Known brand names include Flovent, Armonair, Arnuity, and Flonase.
An inhaled corticosteroid used twice a day to control asthma and prevent attacks in people 4 and older. It does not relieve a sudden attack, which needs a rescue inhaler such as albuterol. Rinsing the mouth after each use helps prevent thrush.
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The label does not describe a narrow therapeutic index or direct dosing by measured blood levels; plasma levels do not predict effect.
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No antidote. Chronic overdose can cause hypercorticism; reduce to the lowest effective dose.
Doses come from the FDA label. Study tool, not for clinical decisions.
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Not studied. It is cleared mainly by the liver and may accumulate, so monitor patients with hepatic disease closely.
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A synthetic trifluorinated corticosteroid with high glucocorticoid receptor affinity, about 18 times that of dexamethasone. It acts on many inflammatory cells (mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (histamine, eicosanoids, leukotrienes, cytokines) in the airways. Benefit builds over 1 to 2 weeks or longer. It acts locally in the lung; oral bioavailability is under 1% because of first-pass metabolism, while drug reaching the lung is absorbed. It is cleared by hepatic CYP3A4, with a half-life of about 7.8 hours.