What to Know About Flovent (Fluticasone Propionate)

An inhaled steroid used to help manage asthma

Flovent (fluticasone propionate) is an inhaled corticosteroid used to maintain long-term control of asthma symptoms. It is used every day in regularly spaced doses to prevent attacks from occurring. As with other types of corticosteroid drugs, Flovent works by suppressing the immune response and, by doing so, reduces the inflammation that promotes airway hyperresponsiveness.

The two forms of Flovent approved by the U.S. Food and Drug Administration (FDA)—Flovent HFA (aerosolized fluticasone) and Flovent Diskus (powder form)—are available by prescription only. There are no generic forms in the United States.

Other FDA-approved fluticasone inhalants used in the treatment of asthma, including ArmonAir RespiDisk, ArmonDisk Digihaler, and Arnuity Ellipta.

Young woman using inhaler
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Uses

Referred to as a prophylactic therapy, Flovent is used on an ongoing basis to prevent asthma symptoms.

Flovent cannot be used to relieve sudden attacks and won't replace a rescue inhaler. Rather, it is prescribed as an addition to your treatment when you are unable to maintain control of your asthma symptoms with a rescue inhaler alone.

Flovent can be used on its own but is more commonly used today in combination with a long-acting beta-agonist (LABA).

In the past, inhaled corticosteroids were staged before LABAs, but current guidance from the Global Initiative for Asthma (GINA) recommends that they be started together for better long-term control.

In order for the drug to work, Flovent must be used every day on a schedule as directed by your doctor.

The two different types of Flovent are approved for adults and children over 4.

  • Flovent HFA is an aerosolized form of fluticasone delivered in a traditional meter dose inhaler. It uses an aerosolized propellant to deliver the drug into your lungs.
  • Flovent Diskus is a powder that does not utilize a propellant to get the drug into your lungs. Instead, you have to inhale the powder on your own.

While neither is inherently better than the other in controlling asthma symptoms, there are factors that may make one more appealing to you than the other.

Flovent HFA
  • Requires hand-breath coordination that new users may find awkward

  • Familiar function for experienced inhaler users

  • Can be used with a spacer to reduce the amount of drug in your mouth

  • Has to be primed before use and may clog if not used regularly

  • Has a 12-month shelf life

Flovent Diskus
  • Requires simple inhalation (no hand-breath coordination needed)

  • Cannot be used with a spacer

  • Doesn't require priming and generally won't get clogged

  • Must be used six weeks to two months, depending on the strength

  • Does not need to be regularly washed

Before Taking

Flovent HFA and Flovent Diskus are typically prescribed when a short-acting rescue inhaler like albuterol is unable to effectively control your asthma symptoms.

If you use a rescue inhaler more than twice a week, the American Academy of Allergy, Asthma & Immunology (AAAAI) recommends the introduction of daily inhaled medications to provide better long-term control. These include inhaled corticosteroids like Flovent and inhaled LABAs like Serevent (salmeterol).

The decision to start Flovent is based on the frequency and severity of asthma attacks. While pulmonary function tests (PFTs) play a central role in the diagnosis of asthma, they do not factor in as much with respect to the introduction of inhaled steroids in an asthma treatment plan.

Precautions and Contraindications

Flovent should never be used in people with a known allergy to fluticasone propionate or a similar drug called fluticasone furoate.

Flovent Diskus contains milk powder and should be avoided in people with a known milk allergy. In these individuals, Flovent can cause a potentially life-threatening, whole-body allergy called anaphylaxis.

Flovent should be used with caution in people with the following conditions:

Flovent is not contraindicated for use in people with these conditions, but it may accelerate disease progression with long-term use. If prescribed, extra care should be taken to monitor for disease progression in anyone with vision problems, adrenal gland dysfunction, or osteoporosis.

Care should also be taken when considering prescribing Flovent to adults over 65, as they are more likely to have these health concerns and/or take multiple medications, some of which may interact with Flovent.

