Fluticasone Oral Inhalation

Fluticasone oral inhalation is used to prevent difficulty breathing, chest tightness, wheezing, and coughing caused by asthma in adults and children. It is in a class of medications called corticosteroids. Fluticasone works by decreasing swelling and irritation in the airways to allow for easier breathing.

Fluticasone comes as an aerosol to inhale by mouth using an inhaler and as a powder to inhale by mouth using an inhaler. Fluticasone aerosol oral inhalation (Flovent HFA) is usually inhaled twice daily. Fluticasone powder for oral inhalation is usually inhaled once daily (Armonair, Arnuity Ellipta) or twice daily (Armonair Respiclick, Flovent Diskus). Try to use fluticasone at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use fluticasone exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Talk to your doctor about how you should use your other oral and inhaled medications for asthma during your treatment with fluticasone inhalation. If you are using any other inhaled medications, ask your doctor if you should inhale these medications a certain amount of time before and after you inhale fluticasone inhalation. If you were taking an oral steroid such as dexamethasone, methylprednisolone (Medrol), or prednisone (Rayos), your doctor may want to gradually decrease your steroid dose starting at least 1 week after you begin to use fluticasone.

Fluticasone helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use fluticasone during an asthma attack. Your doctor will prescribe a short-acting inhaler to use during asthma attacks.

Your doctor will probably start you on an average dose of fluticasone. Your doctor may decrease your dose when your symptoms are controlled or increase it if your symptoms have not improved after at least 2 weeks.

Fluticasone controls asthma but does not cure it. Your symptoms may improve 24 hours after you begin using fluticasone, but it may take 2 weeks or longer before you feel the full benefit of the medication. Continue to use fluticasone even if you feel well. Do not stop using fluticasone without talking to your doctor.

If your child will be using the inhaler, be sure that they know how to use it. Watch your child each time they use the inhaler to be sure that they are using it correctly.

Tell your doctor if your asthma worsens during your treatment. Call your doctor if you have an asthma attack that does not stop when you use your fast-acting asthma medication, or if you need to use more of your fast-acting medication than usual.

The inhaler that comes with fluticasone aerosol is designed for use only with a canister of fluticasone. Never use it to inhale any other medication, and never use any other inhaler to inhale fluticasone.

Each product is designed to provide 30, 60, or120 inhalations, depending on the type of inhaler. After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication. You should keep track of the number of inhalations you have used. You can divide the number of inhalations in your inhaler by the number of inhalations you use each day to find out how many days your inhaler will last. Dispose of the canister after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed. Do not float the canister in water to see if it still contains medication.

Do not use your fluticasone aerosol inhaler while you are near an open flame or a heat source. The inhaler may explode if it is exposed to very high temperatures.

Before you use fluticasone the first time, read the written instructions that come with it. Look at the diagrams carefully and be sure that you recognize all the parts of the inhaler. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it. Practice using the inhaler while they watch you.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using fluticasone oral inhalation,

