Fluticasone

Key facts

• Fluticasone is a corticosteroid that switches off local inflammation. It comes as a nasal spray for allergies, an inhaler for asthma and COPD (often combined with a long-acting bronchodilator such as salmeterol), and a cream for eczema and other skin conditions.
• It works best used regularly, not just when symptoms flare; nasal and inhaled forms can take several days to reach full effect.
• At high doses or with long-term use, corticosteroids from any route can suppress the body's own cortisol production and slow growth in children. Long courses are reduced gradually rather than stopped suddenly.
• Rinse your mouth with water after each inhaled or nasal dose to prevent oral thrush and hoarseness.

What fluticasone treats

Nasal fluticasone treats allergic rhinitis: sneezing, a blocked or runny nose, and itchy or watery eyes. Inhaled fluticasone controls asthma and, combined with a bronchodilator, chronic obstructive pulmonary disease (COPD). Fluticasone cream or ointment treats eczema and other inflammatory skin conditions. It relieves inflammation; it does not treat infections and is not a rescue treatment for a sudden asthma attack.

How fluticasone works

Fluticasone enters cells in the nose, lungs or skin and switches off the genes that drive inflammation, reducing swelling, mucus production and irritation in the treated tissue. Only a small amount reaches the rest of the body when used as directed, which is why side effects are usually mild and local.

Before you take it

• Tell your prescriber about any recent live vaccine, active infection (especially tuberculosis or a severe viral chest infection), or weakened immune system before starting.
• Inhaled fluticasone is linked to a higher risk of pneumonia in people with COPD; report any new fever, cough or breathlessness.
• Long-term high-dose use, particularly of the nasal or topical form on broken skin, can increase the amount absorbed into the bloodstream, raising the risk of adrenal suppression.
• Children on inhaled or intranasal fluticasone should have their growth checked periodically.

Side effects

Common effects include nosebleeds and nasal irritation with the spray, a hoarse voice or throat irritation with the inhaler, and thinning or dryness of the skin with the cream.

Stop and seek urgent medical care for any of these:

• Sudden vision changes or eye pain.
• Persistent fever, worsening cough, or new shortness of breath, especially if you have COPD.
• Signs of a severe allergic reaction: swelling of the face or throat, or difficulty breathing.
• White patches in the mouth or throat that do not clear (possible thrush).

Safety essentials

• Corticosteroids can suppress your body's own cortisol production when used at high doses or for a long time, from any route. Do not stop a long course abruptly; your prescriber will taper it.
• If you use an inhaled fluticasone product and have COPD, be alert for signs of pneumonia (fever, worsening breathlessness, new cough) and report them promptly.
• Rinse your mouth after inhaled or nasal doses and wash your hands after applying cream to avoid spreading it to other areas or people.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.