Fluticasone propionate

Fluticasone propionate is a synthetic trifluorinated glucocorticoid available in metered-dose pressurized inhaler and Diskhaler form for asthma prophylaxis.

Fluticasone proprionate has yet to be shown to surpass low dose beclomethasone or budesonide as prophylaxis against asthma (1). Equally, it has still to be shown that it is safer in patients requiring high doses of inhaled corticosteroids, or that fluticasone is any better than beclomethasone or budesonide at reducing the need for oral steroids.

• dose of fluticasone (2)
  • 100 mcg twice daily is appropriate starting dose for patients with mild asthma
  • 250-500 mcg twice daily - starting doses in moderate or more severe asthma
    
    
• doses above 500 mcg twice daily (2)
  • only for patients with severe asthma where additional clinical benefit is expected and is demonstrated either by an improvement in pulmonary function and/or symptom control, or by the ability to reduce oral corticosteroid therapy
  • doses above 500 mcg twice daily should be initiated by a specialist in the management of asthma (such as a consultant physician or a general practioner with appropriate experience)

Reference:

• (1) Drug & Therapeutic Bulletin (April 1994). Fluticasone for asthma prophylaxis. Consumers' Association.
• (2) CSM/MCA (2001). Current problems in pharmacovigilance, 27, 10.