• tell your doctor and pharmacist if you are allergic to fluticasone, any other medications, milk proteins, or any of the ingredients in fluticasone inhalation. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using fluticasone oral inhalation. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. .
• do not use fluticasone inhalation during an asthma attack. Your doctor will prescribe a short-acting inhaler to use during asthma attacks. Call your doctor if you have an asthma attack that does not stop when using the fast-acting asthma medication, or if you need to use more of the fast-acting medication than usual.
• if you are using any other inhaled medications, ask your doctor if you should inhale these medications a certain amount of time before or after you inhale fluticasone inhalation.
• tell your doctor if you or anyone in your family has or has ever had osteoporosis (a condition in which the bones become thin and weak and break easily) and if you have or have ever had tuberculosis (TB; a type of lung infection) in your lungs, cataracts (clouding of the lens of the eye), glaucoma (an eye disease), or liver disease. Also tell your doctor if you have any type of untreated infection anywhere in your body or a herpes eye infection (a type of infection that causes a sore on the eyelid or eye surface), if you smoke or use tobacco products, or if you are on bedrest or unable to move around.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using fluticasone, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using fluticasone.
• if you have any other medical conditions, such as asthma, arthritis, or eczema (a skin disease), they may worsen when your oral steroid dose is decreased. Tell your doctor if this happens or if you experience any of the following symptoms during this time: extreme tiredness, muscle weakness, or pain; sudden pain in stomach, lower body, or legs; loss of appetite; weight loss; upset stomach; vomiting; diarrhea; dizziness; fainting; depression; irritability; and darkening of skin. Your body may be less able to cope with stress such as surgery, illness, severe asthma attack, or injury during this time. Call your doctor right away if you get sick and be sure that all healthcare providers who treat you know that you recently replaced your oral steroid with fluticasone inhalation. Carry a card or wear a medical identification bracelet to let emergency personnel know that you may need to be treated with steroids in an emergency.
• tell your doctor if you have never had chickenpox or measles and you have not been vaccinated against these infections. Stay away from people who are sick, especially people who have chickenpox or measles. If you are exposed to one of these infections or if you develop symptoms of one of these infections, call your doctor right away. You may need treatment to protect you from these infections.
• you should know that fluticasone inhalation sometimes causes wheezing and difficulty breathing immediately after it is inhaled. If this happens, use your fast-acting (rescue) asthma medication right away and call your doctor. Do not use fluticasone inhalation again unless your doctor tells you that you should.

Unless your doctor tells you otherwise, continue your normal diet.

Skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Fluticasone inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• stuffy or runny nose
• hoarseness
• toothache
• sore or irritated throat
• painful white patches in the mouth or throat
• fever
• ear infection

Some side effects can be serious. If you experience any of the following symptoms or those in the SPECIAL PRECAUTIONS section, call your doctor immediately:

• hives
• rash
• itching
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• difficulty breathing or swallowing
• cough
• shortness of breath

Fluticasone may cause children to grow more slowly. There is not enough information to tell whether using fluticasone decreases the final height that children will reach when they stop growing. Your child's doctor will watch your child's growth carefully while your child is using fluticasone. Talk to your child's doctor about the risks of giving this medication to your child.

Fluticasone may increase the risk that you will develop glaucoma or cataracts. You will probably need to have regular eye exams during your treatment with fluticasone. Tell your doctor if you have any of the following: pain, redness, or discomfort of the eyes, blurred vision, seeing halos or bright colors around lights, or any other changes in vision. Talk to your doctor about the risks of using this medication.

Fluticasone may increase your risk of developing osteoporosis. Talk to your doctor about the risks of using this medication.

Fluticasone may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Store your fluticasone aerosol inhaler with the mouthpiece pointing down. Store it out of reach of children, at room temperature and away from excess heat and moisture (not in the bathroom). If you are using the fluticasone powder for inhalation (Flovent Diskus) 50 mcg or the Arnuity Ellipta 50 mcg, 100, mcg, or 200 mcg, you must dispose of the inhaler 6 weeks after opening the foil pouch or after every blister has been used (when the dose counter reads 0), whichever comes first. If you are using the fluticasone powder for inhalation (Flovent Diskus) 100 mcg or 250 mcg, you must dispose of the inhaler 2 months after opening the foil pouch or after every blister has been used (when the dose counter reads 0), whichever comes first. If you are using the fluticasone powder for inhalation (Armonair Respiclick), you must dispose of it 30 days after opening the foil pouch or (when the dose counter reads 0), whichever comes first. Do not store the inhaler near a heat source or an open flame. Protect the inhaler from freezing and direct sunlight. Do not puncture the aerosol container and do not dispose of it in an incinerator or fire.

Your medication may come with a desiccant packet (small packet that contains a substance that absorbs moisture to keep the medication dry) in the container. Do not eat or inhale it. Throw it away in the household trash out of reach of children and pets.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Armonair^® Respiclick
• Arnuity^® Ellipta
• Flovent^® Diskus^®
• Flovent^® HFA