Flovent Diskus

Flovent Diskus Uses, Dosage, Side Effects, Food Interaction and all others data.

Flovent Diskus propionate is a glucocorticoid with high topical anti-inflammatory potency, but a low HPA-axis suppressive activity after dermal administration. It, therefore, has a therapeutic index which is greater than most of the commonly available steroids. Flovent Diskus propionate has a high degree of selectivity for the glucocorticoid receptor. In vitro studies show that fluticasone propionate has a strong affinity for, and agonist activity at, human glucocorticoid receptors. This receptor is believed to be responsible for the anti-inflammatory properties of glucocorticoids.

Flovent Diskus propionate has weak affinity for the progesterone receptor, and virtually no affinity for the mineralocorticoid, estrogen, or androgen receptors. The therapeutic potency of glucocorticoids is related to the half-life of the glucocorticoid-receptor complex. The half-life of the Flovent Diskus propionate glucocorticoid-receptor complex is approximately 10 hours.

Systemically, in vitro experiments show Flovent Diskus furoate activates glucocorticoid receptors, inhibits nuclear factor kappa b, and inhibits lung eosinophilia in rats. Flovent Diskus propionate performs similar activity but is not stated to affect nuclear factor kappa b. Flovent Diskus propionate as a topical formulation is also associated with vasoconstriction in the skin.

Trade Name Flovent Diskus
Availability Prescription only
Generic Fluticasone
Fluticasone Other Names Fluticason, Fluticasona, Fluticasone, Fluticasonum
Related Drugs Dupixent, Xolair, ProAir Digihaler, dexamethasone, prednisolone, Symbicort, Breo Ellipta, Decadron, Ventolin, Xopenex
Type Inhalation aerosol, inhalation powder
Formula C22H27F3O4S
Weight Average: 444.51
Monoisotopic: 444.158215012
Protein binding

Fluticasone furoate is >99% protein bound in serum and may be as high as 99.6%.

Fluticasone propionate is 99% protein bound in serum. Topical Fluticasone propionate is only 91% protein bound in serum however.

Groups Approved, Experimental
Therapeutic Class Fluticasone & combined preparations topical
Manufacturer
Available Country United States
Last Updated: September 19, 2023 at 7:00 am
Flovent Diskus
Flovent Diskus

Uses

Flovent Diskus Propionate is used for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive eczema or dermatitis.

Flovent Diskus is also used to associated treatment for these conditions: Asthma, Bronchostenosis, Skin discomfort, Moderate, severe Chronic Obstructive Pulmonary Disease (COPD)

How Flovent Diskus works

Flovent Diskus furoate and Flovent Diskus propionate work through an unknown mechanism to affect the action of various cell types and mediators of inflammation. In vitro experiments show Flovent Diskus furoate activating glucocorticoid receptors, inhibiting nuclear factor kappa b, and inhibiting lung eosinophilia in rats. Flovent Diskus propionate performs similar activity but is not stated to affect nuclear factor kappa b.

Dosage

Flovent Diskus dosage

Cream: Apply a thin layer of Flovent Diskus propionate cream to the affected skin areas once daily.

Ointment: Apply a thin layer of Flovent Diskus propionate Ointment to the affected skin areas twice daily.

Side Effects

The fluticasone propionate preparations are usually well tolerated; local burning and pruritus have been reported. If signs of hypersensitivity appear, application should be stopped immediately. Prolonged and intensive treatment with potent corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, dilatation of the superficial blood vessels, hypertrichosis and hypopigmentation.

Secondary infection, particularly when occlusive dressings are used or when skin folds are involved and allergic contact dermatitis have also been reported with corticosteroid use. Exacerbation of the signs and symptoms of the dermatoses have been reported with corticosteroid use.

Prolonged use of large amounts of corticosteroids, or treatment of extensive areas, can result in sufficient systemic absorption to produce the features of hypercorticism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. In infants, the napkin may act as an occlusive dressing.

