What is the recommended dose and frequency of Fluticasone (Fluticasone propionate)?

From the Guidelines

The recommended dose and frequency of Fluticasone (Fluticasone propionate) is 880 μg per day, with a typical dosing regimen of 2-4 puffs twice daily 1.

Key Considerations

• The dose of Fluticasone propionate may vary depending on the patient's response to therapy and the severity of their asthma, with higher doses required for more severe cases 1.
• The Expert Panel recommends that the dose be carefully titrated to the minimum dose required to maintain control, and that preparations are not interchangeable on a mcg or per-puff basis 1.
• For children under 4 years of age, the dose may be administered through a face mask, and the low dose for children under 4 years of age is higher than for children 5-11 years of age due to lower dose delivered with face mask and data on efficacy in young children 1.

Dosing Regimens

• Intermittent treatment: 750 μg twice daily at onset of a respiratory tract infection for up to 10 days 1.
• Continuous treatment: 880 μg per day, with a typical dosing regimen of 2-4 puffs twice daily 1.

Important Notes

• The safety and efficacy of ICSs in children under 1 year has not been established 1.
• Corticosteroid side effects can be minimized by washing the face after each treatment to prevent local side effects 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Patients should use Fluticasone Propionate Nasal Spray, USP, at regular intervals for optimal effect. Adults The recommended starting dosage in is 2 sprays (50 mcg of fluticasone propionate each) in each nostril once daily (total daily dose, 200 mcg). The same dosage divided into 100 mcg given twice daily (e.g., 8 a.m. and 8 p.m.) is also effective. After the first few days, patients may be able to reduce their dosage to 100 mcg (1 spray in each nostril) once daily for maintenance therapy. Adolescents and Children (4 Years of Age and Older) Patients should be started with 100 mcg (1 spray in each nostril once daily). Patients not adequately responding to 100 mcg may use 200 mcg (2 sprays in each nostril). Once adequate control is achieved, the dosage should be decreased to 100 mcg (1 spray in each nostril) daily The maximum total daily dosage should not exceed 2 sprays in each nostril (200 mcg/day).

The recommended dose and frequency of Fluticasone (Fluticasone propionate) is:

• Adults: 2 sprays (50 mcg each) in each nostril once daily (total daily dose, 200 mcg) or 100 mcg given twice daily, with a possible reduction to 100 mcg (1 spray in each nostril) once daily for maintenance therapy.
• Adolescents and Children (4 Years of Age and Older): 100 mcg (1 spray in each nostril) once daily, with a possible increase to 200 mcg (2 sprays in each nostril) if needed, and a decrease to 100 mcg (1 spray in each nostril) daily once adequate control is achieved. The maximum total daily dosage should not exceed 200 mcg/day 2.

From the Research

Recommended Dose and Frequency of Fluticasone

The recommended dose and frequency of Fluticasone (Fluticasone propionate) can be determined based on several studies.

• The dose of Fluticasone propionate ranges from 50 to 1,000 microg administered twice-daily 3.
• Studies have compared the efficacy of once-daily and twice-daily dosing of Fluticasone propionate, with twice-daily dosing generally showing greater therapeutic benefit 4, 3, 5, 6.
• A meta-analysis of six studies found that twice-daily dosing of Fluticasone propionate was associated with significantly greater efficacy compared with once-daily dosing, for all outcome measures except night wakenings 4.
• Another study found that twice-daily dosing of Fluticasone propionate was numerically superior to once-daily dosing at the same nominal dose in all comparative studies for the primary end point, change in predose FEV(1) 3.
• The findings suggest that twice-daily administration of Fluticasone propionate will provide greater therapeutic benefit than a once-daily morning regimen 4, 3, 5, 6.

Dosage Comparison

• A study compared the efficacy of once- and twice-daily dosing of Fluticasone propionate 200 micrograms per day administered by diskus device in patients with asthma treated with or without inhaled corticosteroids, and found that twice-daily dosing provided greater improvements in pulmonary function and asthma stability in ICS patients 7.
• Another study found that twice-daily dosing of Fluticasone propionate demonstrated small but statistically significant improvements over once-daily dosing, although patients of both groups generally maintained a good level of asthma control on both regimens according to current treatment guidelines 5.

Key Findings

• Twice-daily dosing of Fluticasone propionate is generally recommended over once-daily dosing due to its greater therapeutic benefit 4, 3, 5, 6.
• The dose of Fluticasone propionate can range from 50 to 1,000 microg administered twice-daily, depending on the patient's condition and response to treatment 3.