Fluticasone propionate dosage, forms, and strengths

Fluticasone propionate is a generic corticosteroid FDA approved for several conditions: seasonal allergies, asthma, nasal polyps, eczema, and other types of dermatitis. Some dosage forms are used off-label to treat conditions such as sinusitis or non-allergic rhinitis. Many of the symptoms of these conditions are caused by the body’s inflammatory response to allergens or other provocations. As a corticosteroid, fluticasone blocks the immune system from mounting an inflammatory response. There are several dosage forms: nasal sprays, inhalers, and topical formulations. Each will have different dosage regimens and side effects. The most common side effects include throat irritation, sore throat, and hoarseness for inhalers, nasal irritation for nasal sprays, and itchiness, burning, and redness for topical fluticasone.

Fluticasone propionate forms and strengths

Fluticasone propionate is delivered straight to the tissue being treated, so it comes in a variety of dosage forms:

• OTC nasal spray: 50 micrograms (mcg)

• Prescription nasal spray: 93 mcg

• Aerosol inhaler: 44 mcg, 110 mcg, 220 mcg

• Powder inhaler: 50 mcg, 55 mcg, 100 mcg, 113 mcg, 232 mcg, 250 mcg

• Cream: 0.05%

• Lotion: 0.05%

• Ointment: 0.005%

Fluticasone propionate dosage for adults

Fluticasone nasal spray can be purchased without a prescription to treat the symptoms of seasonal allergies. With a prescription, fluticasone inhalers are intended to prevent or minimize asthma symptoms. Prescription nasal spray is used to treat nasal polyps. Prescription topical fluticasone relieves the symptoms of atopic dermatitis.

Fluticasone propionate dosage for seasonal allergies and hay fever

Fluticasone nasal spray can be used daily for several months to treat the symptoms of upper respiratory allergic reactions (allergic rhinitis) such as runny nose, sneezing, congestion, and itchy nose. If allergic rhinitis is still a problem after six months of continual daily dosing, see a doctor before continuing this medicine.

• Standard fluticasone propionate dosage for allergic rhinitis: Two sprays in each nostril daily for one week followed by one to two sprays in each nostril daily for up to six months

Fluticasone propionate dosage for asthma

Fluticasone propionate helps reduce the incidence and severity of asthma symptoms. Its primary mechanism of action is to reduce airway swelling, but it also helps relax airway muscles. Doses start on the low end, but severe asthma may require very large doses. If the medicine doesn’t work after two weeks, therapy may need to be modified.

• Standard fluticasone propionate dosage for asthma prophylaxis: 88 mcg (two doses on a 44 mcg metered aerosol inhaler) taken twice daily OR 100 mcg taken twice daily (powder inhaler)—doses may be higher based on treatment response

• Maximum fluticasone propionate dosage for asthma prophylaxis: 880 mcg twice daily (metered aerosol inhaler) OR 1000 mcg twice daily (powder inhaler)

Fluticasone propionate dosage for eczema

Atopic dermatitis or eczema is a common skin condition characterized by itchiness, dryness, and redness. Topical fluticasone provides symptom relief. Treatment should stop when symptoms are under control.

• Standard fluticasone propionate dosage for atopic dermatitis: Apply a thin film of the medicine to the affected skin once or twice daily

Fluticasone propionate dosage for nasal polyps 

Healthcare providers use prescription fluticasone nasal spray to treat chronic rhinosinusitis with nasal polyps.

• Standard fluticasone propionate dosage for allergic rhinitis: One to two sprays (93–186 mcg) in each nostril twice per day

Fluticasone propionate dosage for children

OTC fluticasone nasal sprays and asthma inhalers can be used in pediatric patients 4 years of age and older. Dosing for adolescents is the same as for adults. For children younger than 12, doses will be lower because fluticasone can slow a child’s growth. Fluticasone propionate cream and lotion can be used to treat dermatitis in children as young as 3 months old. Dosages of topical fluticasone are the same as for adults, but topical treatment should not last longer than four weeks.

