Absorption: <1% (aerosol), 814% (powder) absorbed following oral inhalation. Action is primarily local after inhalation.
Distribution: 1025% of inhaled corticosteroids is deposited in the airways if a spacer device is not used. With the use of a spacer, a greater percentage may reach the respiratory tract.
Protein Binding: 9199%.
Half-Life: 7.8 hr (propionate); 24 hr (furoate).
(improvement in symptoms)
ROUTE | ONSET | PEAK | DURATION |
Inhalation | within 24 hr | 14 wk‡ | several days after discontinuation |
‡Improvement in pulmonary function; decreased airway responsiveness may take longer.
Contraindicated in:
Use Cautiously in:
EENT: cataracts, dysphonia, glaucoma, hoarseness, nasal stuffiness, oropharyngeal fungal infections, rhinorrhea, sinusitis
Endo: adrenal suppression (high-dose, long-term therapy only), Cushing's syndrome, ↓bone mineral density, ↓growth (in children)
GI: diarrhea
MS: muscle pain
Resp: bronchospasm, cough, upper respiratory tract infection, wheezing
Misc: CHURG-STRAUSS SYNDROME, fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND LARYNGEAL EDEMA)
Drug-drug:
Aerosol for Oral Inhalation
Powder for Oral Inhalation
Inhaln
(Adults and Children ≥12 yr): No prior treatment with inhaled corticosteroid: 88 mcg twice daily initially; may ↑ dose in 2 wk if not adequately responding (max dose = 880 mcg twice daily).Inhaln
(Children 411 yr): 88 mcg twice daily (max dose = 88 mcg twice daily).Inhaln
(Adults and Children ≥12 yr): No prior treatment with inhaled corticosteroid: Propionate (Flovent Diskus generic): 100 mcg twice daily initially; may ↑ dose in 2 wk if not adequately responding (max dose = 1,000 mcg twice daily); Furoate: 100 mcg once daily; may ↑ dose in 2 wk to 200 mcg once daily if not adequately responding (max dose = 200 mcg once daily); Prior treatment with inhaled corticosteroid: Furoate: 100200 mcg once daily (max dose = 200 mcg once daily).Inhaln
(Children 511 yr): Furoate: 50 mcg once daily.Inhaln
(Children 411 yr): No prior treatment with inhaled corticosteroid: Propionate (Flovent Diskus generic): 50 mcg twice daily initially; may ↑ dose in 2 wk to 100 mcg twice daily if not adequately responding (max dose = 100 mcg twice daily).Lab Test Considerations: