Flonase - Marketed as Flixonase in New Zealand 

Itchy eyes, runny nose, sneezing, headache, coughing and congestion are all symptoms of seasonal allergies. When one or two symptoms are present, it can really put a damper on life. However, when several of these symptoms are present at once, even participating in simple day-to-day activities can be almost impossible. What can a person with debilitating allergy symptoms do to find relief?

For years, the answer to that question was “almost nothing”. Eventually, the pharmaceutical industry started pushing expensive allergy medication. Some of it worked, but had so many side effects that many people refused to take them. After all, being allergy-free is only amazing if you’re not knocked out by sleep-inducing side effects.

Flonase for Allergy Symptoms

Finally, a drug called Flonase hit the market. A nasal spray with few side effects, it is safe for everyone over the age of four. Best yet, the side effects that are associated with using the spray are very mild, including sore throat, dryness of the nose and minor headaches. Essentially, the side effects are not all that dissimilar from the allergy symptoms themselves. 

Even women who are pregnant or nursing can safely use this drug, which just goes to show how safe the substance is. In fact, the only people who shouldn’t take Flonase are those who are allergic to fluticasone propionate, one of the active ingredients found in the spray.

How Often Should Flonase Be Used?

People interested in controlling their nasal allergy symptoms should talk to their doctor about the options that are available to treat them. With that said, the recommended dosage for a typical adult are two sprays in each nostril, once per day. This works out to approximately 100 mcg per day. 

After using Flonase for a few days, most patients note a drastic reduction in their nasal allergy symptoms. Once the allergy symptoms have been reduced, the amount of nasal spray a patient needs to experience complete relief is cut in half. Most patients only need to use one spray per nostril, to maintain the therapy. It is recommended that total usage not exceed four total sprays per day.

For adolescents and children, the suggested starting dosage of Flonase is 50 mcg – approximately one spray per nostril, per day. If that amount is insufficient, it is safe to increase the dosage of the medication to 100 mcg, total. Regardless of how much children start out taking, once the symptoms are manageable, the daily dosage should not exceed 50 mcg per day.

What’s In It and Who Makes It?

In Canada and the United States, Flonase is marketed by GlaxoSmithKline. In Europe and also New Zealand and Australia, the drug is known as “Flixonase”. The product is the same across all borders, and the active ingredient in the spray is fluticasone propionate. Inactive ingredients include mocrocrystalline cellulose, polysorbate 80, carboxymethyl-cellulose sodium, benzalkonium chloride and dextrose. Each bottle provides 120 doses, holding a net weight of 16 grams of medication.
 

Other Information

Flonase / Flixonase controls the major symptoms of hayfever. Flixonase / Flonase 24-hour contains an active ingredient called fluticasone proprionate, which treats inflamed tissue. Flonase / Flixonase 24-hour works by reducing swelling inside your nose. This makes breathing easier.

Flonase / Flixonase is designed to work best if used on a once daily basis, even if your allergy or hayfever symptoms have gone away or are reduced. Flonase / Flixonase 24-hour is suitable for short term (3-6 months) treatment of seasonal allergies including hayfever. It is not addictive. Flonase / Flixonase provides 24 hour protection from sneezing, nasal congestion and swelling, running and/or itchy nose and irritated eyes. So go on living without those troublesome hayfever symptoms with Flonase / Flixonase 24-hour.

Flonase Nasal Spray is intended for the relief of nasal symptoms of allergies and other seasonal reactions such as runny nose, sneezing, itching and congestion, tearing of the eyes, coughing and headache.

Mode of Action

Fluticasone propionate, the active ingredient of Flonase, is a synthetic steroid that has an anti-inflammatory action. The exact mode of action of this drug in relation to allergic rhinitis is not known. But being a member of the corticosteroid family of drugs it has a wide range of effects on different types of white blood cells such as mast cells, eosinophils, neutropils, macrophages and lymphocytes and acts as third party in the inflammation process. Its effect improves after several days after administration, thus, it is not intended to be used for the immediate relief of allergic symptoms.

Pharmacokinetics

Fluticasone propionate delivered through nasal administration has a complete bioavailability averaging less than 2%. After three weeks of treatment, fluticasone propionate plasma concentration was above the level of detection only when recommended doses were exceeded. Due to poor bioavailability by nasal administration, the majority of pharmacokinetic data was gathered through other routes of administration. Using intravenous administration, the first character stage for fluticasone propionate was rapid and constant with its high lipid solubility and tissue binding. The total blood clearance of this drug is high with renal clearance for less than 0.02% of the total. The only circulating metabolite detected is 17β-carboxylic acid that is formed through cytochrome P450 3A4 pathway. After intravenous administration, the terminal elimination half-life is approximately 7.8 hours. Less than 5% was excreted in the urine as metabolites and the remainder was excreted in the feces.

Drug Interactions

Before initiation of this medication, it is important to inform the physicians of all the medications currently taken to avoid drug-drug interactions that may lead to serious side effects.

Cytochrome P450 3A4

Concurrent Administration of ritonavir (Norvir, Kaletra) can greatly increase Flonase plasma concentration that may lead to systemic corticosteroid effects that includes Cushing syndrome and adrenal suppression. The combination of these two drugs should be avoided.

Concomitant use of azole anti-fungal drugs such as ketoconazole (Nizoral,) and erythromycin increases in complete exposure to fluticasone propionate without significant reductions in serum cortisol concentration. However, rare cases of adrenocortical suppression associated with the use of these drugs and inhaled fluticasone propionate were reported during post-marketing use. Caution should be exercised when co-administration of ketoconazole or erythromycin as there is potential increase of fluticasone propionate concentration in the body.

Indications

Flonase Nasal Spray is intended for the management of the nasal symptoms of hay fever and perennial allergic rhinitis in adults and children ages 4 years and older.

Contraindications

Flonase Nasal Spray is not recommended in patients with allergic reactions to fluticasone propionate and any of its components.

Flonase Nasal Spray is not recommended for children under 4 years of age.

Warning and Precautions

Intranasal corticosteroids, like Flonase Nasal Spray, may retard growth in children and cause reduction of adrenal gland function.

There is no established information about the safety of Flonase Nasal Spray in pregnant women and nursing mother. It should be used during pregnancy and breast feeding only if it is deem necessary and if there is no other medication that can be use for this purpose. Caution should be exercised when administering Flonase Nasal Spray to a nursing mother.

Rare cases of glaucoma have been reported after using nasal corticosteroids, including nasal fluticasone.

Adverse Reactions

The side effects of Flonase Nasal Spray are generally mild. The common adverse reactions are headache, nosebleed, burning or dryness of the nose or sore throat. Other side effects although in rare cases are white patches in the nose or throat, ulcers in the nose, runny nose, nausea and vomiting, cough, skin rash or itching, dry mouth.

Dosage and Administrations

To achieve the utmost benefit of Flonase Nasal Spray, patients should use it at regular intervals.

Recommended Dose for Adult
The starting dosage in adult patient is 2 sprays in each nostril once daily or a total of 100 mcg in a day. After the first few days patients may reduce their dosage to 50 mcg or 1 spray into each nostril once daily for maintenance therapy.

Recommended Dose for Adolescents and Children
The starting dose of 50 mcg or 1 spray into each nostril once daily is recommended. If this dose is not sufficient, it may increase to 100 mcg or 2 sprays into each nostril once daily. Once symptoms are controlled, the dosage should be reduced to 50 mcg or 1 spray into each nostril once daily.

The maximum total daily dosage should not exceed 2 sprays into each nostril once daily.

Supplementary Information
Flonase Nasal Spray is marketed by GlaxoSmithKline in United States and Canada. It is also known as Flixonase Nasal Spray in Europe marketed by Allen and Hansburys. The generic version of Flonase Nasal Spray was approved by FDA in February 22, 2006. The Fluticasone Nasal Spray is manufactured by Roxane Laboratories.

The active ingredient is fluticasone propionate, and the non-medicinal ingredients are microcrystalline cellulose, carboxymethyl-cellulose sodium, dextrose, 0.2% w/w benzalkonium chloride, polysorbate 80, and 0.25% w/w phenylethyl alcohol.

Flonase Nasal Spray is supplied in an amber glass bottle fitted with white metering atomizing pump, white nasal adapter, and green dust cover in a box of 1. Each bottle contains a net weight of 16 g and will provide 120 doses.

Resources:

www.flonase.com/use/howto.html