Toxicity

Flovent Diskus furoate administered nasally may be associated with adrenal suppression or an increase in QTc interval though the association has not been well demonstrated in studies. Flovent Diskus furoate requires no dosage adjustment in renal impairment but must be used in caution in hepatic impairment due to the elimination mechanisms. Flovent Diskus furoate is not associated with carcinogenicity, mutagenicity, or impairment of fertility. There are no well controlled studies in pregnancy or lactation though animal studies have shown teratogenicity and hypoadrenalism in the offspring of treated mothers and other corticosteroids are known to be excreted in breast milk. Generally, there are no reported adverse effects with fluticasone in pregnancy. Pediatric patients should be given the lowest possible dose and monitored for reduction in growth velocity. There is insufficient evidence to determine whether geriatric patients respond differently to other patients. Systemic exposure may be 27-49% higher in Japanese, Korean, and Chinese patients compared to Caucasian patients. Caution should be exercised in these patients and the benefit and risk should be assessed before deciding on a treatment.

Flovent Diskus propionate's use in specific populations has not been well studied. Flovent Diskus propionate is not carcinogenic, mutagenic, or clastogenic, nor did it affect fertility in animal studies. Subcutaneous Flovent Diskus propionate has been shown to produce teratogenic effects in rats though oral administration does not. Generally, there are no reported adverse effects with fluticasone in pregnancy. Flovent Diskus propionate in human milk may cause growth suppression, effects on endogenous corticosteroid production, or other effects. Pediatric patients treated with Flovent Diskus propionate ointment experienced adrenal suppression. Geriatric patients treated with Flovent Diskus propionate did not show any difference in safety or efficacy compared to other patient groups, though older patients may be more sensitive to adverse effects. There is no difference in the clearance of Flovent Diskus propionate across genders or race. Patients with hepatic impairment should be closely monitored due to the elimination mechanism.

Precaution

Flovent Diskus propionate has a very low propensity for systemic absorption, nevertheless, prolonged application of high doses to large areas of body surface, especially in infants and small children might lead to adrenal suppression. Children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic toxicity.

The face, more than other areas of the body, may exhibit atropic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating severe eczema.

Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressing, and so the skin should be cleansed before a fresh dressing is applied.

Food Interaction

No interactions found.

Volume of Distribution

608L at steady state for intravenous administration of Flovent Diskus furoate. Other reports suggest the mean volume of distribution at steady state is 661L. A study of 24 healthy Caucasian males showed a volume of distribution at steady state of 704L following intravenous administration.

The volume of distribution of intravenous Flovent Diskus propionate is 4.2L/kg. A study of 24 healthy Caucasian males showed a volume of distribution at steady state of 577L following intravenous administration.

Elimination Route

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Half Life

15.1 hours for intranasal Flovent Diskus furoate and 24 hours for the inhaled formulation. A study of 24 healthy Caucasian males showed a half life of 13.6 hours following intravenous administration and 17.3-23.9 hours followed inhalation.

7.8 hours for intravenous Flovent Diskus propionate. A study of 24 healthy Caucasian males shows a half life of 14.0 hours following intravenous administration and 10.8 hours following inhalation.

Clearance

57.8L/h for Flovent Diskus furoate. A study of 24 healthy Caucasian males showed a clearance of 71.8L/h following intravenous administration.

1093mL/min for Flovent Diskus propionate. A study of 24 healthy Caucasian males showed a clearance of 63.9L/h following intravenous administration.

Contraindication

Flovent Diskus propionate is contraindicated in Rosacea, Acne vulgaris, Peri-oral dermatitis, Primary cutaneous viral infections (e.g., herpes simplex, chicken pox), Hypersensitivity to any of the ingredients, Perianal and genital pruritus, etc. The use of Flovent Diskus propionate is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi or bacteria and dermatoses in children under one year of age, including deramtitis and napkin eruptions.

Acute Overdose

Acute overdosage is very unlikely to occur, however, in case of cronic overdosage or misuse the features of hypercorticism may appear, and in this situation, as with any corticosteroid, application should be discontinued. Overdosage by ingestion of fluticasone propionate cream or ointment is extremely unlikely to occur due to the very low oral bioavailability of fluticasone propionate.

Storage Condition

Store below 30˚ C. Do not freeze.

*** Taking medicines without doctor's advice can cause long-term problems.
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