What are the contraindications for Fluticasone (Fluticasone)?

From the Guidelines

Fluticasone is contraindicated in patients with a known hypersensitivity to the drug.

Contraindications and Precautions

• The provided evidence does not explicitly state contraindications for Fluticasone, but it can be inferred that patients with a history of hypersensitivity to Fluticasone or other corticosteroids should avoid its use.
• Hypersensitivity reactions, such as anaphylaxis, have been reported with the use of corticosteroids, including Fluticasone 1.
• Caution is advised when using Fluticasone in patients with certain medical conditions, such as glaucoma, cataracts, or osteoporosis, as corticosteroids may exacerbate these conditions.
• Growth suppression has been reported in children using intranasal corticosteroids, including Fluticasone, although this effect is generally transient and dependent on the dose and duration of use 1.
• Local side effects, such as nasal irritation, bleeding, and nasal septal perforation, can occur with the use of intranasal Fluticasone, but are rare and can be avoided with proper administration technique 1.
• Systemic side effects, such as hypothalamic-pituitary-adrenal axis suppression, are generally not associated with the use of intranasal Fluticasone at recommended doses 1.
• It is essential to monitor patients closely for any adverse effects and adjust the treatment regimen as needed.

From the FDA Drug Label

Fluticasone Propionate Nasal Spray, USP, is contraindicated in patients with a hypersensitivity to any of its ingredients. The contraindication for Fluticasone is a hypersensitivity to any of its ingredients 2.

• The only listed contraindication is hypersensitivity to the ingredients in Fluticasone Propionate Nasal Spray, USP.

From the Research

Contraindications for Fluticasone

There are no direct contraindications mentioned in the provided studies for Fluticasone. However, some potential risks and side effects are discussed:

• High doses of Fluticasone may show evidence of suppression of the hypothalamic pituitary axis as measured by in vitro tests, but evidence of corresponding clinical adverse effects is lacking 3
• A higher likelihood of pharyngitis was apparent when patients were treated with Fluticasone at twice the dose of BDP/BUD, although there was unexplained heterogeneity in this effect between trials 4
• The incidence of oral candidiasis was < or =8% in patients treated with Fluticasone propionate < or =250 microg twice daily or other agents 5
• Preliminary data from 2 published trials also indicate no significant effect on growth in children, however, wider clinical experience is needed to clarify the effects of long term administration on pituitary-adrenal function, bone metabolism and attainment of adult height in children 6

Potential Risks and Side Effects

Some potential risks and side effects associated with Fluticasone include:

• Suppression of the hypothalamic pituitary axis at high doses 3
• Pharyngitis, particularly at high doses 4
• Oral candidiasis, although the incidence is relatively low 5
• Potential effects on growth in children, although preliminary data suggests no significant effect 6

Special Considerations

Some special considerations for the use of Fluticasone include:

• The need for careful dose selection to minimize the risk of side effects 3, 4, 5
• The potential for interactions with other medications, although this is not discussed in the provided studies
• The importance of monitoring for signs of adverse effects, such as oral candidiasis or pharyngitis 4, 5