Fluticasone

Seasonal and perennial allergic rhinitis in adults and children from 4-6 years (depending on formulation). Per ARIA 2020 and SEAIC 2023, intranasal corticosteroids are first-line for moderate-to-severe and persistent symptoms. Fluticasone propionate dose: 100-200 µg (2 sprays per nostril) once daily; fluticasone furoate (Avamys): 27.5-55 µg once daily. Effect at 6-12 hours, full effect at 3-7 days. Long-term safety on childhood growth confirmed at standard doses (Skoner 2018).

Bronchial asthma in adults and children. Per GINA 2024, an inhaled corticosteroid is the backbone of controller therapy across all steps (1-5). Fluticasone propionate dose: 100-1000 µg/day in two doses for adults; 50-200 µg/day for children 4-16. Fluticasone furoate dose: 100-200 µg once daily. From GINA step 3 onward, use a fixed-dose ICS-LABA combination. Reassess symptoms and spirometry at 4-12 weeks; step down every 3-6 months when stable.

COPD with frequent exacerbations (≥2/year or ≥1 with hospitalization) and eosinophils ≥300 cells/µL. Per GOLD 2024, an inhaled corticosteroid is added to LABA or LABA + LAMA – monotherapy is not indicated. Fluticasone propionate dose: 500 µg twice daily. Increased pneumonia risk in COPD – discuss with the patient and reassess at 12 months.