Adult Dosing

Asthma maintenance

On previous bronchodilators alone

• Flovent Diskus
• Start 100 mcg INH bid; some patients may require starting doses >100 mcg bid
• Range: 100-500 mcg INH bid
• Max: 500 mcg bid

• Flovent HFA
• Start 88 mcg AER bid
• Range: 88-440 mcg AER bid
• Max: 440 mcg bid

On previous inhaled corticosteroids

• Flovent Diskus
• Start 100-250 mcg INH bid; some patients may require starting doses >100 mcg bid
• Range: 100-500 mcg INH bid
• Max: 500 mcg bid

• Flovent HFA
• Start 88-220 mcg AER bid; some patients may require starting doses >88 mcg bid
• Range: 88-220 mcg AER bid
• Max: 220 mcg bid

On previous oral corticosteroids

• Flovent Diskus
• Start 500-1000 mcg INH bid
• Range: 500-1000 mcg INH bid
• Max: 1000 mcg bid
• Note: Taper prednisone at rate of 2.5-5 mg/day qwk after at least 1 wk of therapy

• Flovent HFA
• Start 440 mcg AER bid
• Range: 440-880 mcg AER bid
• Max: 880 mcg bid
• Note: Taper prednisone at rate of 2.5-5 mg/day qwk after at least 1 wk of therapy

Bronchiectasis [Not FDA Approved]

• 500 mcg INH bid

Pediatric Dosing

Asthma maintenance

Child 4-11 yrs

• Flovent diskus
• Start 50 mcg INH bid; patients with poor asthma control may require starting doses >50 mcg bid
• Range: 50-100 mcg INH bid
• Max: 100 mcg bid

• Flovent HFA
• Start 88 mcg AER bid
• Max: 88 mcg bid regardless of prior therapy

Asthma maintenance

Child 12 yrs; on previous bronchodilators alone

• Flovent diskus
• Start 100 mcg INH bid; some patients may require starting doses >100 mcg bid
• Range: 100-500 mcg INH bid
• Max: 500 mcg bid

• Flovent HFA
• Start 88 mcg AER bid
• Range: 88-440 mcg AER bid
• Max: 440 mcg bid

Child 12 yrs; on previous inhaled corticosteroids

• Flovent diskus
• Start 100-250 mcg INH bid; some patients may require starting doses >100 mcg bid
• Range: 100-500 mcg INH bid
• Max: 500 mcg bid

• Flovent HFA
• Start 88-220 mcg AER bid; some patients may require starting doses >88 mcg bid
• Range: 88-440 mcg AER bid
• Max: 440 mcg bid

Child 12 yrs; on previous oral corticosteroids

• Flovent diskus
• Start 500-1000 mcg INH bid
• Range: 500-1000 mcg INH bid
• Max: 1000 mcg bid
• Note: Taper prednisone at rate of 2.5-5 mg/day qwk after at least 1 wk of therapy

• Flovent HFA
• Start 440 mcg AER bid
• Range: 440-880 mcg AER bid
• Max: 880 mcg bid
• Note: Taper prednisone at rate of 2.5-5 mg/day qwk after at least 1 wk of therapy

[Outline]

• Adult Dosing
• Pediatric Dosing

• Maintenance therapy of asthma in patients 4 years and older
• Treatment of asthma for patients requiring oral corticosteroid therapy

• Hypersensitivity to any component of the product
• Status asthmaticus
• Acute episodes of asthma
• Severe hypersensitivity to milk proteins

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: Monitor closely

• Fluticasone is not indicated for rapid relief of bronchospasm. Patients may require therapy with oral corticosteroids. Do not use in acute episodes of asthma
• Monitor patients periodically for signs of adverse effects on the oral cavity since candida albicans infections have been reported. Advise patients to rinse mouth following inhalation
• Increased risk of impaired adrenal function when patients are transferred from oral steroids. Taper slowly from systemic corticosteroids while transfer
• Hypercorticism and adrenal suppression may occur with high dosages or at the regular dosage in susceptible individuals. Discontinue fluticasone slowly if such changes occur
• Hypersensitivity reactions, including anaphylaxis, may occur. Discontinue in the event if such reactions occur
• Monitor growth in pediatric patients
• Long term administration of corticosteroids may cause decreases in bone mineral density (BMD), Glaucoma, increased intraocular pressure, and cataracts
• Serious systemic eosinophilic conditions have been reported with inhaled corticosteroid use, including fluticasone

Cautions: Use cautiously in

• Hepatic impairment
• Diabetes
• Glaucoma
• Cataracts
• Systemic corticosteroid therapy
• Tuberculosis
• Local or systemic infection, untreated
• Ocular herpes simplex
• Measles/varicella exposure
• Pregnancy
• Lactation
• Elderly patients
• Concurrent use of CYP450 3A4 inhibitors like ritonavir, ketoconazole

Flovent Diskus, Flovent HFA interacts with :