• Standard fluticasone propionate dosage for allergic rhinitis in children 4–11 years of age: One spray in each nostril daily

• Standard fluticasone propionate dosage for asthma in children 4–11 years of age: 88 mcg (two 44 mcg actuations on a metered aerosol inhaler) taken twice daily OR 50 mcg taken twice daily (powder inhaler)

• Maximum fluticasone propionate dosage for asthma in children 4–11 years of age: 88 mcg (two 44 mcg actuations on a metered aerosol inhaler) taken twice daily OR 100 mcg taken twice daily (powder inhaler)

Fluticasone propionate dosage restrictions

In all its dosage forms and brand names, fluticasone propionate does not have dosage restrictions or reductions for reasons such as kidney impairment or liver problems. The only contraindications are allergies to the drug or, in the case of dry powder inhalers, severe hypersensitivity to milk proteins or lactose. As with all medicines, there’s a risk of life-threatening allergic reactions in people sensitive to the drug.

Fluticasone propionate dosage for pets

According to Plumb’s Veterinary Manual, veterinarians may use inhaled fluticasone propionate for asthma in cats or chronic bronchitis in dogs. However, vets usually use oral systemic corticosteroids for long-term treatment. Powder inhalers can’t be used with animals, so the standard treatment will involve either aerosol inhalers with spacers or oral corticosteroids. 

How to take OTC fluticasone propionate nasal spray (Flonase Allergy Relief)

Although sold over-the-counter, fluticasone nasal spray requires some care to make sure a complete dose is taken.

• Read the starting guide insert or drug information on the package carefully. Using the nasal spray incorrectly may result in an ineffective dose. 

• Do not spray fluticasone nasal spray in the eyes or mouth.

• Clean the spray nozzle weekly to ensure that enough medicine is delivered with each dose. 

Taking a dose:

• Shake the bottle gently.

• If it’s the first time the bottle’s being used or it hasn’t been used in a while, prime the spray bottle by pointing it away from your face and pumping it until a fine mist appears.

• Blow your nose into a tissue.

• Close one nostril with your finger and put the tip of the spray bottle in the other nostril

• Point the tip away from the center of the nose.

• Breathe in gently while spraying the medicine into the nostril

• Do the same for the other nostril.

• Wipe off the spray nozzle before replacing the cap.

How to take prescription fluticasone propionate nasal spray (XHANCE)

Prescription fluticasone propionate isn’t like most other nasal sprays. It involves blowing into a mouthpiece while spraying the medicine into the nose. It may take some getting used to.

• Watch the instructional video or read the instructions 

• Do not spray fluticasone nasal spray in the eyes or mouth.

• The nasal spray device will need to be primed the first time it’s used. Shake the nasal spray device, point the end away from you, and then pump it seven times until a fine mist comes out.

Taking a dose:

• Shake the bottle gently.

• Hold the spray device BELOW the mouthpiece. 

• Put the tip into one nostril as far as it can comfortably go to form a tight seal. Aim the tip up into the nose. 

• Do not close the other nostril.

• Put the mouthpiece in your mouth and close your lips around it.

• Blow hard into the mouthpiece while pushing the pump at the bottom to deliver the medicine. 

• Do the same for the other nostril.

How to take fluticasone propionate HFA (Flovent HFA)

One of the conveniences of HFA inhalers is their ease of use. 

• Never take a missed dose. If a dose is forgotten, just take the next dose as scheduled.

• Read the instructions or starting guide before using this medicine. 

• If you are unfamiliar with the parts of the inhaler—canister, actuator, counter, mouthpiece, or cap—read the instructions or ask a healthcare provider for medical advice.

• Only use a fluticasone propionate canister with a fluticasone propionate actuator. 

• Store this medicine at room temperature, away from heat and light.

Priming the inhaler:

• When the inhaler is first used, it must be primed.

• Remove the cap.

• Gently shake the inhaler for five seconds.

• To prime the actuator, point the inhaler away from you and spray once.

• Shake and spray the inhaler two more times. 

Taking a dose:

• Make sure the canister is in place.

• Shake the inhaler gently.

• Breathe out as much air as you can.

• Insert the mouthpiece into your mouth.

• Push down on the canister while breathing in. 

• Hold your breath for 10 seconds.

• Rinse your mouth with water and spit out the water. 

