From the Guidelines
Fluticasone propionate 250 mcg inhaler should be used twice daily, with approximately 12 hours between doses, as this frequency is likely to provide the best balance between efficacy and safety, according to the most recent guidelines 1. The standard regimen involves taking one or two inhalations (250-500 mcg) in the morning and again in the evening.
- After inhalation, patients should rinse their mouth with water and spit it out to reduce the risk of oral thrush, a common side effect of inhaled corticosteroids.
- Consistency in timing is important for maintaining therapeutic blood levels and achieving optimal control of respiratory symptoms.
- Fluticasone works by reducing inflammation in the airways, which takes time to develop full effectiveness, so regular use as prescribed is essential even when symptoms improve.
- Patients should not exceed the prescribed dose frequency, as this does not provide additional benefit but may increase the risk of side effects, as higher doses of ICSs may provide little added benefit when weighed against the increased risk of systemic effects 1. If symptoms are not adequately controlled with the prescribed regimen, patients should consult their healthcare provider rather than adjusting the dose themselves, as adjunctive therapies may be necessary for patients with poorly controlled asthma 1.
From the Research
Recommended Inhaler Frequency for Fluticasone Propionate 250 mcg
- The recommended inhaler frequency for fluticasone propionate 250 mcg is twice daily, as stated in the study 2.
- This study found that dosages of 50 to 250 microg twice daily produced consistent improvement in spirometric measures of lung function, reduced the frequency of as-needed beta2-agonist bronchodilator use, asthma symptom scores and night-time wakenings, and prevented asthma exacerbations compared with placebo.
- Another study 3 compared the efficacy and safety of fluticasone propionate administered as a once-daily or twice-daily regimen over a period of 1 year to patients with moderate asthma, and found that twice-daily dosing demonstrated significantly greater improvement in some efficacy parameters than once-daily dosing over the first 12 weeks of treatment.
- A study 4 also compared the effectiveness of fluticasone propionate powder 200 microg/d administered as a once- or twice-daily dosage regimen in patients with asthma, and found that the efficacies of twice-daily and once-daily dosing were comparable with regard to improvement in pulmonary function and asthma stability in patients treated with bronchodilators only.
Comparison with Other Studies
- A study 5 compared the efficacy and safety of once-daily salmeterol/fluticasone propionate combination therapy with twice-daily fluticasone propionate in patients with mild asthma, and found that once-daily salmeterol/fluticasone propionate was non-inferior to twice-daily fluticasone propionate with respect to mean morning peak expiratory flow.
- Another study 6 compared the lung function effects of once-daily fluticasone furoate/vilanterol with twice-daily fluticasone propionate/salmeterol in COPD patients, and found that once-daily fluticasone furoate/vilanterol provided FEV(1) improvement that was at least comparable with that conferred by twice-daily fluticasone propionate/salmeterol.