• See Also
  1. Inhaled Corticosteroid
  2. Asthma Management
  • Indications
  1. Inhaled Corticosteroids are the most important agent in Asthma Management
  2. Indicated as daily maintenance agents in all persistent Asthma
    1. Mild Persistent Asthma
    2. Moderate Persistent Asthma
    3. Severe Persistent Asthma
  • Dosing
  • Fluticasone Propionate (Flovent HFA, Flovent Discus, ArmonAir)
  1. Use child dosing for age 6 to 11 years old
  2. Dose per puff
    1. Flovent HFA 44, 110, 220 mcg/puff (120 puffs/Inhaler)
    2. Flovent Discus (dry powder) 50, 100, 250 mcg/puff (60 puffs/Inhaler)
    3. ArmonAir (dry powder) 55, 113, 232 mcg/puff (60 puffs/Inhaler)
  3. Low dose
    1. Adult: 220 mcg (e.g. 110 mcg Inhaler, 1 puff twice daily)
    2. Child: 88 mcg (e.g. 44 mcg Inhaler, 1 puff twice daily)
  4. Medium dose
    1. Adult: 440 mcg (e.g. 220 mcg Inhaler, 1 puff twice daily)
    2. Child: 220 mcg (e.g. 110 mcg Inhaler, 1 puff twice daily)
  5. High dose
    1. Adult: 880 mcg (e.g. 220 mcg Inhaler, 2 puffs twice daily)
    2. Child: 440 mcg (e.g. 220 mcg Inhaler, 1 puff twice daily)
  • Dosing
  • Fluticasone Furoate DPI (Arnuity Ellipta)
  1. Use child dosing for age 6 to 11 years old
  2. Dose per puff
    1. Arnuity Ellipta (Dry Powder): 50, 100, 200 mcg/puff (14 and 30 Blister packs)
  3. Low to Medium Dose
    1. Adult: 100 mcg (e.g. 100 mcg Inhaler, 1 puff daily)
    2. Child: 50 mcg (e.g. 50 mcg Inhaler, 1 puff daily)
  4. High Dose
    1. Adult: 200 mcg (e.g. 200 mcg Inhaler, 1 puff daily)
  • Medications
  • Combinations
  1. Salmeterol/Fluticasone (Advair Diskus, Advair HFA, AirDuo Digihaler, AirDuo Respiclick, Wixela Inhub)
  2. Umeclidinium/Vilanterol/Fluticasone (Trelegy Ellipta)
  3. Vilanterol/Fluticasone (Breo Ellipta)
  • Adverse Effects
  1. See Inhaled Corticosteroid
  2. Fluticasone propionate may have more systemic absorption than other steroid Inhalers (adrenal suppression risk)
  • Efficacy
  1. See Inhaled Corticosteroid
  • Safety
  1. Pregnancy Category C
  2. Unknown Safety in Lactation
  • Resources
  1. Fluticasone Propionate or Flovent HFA (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b49ed7c1-123e-4b1d-fea6-0c6839fd9d6a
  2. Fluticasone Furoate DPI or Arnuity Ellipta (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=50f193ee-1691-486d-9370-a664df63695c
  • References
  1. (2017) Presc Lett 24(10):58
  2. (2022) Comparison of Asthma Medications, Presc Lett, #381217
  3. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200