Fluticasone - Medication Detail

Medication Type:  Long Term Control, should be taken every day as prescribed

Generic Names:  Fluticasone

Brand Names:  Flovent HFA®, Flovent Diskus®, Arnuity™ Ellipta®, ArmonAir™ RespiClick®

Description:  This medication is an inhaler that is used to control long term symptoms of asthma. It prevents irritation and swelling in the airways.

Delivery

MDI (metered dose inhaler); DPI (dry powder inhaler)

Spacer

  • Flovent HFA can be used with a spacer.
  • Flovent Diskus cannot be used with a spacer.
  • Arnuity Ellipta cannot be used with a spacer.
  • ArmonAir RespiClick cannot be used with a spacer.

Dosage

Dosage is based on previous asthma therapy:

Flovent HFA®

AgePrevious TherapyRecommended Starting DosageHighest Recommended Dosage
Aged ≥ 12 yearsBronchodilators alone88 mcg twice daily880 mcg twice daily
Inhaled corticosteroids88-220 mcg twice daily880 mcg twice daily
Aged 4-11 years
88 mcg twice daily88 mcg twice daily

Flovent Diskus®

AgePrevious TherapyRecommended Starting DosageHighest Recommended Dosage
Aged ≥ 12 yearsBronchodilators alone100 mcg twice daily1000 mcg twice daily
Inhaled corticosteroids100-250 mcg twice daily1000 mcg twice daily
Aged 4-11 years
50 mcg twice daily100 mcg twice daily

Arnuity™ Ellipta®

AgePrevious TherapyRecommended Starting DosageHighest Recommended Dosage
Aged ≥ 12 years
None
100 mcg once daily200 mcg daily
Inhaled corticosteroids
100-200 mcg once daily200 mcg daily
Aged 5 to 11 years
50 mcg once daily50 mcg once daily

ArmonAir™ RespiClick®

AgePrevious TherapyRecommended Starting DosageHighest Recommended Dosage
Aged ≥ 12 yearsNo prior treatment with inhaled corticosteroids55 mcg twice daily232 mcg twice daily
Inhaled corticosteroids55-232 mcg twice daily232 mcg twice daily
ArmonAir™ RespiClick® is not indicated for children less than 12 years old

Proper Use

  • See instructions for proper use.
  • After using, rinse mouth with water and spit.

Flovent Diskus: After removing from box and foil pouch, write the “Pouch opened” and “Use by” dates on the label on top of the Diskus. The “Use by” date is either 6 weeks (with 50 mcg dose) or 2 months (with 100 or 200 mcg doses) after date of opening the pouch. Open the Diskus in a level and flat position and slide the lever until you hear a “click”. Every time the lever is pushed back, a dose is ready to be inhaled. Do not close or tilt the Diskus after the lever is pushed back. Do not play with the lever or move the lever more than once. Breathe out and then bring the Diskus to your lips while keeping it in the flat position. Breathe in quickly and deeply. Remove Diskus from your mouth, hold your breath for 10 seconds, and then breathe out slowly. Repeat the procedure for the second inhalation. Close the Diskus when you are done with your doses. The dose indicator tells you how many doses are left. When the numbers 5 to 0 appear in red, only a few doses remain. Discard device after the “Use by” date or when the dose counter reads “0” (whichever comes first). Rinse mouth with water after use and spit to reduce risk of throat and mouth infection.

Flovent HFA: Shake well for 5 seconds before each spray. Prepare inhaler for use before using for the first time with 4 test sprays (into air and away from face). If canister is dropped or not used for > 7 days, spray 1 test spray into the air before use. Do not use the “float test” to test if canister is empty. Use dose counter to check number of doses remaining in the inhaler. Contact pharmacy for refill when the dose counter reads “020”. Discard device when the dose counter reads “000”. Do not spray in eyes. Rinse mouth with water after use and spit to reduce risk of throat and mouth infection. For proper inhaler technique visit our inhaler page.

Arnuity Ellipta: Arnuity comes in a foil tray. Peel back the lid and throw away the tray and drying packet that comes with the tray. Write the date that you opened the tray on the inhaler label. The inhaler is good for 6 weeks only, so also write the “discard date” on the label (discard date is 6 weeks after you opened the tray). Do not open the inhaler cover until you are ready to use. Each time you open the cover, a dose is prepared for use. When you are ready to use, open the cover. You should hear a “click”.

  • Do not shake the inhaler.
  • Breathe out fully and hold the inhaler like a hamburger with both hands. Bring the mouthpiece to your mouth and close your lips around the curved mouthpiece. Breathe in deeply and slowly through your mouth. Do not block the air vent with your fingers.
  • Remove the mouthpiece and hold your breath for 3 or 4 seconds. Breathe out slowly and gently. Close the inhaler.
  • Rinse your mouth with water and spit out.

ArmonAir RespiClick: After removing from box and foil pouch, the RespiClick is only good for 1 month, so write the date opened on the label. The dose indicator tells you how many doses are left. Every time the mouthpiece cap is opened and closed, the dose counter will count down. Do not open the mouthpiece cap unless you are ready to use a dose. Discard device 1 month after you remove it from the foil pouch or when the dose counter reads “0” (whichever comes first). Rinse mouth with water after use and spit to reduce risk of throat and mouth infection. For proper inhaler technique visit our inhaler page.

Precautions

  • Do NOT use this drug to treat an asthma attack.
  • If you have been taking this drug for many weeks, talk with your doctor before stopping. You may want to slowly stop this drug.
  • Avoid being near anyone with chickenpox or measles.
  • Talk with your doctor if you have glaucoma or cataracts, high blood sugar (diabetes), a fast heartbeat, heart disease, high blood pressure, liver disease, soft and brittle bones (osteoporosis), overactive thyroid, seizures, if you are being treated for any type of infection, or if you have a severe milk allergy.
  • Do not drink grapefruit juice while taking this medication.

Common Interactions

This drug interacts with echinacea and itraconazole and other less common medications.

Tell your doctor and pharmacist about all of your medications and health problems so they can check for any interactions.

Possible Side Effects

Possible side effects include fatigue, headache, mouth and throat infection (rinse mouth with water after using medication to prevent mouth and throat infections), and nausea.

Tell your doctor or seek medical attention if you notice any signs of an allergic reaction (rash, hives, wheezing, tightness in the chest or throat, trouble breathing or swelling of the face), signs of infection including redness or white patches in mouth or throat, or trouble breathing after taking a dose (use rescue inhaler and seek medical attention).

Proper Storage

  • Store at room temperature.
  • Protect from heat, light and water.
  • Do not store in a bathroom.
  • Keep HFA inhaler away from open flame.
  • Do not puncture canister.
  • Do not store in extreme temperatures, such as in a parked car.
  • Do not use the “float test” to test if canister is empty.
  • Use dose counter to check number of doses remaining in the inhaler.