone Propionate is used to treat inflammation and itching resulting from allergic reactions, eczema, and psoriasis.
  • Other conditions: Fluticasone Propionate may be used to treat other skin conditions, such as post-surgical scarring, at the physician’s discretion.
  • Other Information: This drug should not be used as treatment for severe acne, rosacea, or viral skin infection such as chickenpox or herpes.

Side Effects and Drug Interactions

Fluticasone Propionate can cause different side effects in spray versus topical form.

Common side effects of the drug in spray form include2:

  • Headache
  • Back pain
  • Sore throat, coughing, and sneezing
  • Nausea and vomiting
  • Menstrual problems, or loss of interest in sex
  • Nose bleeds and nasal irritation
  • Skin rash and itching
  • Facial swelling

Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Patients who experience anaphylaxis, abdominal pain, diarrhea, fever, flu-like symptoms, dizziness, or bronchitis should inform their physician immediately.

Drug interactions with ritonavir, ketoconazole, and other CYP3A4 inhibitors (atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin, conivaptan, lopinavir, nefazodone, and voriconazole) may increase the blood concentrations of fluticasone propionate and should be avoided.

Fluticasone propionate should not be used as the primary treatment of severe acute asthmatic attacks or continuous asthmatic attacks when intensive measures such as oxygen, parenteral bronchodilators, and IV corticosteroids are required.3

There are no adequate studies of fluticasone propionate and lactating mothers—the drug should be used only when necessary in pregnant or breastfeeding patients.

Note that spray and aerosol treatment with fluticasone propionate can lessen body’s abilities to fight infections and to manage stress of surgery, illness, severe asthma attack, or injury. Fluticasone propionate can increase risk of developing osteoporosis. In rare cases, extended use of fluticasone propionate can lead to development of glaucoma or cataracts.4

Common side effects of the drug in topical form include5:

  • Mild skin irritation
  • Changes in skin appearance and feel
  • Skin rash or irritation around mouth
  • Redness or crusting of hair follicles
  • Acne and crusting of treated skin

Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Patients who experience allergic reaction, such as hives, difficulty breathing, swelling of face, lips, tongue, or throat, blurred and distorted vision, headache, back ache, weakness or fatigue, confusion and mood changes, insomnia, weight gain, muscle weakness, or increase in blood sugar should inform their physician immediately.

Drug interactions are unlikely to occur with the topical form of this drug.

Patients who are allergic to fluticasone propionate or its excipients, or who are taking another medication containing gabapentin, should not take this drug.

This drug may interfere with certain laboratory tests for urine protein. Patients should notify laboratory personnel before submitting testing sample.

Latest News and Research

Fluticasone propionate is a mainstay of allergy and COPD treatment, but has also shown efficacy for asthma control and management. In a study of asthmatic patients using oral prednisone, fluticasone propionate was shown to be effective both in weaning off of the prednisone and in improving asthma symptoms.6 Such studies have led to broader research into using fluticasone propionate to treat eosinophilic esophagitis, a condition that is increasingly being identified, but for which current guidelines are lacking.7 More specifically, eosinophilic esophagitis is a chronic immune system disease in which eosinophils (white blood cells) line the esophagus. Both oral prednisone and swallowed fluticasone propionate showed efficacy, which implies that one or both could prove to be an effective treatment.

It terms of safety and efficacy, a new study shows quantified analysis of safety of fluticasone propionate in pregnant women.8 A total of 5,362 cases were studied in which pregnant women received a prescription for inhaled fluticasone propionate during their first trimester. The results support smaller studies conducted earlier in showing that the drug is safe for pregnant women and should be considered a part of treatment options to maintain good asthma control in these patients.

Buying Guide

PNA is a recommended bulk supplier of Fluticasone Propionate and other APIs. You can learn more about Fluticasone Propionate here.

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Resources

Show 8 footnotes

  1. “fluticasone (Flonase, Flonase Allergy Relief),” April 14, 2014, http://www.medicinenet.com/fluticasone_propionate_nasal_inhaler-spray/article.htm
  2. “Flonase Side Effects Center,” February 24, 2015, http://www.rxlist.com/flonase-side-effects-drug-center.htm
  3. “Fluticasone Propionate,” December 1, 2015, http://www.drugs.com/monograph/fluticasone-propionate.html
  4. “What Is Fluticasone?” July 31, 2014, http://www.everydayhealth.com/drugs/fluticasone
  5. “Cutivate Cream,” 2015, http://www.rxlist.com/cutivate-drug/patient-images-side-effects.htm
  6. “Fluticasone propionate reduces oral prednisone use while it improves asthma control and quality of life,” 1995, http://www.atsjournals.org/doi/abs/10.1164/ajrccm.152.5.7582278#.VorHSpMrLxQ
  7. “Comparison of Oral Prednisone and Topical Fluticasone in the Treatment of Eosinophilic Esophagitis: A Randomized Trial in Children,” 2008, http://www.sciencedirect.com/science/article/pii/S1542356507011044
  8. “The safety of fluticasone propionate when taken during pregnancy,” June 25, 2015, http://www.aaaai.org/global/latest-research-summaries/New-Research-from-JACI-In-Practice/fluticasone-pregnancy.aspx