Flovent HFA and Flovent Diskus are both Pregnancy Category C drugs, meaning that animal studies have shown a potential for fetal harm, but well-controlled studies in humans are not available. The benefits of the treatment may outweigh the risks, but careful consideration is needed with the guidance of your doctor or healthcare provider.

Other Corticosteroid Options

Other types of inhaled corticosteroids are available if fluticasone either fails to provide adequate control or causes intolerable side effects. These include combination inhalers that use both an inhaled steroid and a LABA.

The following inhaled steroids or steroid/LABA combinations are licensed for use by the FDA for moderate to severe asthma:

Dosage

Flovent HFA is available in 44-microgram (mcg), 110-mcg, and 220-mcg strengths. Flovent Diskus is available in 50-mcg, 100-mcg, and 250-mcg strengths.

The recommended dosage is based on a person's age. As a rule, the lowest dose should be used when first starting and increased as/if needed, never exceeding the recommended daily dose.

This is particularly important for children as Flovent's effects on the adrenal gland may impair their growth, though the risk is considered low because the drug is inhaled rather than injected or taken by mouth. Nevertheless, children should be prescribed the lowest possible dose and have their growth monitored during treatment.

Recommended Dosage
  Flovent HFA Flovent Diskus
Adults and adolescents over 12 Start with 88 mcg twice daily.
Never exceed 880 mcg twice daily.
Start with 100 mcg twice daily.
Never exceed 100 mcg twice daily.
Children 4 to 11 Limit intake to 88 mcg twice daily.
Never exceed 88 mcg twice daily.
Start with 50 mcg twice daily.
Never exceed 100 mcg twice daily.
All doses should be spaced 12 hours apart.

It generally takes around one to two weeks from the start of Flovent treatment to feel the full benefits. Flovent needs to be taken daily no matter how well your asthma symptoms are controlled.

If you feel your asthma control is good, you can speak to your doctor about decreasing the strength of your daily dose.

If Flovent is unable to sustain control of your symptoms, let your doctor know. If needed, a long-acting beta-agonist may be added to your daily treatment plan, or an oral corticosteroid may be recommended if your asthma attacks are severe and recurrent.

How to Take and Store

Flovent HFA and Flovent Diskus can both be stored at room temperature between 68 and 77 degrees F. Do not puncture Flovent HFA or store it near a heater or open flame. Keep these medications out of the reach of children.

Because Flovent HFA uses an aerosolized propellant and Flovent Diskus is simply inhaled, instructions for use differ. Speak to your doctor or pharmacist if you are unsure if you are using your Flovent inhaler properly.

Using Flovent HFA

  1. When using the inhaler for the first time (or if you've not used it in four weeks), prime it by spraying it into the air four times. You only need to spray it once if not used within one to three weeks.
  2. Shake the inhaler vigorously for five seconds.
  3. Take the cap off and place a spacer on the end, if you use one.
  4. Exhale fully and place the mouthpiece in your mouth in a downward position, wrapping your lips tightly to form a seal.
  5. Breathe in deeply through your mouth as you simultaneously depress the inhaler completely.
  6. Hold your breath for about 10 seconds and exhale slowly.
  7. If additional doses are needed, wait 30 seconds, shake the inhaler, and start again.
  8. Once completed, rinse your mouth. Do not swallow.
  9. Replace the cap.

Clean the mouthpiece and spacer at least once weekly. When the dose counter reads "020," it's time for a refill.

Using Flovent Diskus

  1. Push the thumb grip at the top as far down as it can go to open the disk.
  2. Hold the disk level with the mouthpiece so that it faces you.
  3. Slide the lever next to the mouthpiece down until it clicks. This loads the precise dose into the well of the actuator.
  4. Hold the disk away from your face and exhale fully.
  5. Place your mouth tightly over the mouthpiece and inhale as deeply as you can.
  6. Remove your mouth from the mouthpiece, holding your breath for around 10 seconds.
  7. Exhale slowly and fully.
  8. If additional doses are needed, repeat the above steps.
  9. Close the mouthpiece cover when finished.

