Pronounced:FLOW-naze
Generic name:Fluticasone
Brand names: Flonase, Flovent, Flovent Diskus, Flovent Rotadisk

Why is Flonase prescribed?

Flonase nasal spray is a remedy for the stuffy, runny, itchy nose that plagues many allergy-sufferers. It can be used either for seasonal attacks of hay fever or for year-round allergic conditions. Flonase is a steroid medication. It works by relieving inflammation within the nasal passages.

The Flovent, Flovent Rotadisk, and Flovent Diskus oral inhalers are used to prevent flare-ups of asthma. (They will not, however, relieve an acute attack.) They sometimes serve as a replacement for the steroid tablets that many people take to control asthma.

Most important fact about Flonase

Fluticasone is not an instant cure. It may take a few days for the medication to start working; and you need to keep taking it regularly in order to maintain its benefits. While you are waiting for fluticasone to take effect, neither increase the dose nor stop taking the medication.

How should you take Flonase?

Flonase is taken in the nostrils. For best effect, take the prescribed doses at regular intervals. First, blow your nose. Then shake the spray bottle gently, prime the pump 6 times if it hasn't been used during the past week, tilt your head back, press one nostril closed, and insert the tip of the bottle a short way into the other nostril. Spray once, pull the tip of the bottle away from your nose, and inhale deeply through the treated nostril. Repeat with the other nostril. Avoid spraying in eyes.

Flovent inhalation aerosol is taken orally. Shake the canister before each use. Take a deep breath and exhale. Then, as you begin to inhale, put your lips around the mouthpiece and depress the canister. Rinse your mouth with water after each use of the inhaler. Avoid spraying the contents in your eyes.

Flovent Rotadisk inhalation powder is also taken orally. Assemble the Rotadisk Diskhaler according to package instructions. To use, exhale, then place the Diskhaler mouthpiece between your teeth (without biting down) and close your lips firmly around it. (Be careful to avoid covering the small air holes on either side of the mouthpiece.) Breathe in through your mouth as deeply as you can, then hold your breath while you remove the Diskhaler. Continue to hold your breath as long as you comfortably can, up to a maximum of 10 seconds.

Flovent Diskus is a disposable oral inhaler that contains 60 inhalations. It must be kept dry. Do not wash it or attempt to take it apart. Always activate the inhaler in a level, horizontal position. Do not exhale into it. Do not use a spacer.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Flonase may be stored at room temperature or in the refrigerator.

Flovent inhalation aerosol may be stored at room temperature away from sunlight, or in the refrigerator.

Flovent Rotadisk inhalation powder should be stored at room temperature in a dry place. Use the Rotadisk blisters within 2 months after opening the foil overwrap or before the expiration date, whichever comes first. Do not puncture the blisters until you are ready to use them in the Diskhaler.

The Flovent Diskus disposable inhaler should be stored at room temperature in a dry place, away from direct heat or sunlight. Once removed from its foil pouch, the device should be discarded after 2 months if not used up (after 6 weeks for the 50-microgram inhaler).

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking fluticasone.

Side effects may include:

• abdominal pain
• aches and pains
• agitation
• aggression
• back problems
• bad taste in mouth
• brittle bones
• bronchitis
• bruising
• cataracts
• congestion
• cough
• depression
• diarrhea
• dizziness
• dry mouth
• dry nose
• eye problems
• facial changes
• fever
• flu
• headache
• hives
• hoarseness
• indigestion
• itching
• loss of speech
• mouth infection or swelling
• nasal congestion
• nasal irritation or burning
• nasal sores
• nausea
• nosebleeds
• rash
• respiratory tract infection
• runny nose
• shortness of breath
• sinus problems
• sneezing
• sore or irritated throat
• stunted growth
• swelling of the face and tongue
• vomiting
• weight gain
• wheezing
• worsening of asthma

Why should Flonase not be prescribed?

If you have ever had an allergic reaction to Flonase or similar steroid inhalants such as Flovent, you should not take this medication.

Flovent is not to be used to treat status asthmaticus or acute asthma attacks.

Special warnings about this medication

If your symptoms do not improve after the first few days of fluticasone therapy, check with your doctor. Never take more than the recommended dose. High doses of steroid medications such as fluticasone can cause a condition known as Cushing's syndrome. Warning signs of this problem include weight gain and changes in the appearance of the face.

If you are being switched from an oral steroid tablet to fluticasone, you may experience joint pain, muscle pain, weakness, depression, or fatigue while your body adjusts to the absence of steroid tablets and increases its own production of steroids. You may also experience eye inflammation, eczema, arthritis, and nasal inflammation.

People taking steroid medications run an increased risk of infections such as chickenpox and measles, and when an infection develops, it's more likely to be serious. If you've never had these diseases and have not been vaccinated against them, avoid anyone who may have them. If by chance you're exposed, contact your doctor immediately.

In rare cases, fluticasone can also cause a fungal infection in the nose and throat. And steroid treatment can also make an existing infection worse. Be sure the doctor is aware of any infections you may have, including TB and viral infections of the eye.

Steroid medications can stunt growth. If your child is on fluticasone therapy, the doctor should periodically check height and weight. In rare cases, people using Flovent have developed a serious lung condition marked by worsening asthma, heart problems, and numbness. If you start to notice any of these symptoms, report them to your doctor immediately.

If you develop wheezing and an asthma attack after inhaling any form of Flovent, use an emergency medicine such as an inhaled bronchodilator and call your doctor immediately. Also alert your doctor immediately if emergency medications fail to work as well once you've started Flovent therapy.

In rare cases, inhaled steroids such as Flovent have caused cataracts or increased pressure in the eye (glaucoma). Alert your doctor if you suffer from either problem.

If you have recently had a nasal injury or ulcer, or had surgery on your nose, you should wait until you are fully healed before using Flonase.

Possible food and drug interactions when taking Flonase

The risk of developing Cushing's syndrome and other side effects increases when you take other steroid medications while using fluticasone. Prednisone and dexamethasone are examples of oral steroid medications. Certain other asthma inhalers, skin creams, eyedrops, and eardrops also may contain steroids.

Also be sure to check with your doctor before combining fluticasone with ketoconazole (Nizoral) or HIV drugs known as protease inhibitors, including Agenerase, Crixivan, Fortovase, Norvir, and Viracept.

Special information if you are pregnant or breastfeeding

The effects of this drug during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known whether fluticasone appears in breast milk. If the drug is essential to your health, your doctor may advise you to stop nursing until your treatment is finished.

Recommended dosage

ADULTS

The usual starting dose is 2 sprays in each nostril once daily. (Some doctors may prescribe 1 spray in each nostril every 12 hours.) Once your symptoms are under control, your doctor may reduce the dose to 1 spray in each nostril once daily.

Some people (12 and over) with seasonal allergies find that it's sufficient to use Flonase only on days when their symptoms flare up. If you use Flonase this way, take no more than 2 sprays per nostril on any given day.

CHILDREN

Flonase is not recommended for children under the age of 4. The recommended starting dose is 1 spray in each nostril once a day. If symptoms do not improve in a few days, the dose can be increased to 2 sprays in each nostril once a day, or 1 spray in each nostril twice a day. The dose should be reduced again once symptoms have subsided.

Overdosage

Any medication taken in excess can have serious consequences. If you habitually use too much fluticasone, you run the risk of developing Cushing's syndrome (see "Special warnings about this medication").