	Agenerase
	Akne-mycin
	Amiodarone
	Amprenavir
	Aprepitant
	Atazanavir
	Biaxin
	Biaxin XL
	Calan
	Calan SR
	Cardizem
	Cardizem CD
	Cardizem LA
	Cartia XT
	Clarithromycin
	Conivaptan
	Cordarone
	Covera-HS
	Crixivan
	Cyclosporine
	Darunavir
	Delavirdine
	Diflucan
	Dilacor XR
	Dilt-CD
	Diltiazem
	Diltzac
	Dronedarone
	E-Mycin
	E.E.S.
	Emend
	Ery-Tab
	Eryc
	Erygel
	Eryped
	Erythra-Derm
	Erythro-statin
	Erythrocin
	Erythromycin
	Extina
	Fluconazole
	Fluvoxamine
	Gengraf
	Grapefruit
	Incivek
	Indinavir
	Invirase
	Isoptin
	Isoptin SR
	Itraconazole
	Ketek
	Ketoconazole
	Luvox
	Luvox CR
	Multaq
	Nefazodone
	Nelfinavir
	Neoral
	Nexterone
	Nizoral
	Nizoral A-D Shampoo
	Nizoral Shampoo
	Norvir
	Noxafil
	Onmel
	Pacerone
	PCE
	Pediamycin
	Posaconazole
	Prezista
	Rescriptor
	Restasis
	Reyataz
	Ritonavir
	Sandimmune
	Saquinavir
	Sporanox
	TAO
	Taztia XT
	Telaprevir
	Telithromycin
	Tiazac
	Troleandomycin
	Vaprisol
	Veralan
	Verapamil
	Verelan PM
	Vfend
	Viracept
	Voriconazole
	Xolegel

Pregnancy Category:C

Breastfeeding: The amounts of inhaled corticosteroids absorbed and excreted in breast milk are too small to affect a breastfed infant.This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 16 June 2010).

• EENT: Upper respiratory tract infection, throat irritation, oral candidiasis, hoarseness, rhinorrhea, sinusitis, aphonia, cataracts
• RESP: Bronchospasm, cough, upper respiratory tract infection, wheezing
• GI: Nausea, vomiting, viral gastrointestinal infection
• CNS: Headache, dizziness
• MUSC: Arthralgia, articular rheumatism, muscle pain
• DERM: Pruritus, skin rashes
• Endo: Adrenal suppression (high-dose, long-term therapy only), decreased bone mineral density and growth (in children), Cushing syndrome
• MUSC: Muscle pain
• MISC: Churg-Strauss syndrome, fever, anaphylaxis, angioedema, urticaria

• Corticosteroid; local antiinflammatory effect; produces multiple glucocorticoid and mineralocorticoid effects
• Extensively metabolized by liver; CYP450: 3A4 (primarily)
• Primarily excreted in feces; urine (<5%)
• Half-Life: 7.8 hrs

US Trade Name(s)

• Flovent Diskus
• Flovent HFA

US Availability

Flovent Diskus

• Diskus (PWDR for INH): 50, 100, 250 mcg

Flovent HFA

• Inhalation AER: 44 mcg/metered spray
• Inhalation AER: 110 mcg/metered spray
• Inhalation AER: 220 mcg/metered spray

Canadian Trade Name(s)

• Flovent Diskus
• Flovent HFA

Canadian Availability

Flovent Diskus

• Diskus (PWDR for INH): 50, 100, 250, 500 mcg

Flovent HFA

• Aerosol: 50 mcg/metered spray
• Aerosol: 125 mcg/metered spray
• Aerosol: 250 mcg/metered spray

UK Trade Name(s)

• Flixotide Accuhaler
• Flixotide Diskhaler
• Flixotide Evohaler
• Flixotide Nebules

UK Availability

Flixotide Accuhaler

• Accuhaler (PWDR for INH): 50, 100, 250, 500 mcg

Flixotide Diskhaler

• Diskhaler (PWDR for INH): 100, 250, 500 mcg

Flixotide Evohaler

• Evohaler (aerosol INH): 50 mcg/metered spray
• Evohaler (aerosol INH): 125 mcg/metered spray
• Evohaler (aerosol INH): 250 mcg/metered spray

Flixotide Nebules

• NEB: 0.5 mg/2 mL
• NEB: 2 mg/2 mL

Australian Trade Name(s)

• Flixotide
• Flixotide Accuhaler
• Flixotide Nebules

Australian Availability

Flixotide

• MDI: 50 mcg/actuation
• MDI: 125 mcg/actuation
• MDI: 250 mcg/actuation

Flixotide Accuhaler

• Accuhaler (PWDR for INH): 100 mcg/actuation
• Accuhaler (PWDR for INH): 250 mcg/actuation
• Accuhaler (PWDR for INH): 500 mcg/actuation

Flixotide Nebules

• NEB: 0.5 mg/2 mL
• NEB: 2 mg/2 mL

[Outline]

Pulmonary

Steroids; Inhaled

Pricing data from www.DrugStore.com in U.S.A.

• Flovent Diskus 250 MCG/BLIST AEPB [Inhaler] (GLAXO SMITH KLINE)
  60 blist = $166.99
  180 blist = $468.98
• Flovent HFA 220 MCG/ACT AERO [Inhaler] (GLAXO SMITH KLINE)
  12 act = $246.99
  36 act = $695.98
• Flovent Diskus 50 MCG/BLIST AEPB [Inhaler] (GLAXO SMITH KLINE)
  60 blist = $114.99
  180 blist = $323.97
• Flovent HFA 110 MCG/ACT AERO [Inhaler] (GLAXO SMITH KLINE)
  12 act = $162.98
  36 act = $461.96
• Flovent HFA 44 MCG/ACT AERO [Inhaler] (GLAXO SMITH KLINE)
  10.6 act = $119.99
  31.8 act = $339.97
• Flovent Diskus 100 MCG/BLIST AEPB [Inhaler] (GLAXO SMITH KLINE)
  60 blist = $119.99
  180 blist = $349.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.