When the dose counter on the disk reads "5," refill your prescription. Do not wash the inhaler. Always keep it dry.

If you miss a dose of Flovent HFA or Flovent Diskus, take it as soon as possible. However, if it is near the time of your next dose, skip the missed dose and go back to your regular dosing schedule. Never double up doses.

Side Effects

While using Flovent is generally safe, Flovent does carry some risk of side effects like all other medications. While most side effects will decrease with continued use, tell your doctor if they persist or worsen.

Common

The side effects of Flovent HFA and Flovent Diskus are similar. While Flovent Diskus has fewer constitutional symptoms, comparatively speaking, Flovent HFA has far less risk of oral candidiasis (thrush) due to the use of spacers.

The most common side effects of Flovent HFA and Flovent Diskus (in order of frequency):

Flovent HFA
  • Upper respiratory infection

  • Throat irritation

  • Headache

  • Sinus infection

  • Nausea and vomiting

  • Fever (usually mild)

  • Sneezing and runny nose

  • Stomach ache

  • Muscle and joint pain

Flovent Diskus
  • Upper respiratory infection

  • Headache

  • Throat irritation

  • Sinus infection

  • Oral candidiasis (thrush)

  • Cough

Severe

While Flovent is considered safe with relatively few intolerable side effects, it can cause problems with long-term use. Some may relate to the development of cataracts, glaucoma, bone mineral loss, or adrenal dysfunction that can occur, albeit uncommonly, in Flovent users.

Call your doctor if you experience any of the following while using either Flovent HFA or Flovent Diskus:

  • Blurred vision
  • Eye pain
  • Vision loss
  • Erectile dysfunction
  • Irregular or missed periods
  • Shortness of breath or wheezing
  • High fever
  • Bone fractures
  • Severe weakness
  • Confusion or disorientation

When to Call 911

Seek emergency care if you experience symptoms of anaphylaxis after using Flovent (especially Flovent Diskus):

  • Rash or hives
  • Shortness of breath
  • Wheezing
  • Rapid or irregular heartbeat
  • Dizziness or lightheadedness
  • Swelling of the face, tongue, or throat
  • A feeling of impending doom

If left untreated, anaphylaxis can lead to shock, coma, asphyxiation, heart or respiratory failure, or death.

Warnings and Interactions

Because Flovent can suppress the immune system, children may also be at greater risk of communicable infection. Extra care should be taken to avoid exposure to childhood infections like measles or chickenpox. If there is an outbreak in your child's school or your child gets infected, contact your doctor immediately for advice on what to do.

Flovent should also be stopped if you develop oral thrush as the medication can make it worse. You should also call your asthma doctor if you develop a respiratory infection, particularly a lower respiratory infection, as you may also need to stop treatment temporarily.

Drug Concentration Concerns

Flovent HFA and Flovent Diskus both use an enzyme called cytochrome P450 (CYP450) for metabolization. Because of this, it may interact with other drugs that use the same enzyme for metabolization. If this occurs, the concentration of one or both drugs can rise or drop.

A decrease in drug concentration may reduce the effectiveness of a drug, while an increase can increase the risk of side effects.

Drugs of potential concern include:

Some interactions may require a drug substitution, a dose reduction, or the separation of each dose by several hours to avoid an interaction. Others may require no adjustment at all.

Because of the wide range of possible interactions, it is important to let your doctor know about any drugs you are taking, whether they are prescription, over-the-counter, herbal, nutritional, or recreational.

A Word From Verywell

Flovent HFA and Flovent Diskus are both valuable tools for gaining control of your asthma symptoms. But they only work if you take them as prescribed. If you have problems with adherence, let your doctor know.

If your symptoms are not controlled, it's possible that you've been taking the drug incorrectly. In other cases, your doctor may opt to change you to a once-daily inhaler like Breo Ellipta if appropriate.

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Article Sources
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