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RX BIN: 015558
RX PCN: HT
Group ID: DDN6600
Card Holder ID: DDN6600

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2018 Price of Fluticasone Propionate

Advair Diskus 500 mcg/dose Metered Inhalation Powder

$1.55

dose

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Fluticasone Propionate volume of distribution

IV administration = 4.2 L/kg. It is intended for long-term treatment, and not for relief of asthma attacks. When transferring patients with systemic corticosteroids to treatment with fluticasone propionate, caution should be exercised because of the risk of developing adrenal insufficiency. Possible the emergence of systemic effects, especially with prolonged use in high doses. Suppression of adrenal function can reach a clinically significant level as a result of treatment with higher doses than recommended. It is necessary to take into account the possibility of a residual disturbance of the function of the adrenal cortex in stressful situations (including respiratory infections, surgery, trauma) and decide on the need for an additional appointment. Corticosteroids for nasal or inhalation use can cause systemic effects, especially with prolonged use in high doses. There are reports that some glucocorticosteroids for intranasal use in high doses can cause growth retardation in children. It is recommended to regularly monitor the growth of children, long using such medicinal forms of glucocorticosteroids. In case of detection of growth retardation, the treatment should be adjusted to reduce the dose of the drug for intranasal use if possible to a minimal but effective control of the symptoms of the disease. In addition, it is necessary to examine the patient from a pediatrician. Given the side effect, care must be taken when driving vehicles or potentially dangerous mechanisms.

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What is Fluticasone Propionate

With inhalation or intranasal application of fluticasone propionate, as a rule, its concentration in the plasma is low due to intensive metabolism during the “first passage” through the liver and high systemic clearance under the influence of the CYP3A4 isoenzyme in the intestine and liver. Due to this, clinically significant interaction with the participation of fluticasone propionate is unlikely. A study of the drug interaction showed that ritonavir (a highly active inhibitor of the isoenzyme CYP3A4) can significantly increase the concentrations of fluticasone propionate in the blood plasma, thereby significantly reducing the concentration of serum cortisol. There are reports of clinically significant drug interactions in patients who simultaneously received fluticasone propionate and ritonavir. This interaction caused such side effects as Cushing’s syndrome and suppression of adrenal function. Given this, simultaneous use of fluticasone propionate and ritonavir should be avoided, unless the potential benefit to the patient exceeds the risk of systemic side effects of the drug. Other inhibitors of the CYP3A4 isoenzyme cause a negligible small (erythromycin) and insignificant (ketoconazole) increase in plasma fluticasone propionate, in which the serum cortisol concentrations are virtually unchanged. Despite this, caution should be exercised while using fluticasone propionate and strong inhibitors of the CYP3A4 isoenzyme (eg, ketoconazole), since this combination can potentially increase the systemic effects of fluticasone propionate.

Fluticasone Propionate mechanism of action

After intranasal administration of fluticasone propionate (200 g/day) Cmax in blood plasma in most patients is below the detection level (less 0.01 ng/ml). The highest value of Cmax is 0.017 ng/ml. Direct absorption from the mucosa of the nasal cavity is negligible due to the low solubility of the active substance in the water, as a result, most of the dose is ultimately swallowed. With oral administration of fluticasone propionate, less than 1% of the dose is absorbed into the blood due to poor absorption and presystemic metabolism. All this leads to the fact that the total absorption from the nasal cavity and gastrointestinal tract (if swallowed) is extremely low. After inhalation, systemic absorption occurs predominantly in the lungs. Part of the inhaled dose can be swallowed. After swallowing, the systemic effect is minimal due to intensive metabolism during the “first pass” through the liver. There is a direct relationship between the magnitude of the inhalation dose and the systemic effect of fluticasone propionate. Binding to plasma proteins – 91%. Vd is more than 300 liters. Fluticasone propionate is rapidly eliminated from the blood plasma, mainly as a result of liver metabolism to the inactive carboxyl metabolite under the action of the CYP3A4 isoenzyme. T1/2 is approximately 8 hours. Plasma clearance is 1150 ml/min. It is excreted mainly with bile in the form of unchanged substance and in the form of metabolites. Renal clearance of unchanged fluticasone propionate is negligible (less 0.2%), in the form of a metabolite with urine, less than 5% of the dose is excreted.

Dosage forms of Fluticasone Propionate

DrugDosageQuantityPrice
Flovent HFA50mcg120doses Inhaler$28.95
Flovent HFA50mcg360doses Inhaler$51.95
Flovent HFA125mcg120doses Inhaler$49.50
Flovent HFA125mcg360doses Inhaler$72.95
Flovent HFA250mcg120doses Inhaler$69.00
Flovent HFA250mcg360doses Inhaler$180.00
Flovent Diskus100mcg60doses Diskus (powder)$36.00
Flovent Diskus250mcg60doses Diskus (powder)$53.00
Prescription Generics

Arnuity Ellipta, Flovent, Flovent Rotadisk

International Brands

24 Hour Allergy Nasal

Synonyms

Cutivate Fluticason

Manufacturers

Walgreen Company

CAS number

80474-14-2

UNII

O2GMZ0LF5W

State

solid

Affected organisms

Humans and other mammals

Indication of Fluticasone Propionate

Prevention and treatment of seasonal allergic rhinitis (including hay fever). Prevention and treatment of year-round allergic rhinitis. Regular therapy of bronchial asthma. Supportive therapy for COPD in adults, including chronic obstructive bronchitis and emphysema.

Toxicity of Fluticasone Propionate

With inhalation or intranasal application of fluticasone propionate, as a rule, its concentration in the plasma is low due to intensive metabolism during the “first passage” through the liver and high systemic clearance under the influence of the CYP3A4 isoenzyme in the intestine and liver. Due to this, clinically significant interaction with the participation of fluticasone propionate is unlikely. A study of the drug interaction showed that ritonavir (a highly active inhibitor of the isoenzyme CYP3A4) can significantly increase the concentrations of fluticasone propionate in the blood plasma, thereby significantly reducing the concentration of serum cortisol. There are reports of clinically significant drug interactions in patients who simultaneously received fluticasone propionate and ritonavir. This interaction caused such side effects as Cushing’s syndrome and suppression of adrenal function. Given this, simultaneous use of fluticasone propionate and ritonavir should be avoided, unless the potential benefit to the patient exceeds the risk of systemic side effects of the drug. Other inhibitors of the CYP3A4 isoenzyme cause a negligible small (erythromycin) and insignificant (ketoconazole) increase in plasma fluticasone propionate, in which the serum cortisol concentrations are virtually unchanged. Despite this, caution should be exercised while using fluticasone propionate and strong inhibitors of the CYP3A4 isoenzyme (eg, ketoconazole), since this combination can potentially increase the systemic effects of fluticasone propionate.

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