Fluticasone (Nasal spray)
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 BRAND NAMES
- Australia: Avamys
- Canada: Avamys PI, Flonase PI
- Europe: Avamys PI, Flixonase
- India: Ezicas F, Flixonase, Furamist.
- Italy: Avamys, Flixonase
- UK: Pirinase
- US: Flonase PI, Veramyst PI
 MECHANISM OF ACTION
Fluticasone propionate is a synthetic trifluorinated corticosteroid, it has a direct anti-inflammatory action on the nasal mucosa
The antiinflammatory actions of corticosteroids involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.
Fluticasone Nasal spray does not have an immediate effect on allergic symptoms. Maximum benefit may require several days.
Fluticasone Nasal spray is indicated for the management of the nasal symptoms of seasonal and perennial allergic and nonallergic rhinitis in adults and pediatric patients 4 years of age and older.
- Adults: 200-mcg/day divided in two 50 mcg sprays in each nostril once daily or in one 50 mcg spray in each nostril twice daily.
- Pediatric patients (4 years of age and older): 100 mcg/day (1 spray in each nostril once daily)
- Known hypersensitivity to ingredients
 WARNINGS AND PRECAUTIONS
- Fluticasone Nasal spray has an inhibitory effect on nasal wound healing. Do not use it until healing has occurred.
- Intranasal corticosteroids may cause a reduction in growth velocity when administered to pediatric patients. Therefore, children should be maintained on the lowest possible efficacious dose which delivers adequate symptom control and growth of children receiving prolonged treatment should be regularly monitored.
- Nasal and inhaled corticosteroids may result in the development of glaucoma and/or cataracts. Therefore close monitoring is warranted in patients with a change in vision or with a history of increased intraocular pressure, glaucoma and/or cataracts.
- Development of localized infections of the nose and pharynx with Candida albicans (Rarely)
- Hypersensitivity reactions, including anaphylaxis, angioedema, rash, and urticaria, may occur
Ritonavir : Concomitant administration with Ritonavir is not recommended because of the risk of increased systemic exposure of fluticasone.
 PREGNANCY AND LACTATION
- Pregnancy Category C (US). Fluticasone Nasal Spray should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- Nursing Mothers: Caution should be exercised if administered to a nursing woman.
 SIDE EFFECTS
Dryness and irritation of the nose and throat, unpleasant taste and smell, headache and epistaxis.
Hypersensitivity reactions including skin rash and edema of the face or tongue may occur.
- Rarely: Anaphylactic reactions and bronchospasm.
- Very rarely: Glaucoma, raised intraocular pressure and cataract.
- Extremely rarely: nasal ulceration and nasal septal perforation usually following previous nasal surgery
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