What is the recommended duration of Avamys (fluticasone furoate) use in children?

Duration of Avamys (Fluticasone Furoate) Use in Children

Avamys can be used long-term in children aged 2 years and older for chronic conditions like perennial allergic rhinitis, with safety demonstrated in studies up to 12 weeks and clinical practice supporting extended use when needed for symptom control.

Age-Specific Recommendations

Children 2-11 Years Old

• The recommended dose is 55 μg (1 spray per nostril) once daily 1
• Safety and efficacy have been established in pediatric patients aged 2-11 years in controlled trials lasting 12 weeks 2
• No clinically concerning safety findings were identified in these studies, including assessments of hypothalamic-pituitary-adrenal function, nasal and ophthalmic examinations 2

Adolescents 12 Years and Older

• The recommended dose is 110 μg (2 sprays per nostril) once daily 1
• This age group follows adult dosing recommendations 1

Long-Term Use Considerations

Safety Profile for Extended Use

• Fluticasone furoate has negligible bioavailability, making it preferred for long-term use due to reduced potential for systemic side effects 3
• The medication requires only once-daily dosing, which improves adherence for chronic management 3
• Common side effects include epistaxis (nosebleeds), headache, viral infection, pharyngitis, and cough 1

Duration Principles

• For chronic conditions like perennial allergic rhinitis, intranasal corticosteroids are the mainstay of therapy and require long-term adherence 3
• Treatment should be used regularly rather than as-needed to maintain optimal symptom control 1
• Once asthma or rhinitis control is achieved with any inhaled corticosteroid in children, the dose should be carefully titrated to the minimum required to maintain control 4

Important Clinical Caveats

Monitoring Requirements

• The face should be washed after each treatment to prevent local corticosteroid side effects 4
• Response to therapy should be monitored carefully, and if clear benefit is not observed within 4-6 weeks, alternative therapies or diagnoses should be considered 3

Contraindications

• Avamys is contraindicated in patients with a history of hypersensitivity to the medication or its components 1

Onset of Action

• The onset of action may be delayed approximately 12 hours, with maximal efficacy reached in days to weeks 1
• Therapeutic effect can be observed as early as 8 hours after initial administration in some patients 5

Step-Down Approach

• Once control of symptoms is established and sustained, a careful step-down in therapy should be attempted 3
• The goal is to use the minimum effective dose for maintenance 4