Fluticasone Furoate

Registered South African indications:

• Symptoms of seasonal allergic rhinitis
• Symptoms of perennial allergic rhinitis

Contraindications

Registered South African contraindications & Contraindications registered in other jurisdictions

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Pregnancy
• Breastfeeding
• Switching from oral to nasal corticosteroids
• History of increased intraocular pressure
• Glaucoma
• Cataract

Forms avail. in SA and covered in this monograph: nas

Dosages below include:

• South African registered indications and dosages

South African registered indications and dosages

Symptoms of seasonal allergic rhinitis
- Treatment of nasal symptoms (rhinorrhoea, nasal congestion, nasal itching and sneezing) and ocular symptoms (itching/burning, tearing/watering, and redness of the eye)
Symptoms of perennial allergic rhinitis
- Treatment of nasal symptoms (rhinorrhoea, nasal congestion, nasal itching and sneezing)

• Nasal (nas): Initial: 2 sprays (27.5µg/spray) in each nostril once daily; Total daily dose: 110µg; Maintenance: Once symptoms are adequately controlled: Reduce to 1 spray (27.5µg/spray) in each nostril once daily; Total daily dose: 55µg

For full therapeutic benefit regular scheduled usage is recommended. Onset of action has been observed as early as 8 hours after initial administration. It may take several days of treatment to achieve maximum benefit. An absence of an immediate effect should be explained to the patient

See additional prescribing points for administration directions

Paed. forms avail. in SA and covered in this monograph: nas

Paed. dosages below include:

• South African registered indications and dosages

South African registered indications and dosages

Symptoms of seasonal allergic rhinitis
- Treatment of nasal symptoms (rhinorrhoea, nasal congestion, nasal itching and sneezing)
Symptoms of perennial allergic rhinitis
- Treatment of nasal symptoms (rhinorrhoea, nasal congestion, nasal itching and sneezing)

Younger than 2 years

• Not established for use

Between 2-11 years

• Nasal (nas): 1 spray (27.5µg/spray) in each nostril once daily; Total daily dose: 55µg; If inadequate response: Increase to 2 sprays (27.5µg/spray) in each nostril once daily; Total daily dose: 110µg; Once adequate control of symptoms is achieved: Reduction to 1 spray (27.5µg/spray) in each nostril once daily is recommended; Total daily dose: 55µg

Older than 12 years

• See adult dosage

For full therapeutic benefit regular scheduled usage is recommended. Onset of action has been observed as early as 8 hours after initial administration. It may take several days of treatment to achieve maximum benefit. An absence of an immediate effect should be explained to the patient

See additional prescribing points for administration directions

Pregnancy

• Caution
• There are no adequate data from the use of fluticasone furoate in pregnant women. In animal studies, glucocorticoids have been shown to induce malformations including cleft palate and intra-uterine growth retardation. This is not likely to be relevant for humans given recommended nasal doses which result in minimal systemic exposure. Fluticasone furoate should be used in pregnancy only if the benefits to the mother outweigh the potential risks to the foetus or child

Breastfeeding

• Caution
• It is unknown whether nasal administered fluticasone furoate is excreted in human breast milk. Administration of fluticasone furoate to women who are breastfeeding should only be considered if the expected benefit to the mother is greater than any possible risk to the child

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Headache

Respiratory Disorders

• Epistaxis
• Nasal ulceration
• Rhinalgia
• Nasal dryness
• Nasal septum perforation

Musculoskeletal Disorders

• Growth suppression

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity reactions
• Anaphylaxis
• Angioedema
• Rash
• Urticaria

Sensory Disorders

• Transient occular changes

• Ritonavir
• CYP3A4 inhibitors

None routine. Specific cases may require

• Height (children)

Administration directions

• Fluticasone furoate nasal spray is for administration by the intranasal route only. Shake the nasal spray before use
• Before the first use of the device, or if the cap has been left off or the device seems non-functional, it needs to be primed
• To prime the patient should shake the nasal spray vigorously with the cap on for around 10 seconds until the thick fluticasone furoate suspension turns into a liquid
• This is necessary for the spray to work
• Then, they should press the button all the way in about 6 times until a fine mist appears. This process ensures the delivery of a full dose
• Once primed, the nasal spray should be shaken before each use
• Patient should always replace the cap after use to maintain nozzle cleanliness and to avoid the need for re-priming

Fluticasone furoate is a synthetic trifluorinated corticosteroid that possesses a very high affinity for the glucocorticoid receptor and has potent anti-inflammatory and vasoconstrictive actions.

Nasal spray (per spray) 27.5μg

• Avamys (GSK) originator
• Genemist (GSK)