How to take fluticasone propionate dry powder inhaler (Flovent Diskus)

Dry powder inhalers have more steps than aerosol inhalers. That creates more opportunities to make mistakes. The most important thing to know is that the inhaler does not aerosolize the medicine. That’s done by the strength of your breath intake. If the medicine isn’t properly aerosolized, you won’t get enough of it in your lungs. 

• Read the instructions that come with this medicine.

• Do not use a spacer with this inhaler.

• Do not wash or take apart the inhaler.

• Never take a missed dose. Take the next dose as scheduled.

• Store this medicine at room temperature away from heat and light.

Taking a dose:

• Open the inhaler by grabbing the inhaler in one hand. With the thumb of the other hand in the thumb grip, twist the thumb grip counter-clockwise until the mouthpiece shows.

• Slide the lever away from the mouthpiece as far as you can. The inhaler should click when complete.

• Put the mouthpiece between your lips.

• DO NOT breathe out into the mouthpiece.

• Breathe in quickly through the mouth.

• Remove the inhaler from your mouth.

• Hold your breath for 10 seconds.

• Breathe out slowly. 

• Close the inhaler using the thumb grip.

• Rinse your mouth with water and spit it out.

How to take topical fluticasone propionate 

Topical fluticasone comes as a lotion, cream, or ointment. It’s applied in the same way as other topical remedies or drugs, so there aren’t many steps to follow. 

• Apply this medicine only on the skin. Do not use it on the eyes, mouth, or inside the vagina.

• Stop using it when symptoms go away.

• Store this medicine at room temperature.

Taking a dose:

• Wash your hands. Consider wearing gloves if the medicine does not come with an applicator.

• Apply just enough cream, lotion, or ointment to the affected skin to form a thin film over the skin. 

• Avoid covering the treated skin with a bandage, diapers, wraps, or plastic pants.

Fluticasone propionate dosage FAQs

How long does it take fluticasone propionate to work?

Fluticasone nasal spray and topical fluticasone will improve symptoms within a day or two. Fluticasone inhalants take about one or two weeks or longer of dosing to hit their maximum effectiveness at controlling asthma symptoms.

How long can you take fluticasone propionate?

Fluticasone nasal spray, creams, or lotion should be taken only for as long as needed. Although fluticasone inhalants are intended for months or years of daily dosing, long-term use of inhaled corticosteroids increases the risk of adverse effects such as Candida infections of the mouth (thrush), cataracts, glaucoma, acne, skin thinning, and unwanted hair growth. 

How do I stop taking fluticasone propionate?

Fluticasone nasal spray and skin cream can be stopped at any time without problems. Fluticasone inhalant may need a tapering dose when it’s time to stop. Steroid use can decrease the body’s ability to make the hormone cortisol, a condition called HPA axis suppression. This will cause withdrawal symptoms if the medicine is stopped suddenly. People who stop fluticasone inhalants may also experience a worsening of their asthma symptoms.

What interacts with fluticasone propionate?

The most serious drug interactions involving fluticasone involve drugs or supplements called CYP3A4 inhibitors that slow down the body’s ability to break down fluticasone. This increases the risk of adverse reactions. These drugs include the antibiotic clarithromycin, the antiviral drug ritonavir, and the antifungal drug ketoconazole.

Is it safe to take fluticasone propionate during pregnancy?

Clinical trials did not assess the safety of fluticasone propionate during pregnancy or breastfeeding. Healthcare professionals generally believe that fluticasone propionate can be used in women who are pregnant or breastfeeding after weighing potential benefits and risks.

Sources

• Fluticasone propionate cream prescribing information, NIH National Library of Medicine

• Fluticasone propionate Diskus prescribing information, NIH National Library of Medicine

• Fluticasone propionate HFA prescribing information, NIH National Library of Medicine

• Fluticasone propionate lotion prescribing information, NIH National Library of Medicine

• Fluticasone propionate nasal prescribing information, NIH National Library of Medicine

• Fluticasone propionate ointment prescribing information, NIH National Library of Medicine

• Xhance prescribing information, NIH National Library of Medicine

• Fluticasone, StatPearls

• Fluticasone, inhaled, Drugs and Lactation Database, LactMed

• Drugs used to treat lung and airway disorders, MSD Manual