Fluticasone is a Medicine belongs to Corticosteroids group whose information about Brand can be referenced from   Book : Martindale    Page : 1639   Edition : 38, Martindale    Page : 1673   Edition : 37,    Page :   Edition : ,

  ►   Brandname : Floease,Flixonase,Cutivate,Nasofan,Avamys,Flutide,Formoflo,Seroflo,Seroflo rotacap,Formoflo Mdi

  ►  Strength : Aerosol with 44  mcg/puff, Aerosol with 110  mcg/puff, Aerosol with 220  mcg/puff, aerosol powder with 50  mcg/activation, aerosol powder with 100  mcg/activation, aerosol powder with 250  mcg/activation, Cream with   , Nasal Spray with   , Ointment with   , Nasal Drop with   ,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 355   Edition : 12, Martindale    Page : 1639   Edition : 38,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : inhalation, Topical, nasal,
Reference :-   Book : Martindale    Page : 1672   Edition : 37,

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Chronic obstructive pulmonary disease inhalation 500 micrograms Aerosol b.d. Given as an aerosol or powder inhalation.
2 Prophylaxis and treatment of allergic rhinitis nasal 100 micrograms Nasal Spray o.d. Given into each nostril, increased if necessary to 100 micrograms into each nostril twice daily. A maintenance dose of 50 micrograms in each nostril once daily may be effective. Also used in the management of allergic rhinitis, and is given in a starting dose of 55 micrograms into each nostril once daily.
3 Nasal polyps nasal 200 micrograms Nasal Drop o.d/b.d It should be instilled into each nostril for at least 4 to 6 weeks.
4 Asthma inhalation 100 500 micrograms b.d. These initial doses range from 100 twice daily in mild asthma up to 500 micrograms twice daily in severe asthma, adjusted according to response. The drug may also be given via a nebuliser in severe chronic asthma. Usual adult doses are 0.5 to 2 mg twice daily. It is also given by dry powder inhalation in asthma prophylaxis. A delivered dose of 92 micrograms is inhaled once daily; this may be increased to 184 micrograms once daily if necessary.
5 Various skin disorders Topical Creams and ointments containing 0.05% and 0.005%, respectively are available.

Ref :-  Book : Martindale    Page : 1638   Edition : 38,

Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Asthma 4 Year 11Year inhalation 50 100 micrograms Powder b.d.
2 Prophylaxis and treatment of allergic rhinitis 4 Year 11 Year nasal 50 micrograms Nasal Spray o.d.
3 Nasal polyps 16 Year above 16Year nasal

Ref :- Book : Martindale    Page : 1638   Edition : 38,
►  Side Effect : Serious adverse effects: ( immunosuppression, cataract, Hyperglycaemia, hypercortisolism, Depression, euphoria, osteoporosis, growth retardation in children, muscle atrophy), impaired wound healing, hypertension, fluid retention, oropharyngeal candidiasis, dysphonia, skin atrophy,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 503   Edition : 3,

►  Drug Interaction : Drug interaction of Fluticasone is with Potassium-depleting diuretics, Thiazide Diuretics , Xanthines, Beta 2 Agonist, Anticoagulant , Salicylates, anticholinesterases, Non Sterodial Anti- Inflammatory Drugs ,  Amphotericin B , Mifepristone , Furosemide ,
Ref :-   Book : Martindale    Page : 1619,1638   Edition : 38, Martindale    Page : 1632   Edition : 37,

  ►    Mechanism of Drug Drug Interaction :  Use of corticosteroids with potassium-depleting diuretics, such as thiazides or furosemide, may cause excessive potassium loss. There is also an increased risk of hypokalaemia with concurrent amphotericin B or bronchodilator therapy with xanthines or beta2 agonists. There may be an increased incidence of gastrointestinal bleeding and ulceration when corticosteroids are given with NSAIDs. Response to anticoagulants may be altered by corticosteroids and requirements of antidiabetic drugs and antihypertensives may be increased. Corticosteroids may decrease serum concentrations of salicylates and may decrease the effect of anticholinesterases in myasthenia gravis. The antiglucocorticoid effect of mifepristone will antagonise the effects of corticosteroids. ,
Ref :-   Book : Martindale    Page : 1619,1638   Edition : 38,

►  Contraindication : Systemic fungal infection,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 503   Edition : 3,
  ►  Mechanism of Action :   In addition to their effects on lymphocyte number, corticosteroids profoundly alter the immune responses of lymphocytes. These effects are an important facet of the anti-inflammatory and immunosuppressive actions of the glucocorticoids. Multiple mechanisms are involved in the suppression of inflammation by glucocorticoids. Glucocorticoids inhibit the production by multiple cells of factors that are critical in generating the inflammatory response. As a result, there is decreased release of vasoactive and chemoattractive factors, diminished secretion of lipolytic and proteolytic enzymes, decreased extravasation of leukocytes to areas of injury, and ultimately, decreased fibrosis. Glucocorticoids can also reduce expression of pro-inflammatory cytokines, as well as COX-2 and NOS2. The net effect of these actions on various cell types is to diminish markedly the inflammatory response. Stresses such as injury, infection, and disease result in the increased production of cytokines, a network of signaling molecules that integrate actions of macrophages/monocytes, T lymphocytes, and B lymphocytes in mounting immune responses. Among these cytokines, interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF-) stimulate the HPA axis, with IL-1 having the broadest range of actions. IL-1 stimulates the release of CRH by hypothalamic neurons, interacts directly with the pituitary to increase the release of ACTH, and may directly stimulate the adrenal gland to produce glucocorticoids. The increased production of glucocorticoids, in turn, profoundly inhibits the immune system at multiple sites. Factors that are inhibited include components of the cytokine network, including interferon (IFN-), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukins (IL-1, IL-2, IL-3, IL-6, IL-8, and IL-12), and TNF-. Thus, the HPA axis and the immune system are capable of bidirectional interactions in response to stress, and these interactions appear to be important for homeostasis.,
Ref :-   Book : Goodman    Page : 1221,1222   Edition : 12,

Pathway of Dietry Product

​   ► Act.Comp / Nutrient / Food / Herb as follows :- Mulathi i.e licorice with Another pathway,

  ►  Pathway with its reference as follows :-
  • Glyccrazin have antiviral effect --- (Chirumbolo, S. (2016). Commentary: The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Front. Microbiol., 7. http://dx.doi.org/10.3389/fmicb.2016.00531 )

  •   ►  URL -- http://www.sciencedirect.com/science/article/pii/S2211383515000799,

    Dietry Substance Interactions

    ​   ► This Medicine interact with :- NA

    ContraIndication Dietry Substance

    ​   ► This Medicine contraindicate with :- NA

    ►   Route of Elimination :   Hepatic (Metabolism),
    Ref :-   Book : Martindale    Page : 1672   Edition : 37,

    ►    Plasma Half-life :
      Min value :-   NA    Max value :-   NA

    ►    Peak Plasma Concentration :   Min value :-   NA    Max value :-   NA