What is the recommended dose of Avamys (fluticasone furoate) for children over 8 years old with allergic rhinitis?

Recommended Dosage of Avamys (Fluticasone Furoate) for Children Over 8 Years with Allergic Rhinitis

For children over 8 years old with allergic rhinitis, the recommended dose of Avamys (fluticasone furoate) is 2 sprays per nostril once daily (total daily dose of 110 μg). 1

Dosing Guidelines for Fluticasone Furoate

• For children aged 2-11 years (including those over 8 years), the recommended starting dose is 1-2 sprays per nostril once daily 1
• For children over 11 years, the standard dose is 2 sprays per nostril once daily 1
• Once symptoms are controlled, the dose may be reduced to the minimum effective dose for maintenance therapy 1
• Fluticasone furoate (Avamys/Veramyst) contains 27.5 μg per spray, making the total daily dose 55-110 μg for children 2-11 years 1

Efficacy and Safety Considerations

• Intranasal corticosteroids are the most effective medications for treating allergic rhinitis, more effective than the combined use of an antihistamine and a leukotriene antagonist 1
• The onset of therapeutic effect occurs between 3-12 hours after administration, with optimal efficacy reached within days to weeks 1, 2
• Clinical trials have demonstrated that fluticasone furoate nasal spray is effective and well-tolerated in children with seasonal and perennial allergic rhinitis 3
• The 110 μg dose provides optimal risk-benefit ratio with statistically significant and clinically meaningful results for all efficacy endpoints 4

Safety Profile in Children

• Studies have shown that fluticasone furoate has a good safety profile in children with no significant effect on growth at recommended doses 2
• Unlike beclomethasone dipropionate, which has shown growth suppression at high doses, fluticasone furoate has not demonstrated clinically significant systemic side effects at recommended doses 1, 2
• Common side effects include epistaxis (nosebleeds), headache, pharyngolaryngeal pain, nasal ulceration, back pain, pyrexia, and cough 1
• The medication is contraindicated in children with history of hypersensitivity to fluticasone furoate or any components of the formulation 1

Administration Technique

• The child should be instructed to shake the bottle prior to use 2
• Have the child blow their nose before using the spray 2
• Keep the head in an upright position during administration 2
• Hold the spray in the opposite hand in relation to the nostril being treated (contralateral technique) to reduce risk of epistaxis 2
• The child should breathe in gently during spraying 2
• Regular use rather than as-needed approach is recommended for optimal symptom control 1, 2

Treatment Considerations

• For optimal effectiveness, Avamys should be used at regular intervals rather than on an as-needed basis 1
• If nasal symptoms are not adequately controlled with the initial dose, increasing to 2 sprays per nostril once daily may be considered for children 8-11 years 1
• Proper administration technique should be demonstrated to ensure effective delivery and minimize side effects 2