From the Guidelines
Yes, Flonase (fluticasone) is generally safe for patients with asthma and may actually be beneficial for those with coexisting allergic rhinitis and asthma. Fluticasone is a corticosteroid that works by reducing inflammation in the nasal passages and airways. The standard dose for adults is typically 1-2 sprays in each nostril once or twice daily, with a maximum of 4 sprays per nostril daily. For asthma patients specifically, using Flonase to control nasal symptoms can indirectly help improve asthma control, as untreated allergic rhinitis can worsen asthma symptoms, as indicated by guidelines for asthma management 1. This connection exists because the upper and lower airways share inflammatory mechanisms, often referred to as the "united airway concept." When using Flonase, patients should be consistent with their regular asthma medications as prescribed by their healthcare provider, as nasal corticosteroids like Flonase are not a replacement for asthma controllers or rescue medications. Some key points to consider when using Flonase in patients with asthma include:
- Consistency with prescribed asthma medications
- Potential benefits of improved asthma control through reduction of nasal inflammation
- Monitoring for side effects such as nasal irritation, headache, or nosebleeds
- Proper use and maintenance of the nasal spray device to minimize side effects. It's also important to note that inhaled corticosteroids, like fluticasone, are considered the most effective anti-inflammatory medication for treating the underlying inflammation in asthma, according to the guidelines for the diagnosis and management of asthma 1.
From the FDA Drug Label
Asthma symptoms2.97.23.3 The FDA drug label does not directly answer if Flonase is okay with asthma, but it does mention asthma symptoms as an adverse event with an incidence of 2.9% to 7.2% in patients treated with Fluticasone Propionate Nasal Spray, USP 2 2.
- Asthma is not listed as a contraindication.
- The label does not provide information on the safety of using Flonase in patients with asthma.
- Bronchospasm and wheezing are listed as possible hypersensitivity reactions, but it is not clear if these are more common in patients with asthma.
From the Research
Safety of Flonase in Asthma Patients
- Flonase, also known as fluticasone, is a type of inhaled corticosteroid used to treat asthma and other respiratory conditions 3, 4.
- Studies have shown that fluticasone is highly efficacious in preventing worsening asthma, with a relatively flat dose-response curve 3.
- The safety of fluticasone in asthma patients has been evaluated in several studies, with results indicating that it is generally well-tolerated and effective in improving asthma-related outcomes 5, 6, 4.
Efficacy of Flonase in Asthma Patients
- Fluticasone has been shown to improve lung function, reduce symptoms, and decrease the need for rescue medication in asthma patients 4, 7.
- The time to onset of effect of fluticasone has been evaluated in several studies, with results indicating that significant improvements in peak expiratory flow (PEF), asthma symptom scores, and supplemental albuterol use can be observed within 1-3 days of treatment 7.
- The best observed effect of fluticasone on PEF, FEV1, and asthma symptom scores has been shown to occur within 2-3 weeks of treatment 7.
Comparison with Other Treatments
- Fluticasone has been compared to other inhaled corticosteroids, such as beclomethasone dipropionate, budesonide, and triamcinolone acetonide, and has been shown to be at least twice as potent 4.
- Combination therapy with fluticasone and salmeterol has been shown to be effective in reducing asthma-related exacerbations and improving quality of life in asthma patients 6.
- Healthcare costs have been shown to be lower in patients receiving inhaled corticosteroids, such as fluticasone, compared to combination therapy with fluticasone and salmeterol 5.