Buy Flovent Online

Flovent Diskus (fluticasone propionate)

THERAPEUTIC CLASS

Corticosteroid

DEA CLASS

RX

INDICATIONS

Maintenance treatment of asthma as prophylactic therapy in patients ≥4 yrs of age and for patients requiring oral corticosteroid therapy for asthma.

ADULT DOSAGE

Asthma

Maintenance Treatment

Previous Therapy:


Bronchodilators Alone:
Initial: 100mcg bid
Max: 500mcg bid

Inhaled Corticosteroids:
Initial: 100-250mcg bid
Max: 500mcg bid
May consider starting doses >100mcg bid with poorer asthma control or previous high-dose inhaled corticosteroid requirement

Oral Corticosteroids:
Initial: 500-1000mcg bid
Max: 1000mcg bid
Reduce oral prednisone no faster than 2.5-5mg/day on a weekly basis beginning after at least 1 week of fluticasone therapy

Titrate: Reduce to lowest effective dose once asthma stability is achieved. Higher dosages may provide additional asthma control if response to initial dose is inadequate after 2 weeks

PEDIATRIC DOSAGE

Asthma

Maintenance Treatment

4-11 Years:
Previous Therapy:

Oral Corticosteroids:
Initial: 50mcg bid
May consider starting doses >50mcg bid with poorer asthma control or previous high-dose inhaled corticosteroid requirement
Max: 100mcg bid

≥12 Years:
Previous Therapy:
Bronchodilators Alone:
Initial: 100mcg bid
Max: 500mcg bid

Inhaled Corticosteroids:
Initial: 100-250mcg bid
May consider starting doses >100mcg bid with poorer asthma control or previous high-dose inhaled corticosteroid requirement
Max: 500mcg bid

Oral Corticosteroids:
Initial: 500-1000mcg bid
Max: 1000mcg bid
Reduce oral prednisone no faster than 2.5-5mg/day on a weekly basis beginning after at least 1 week of fluticasone therapy

Titrate: Reduce to lowest effective dose once asthma stability is achieved. Higher dosages may provide additional asthma control if response to initial dose is inadequate after 2 weeks

ADMINISTRATION

Orally inhaled powder

Rinse mouth after inhalation

HOW SUPPLIED

Disk: 50mcg/inh [60 blisters]; 100mcg/inh, 250mcg/inh [28, 60 blisters]

CONTRAINDICATIONS

Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Milk protein hypersensitivity.

WARNINGS/PRECAUTIONS

Not indicated for acute bronchospasm relief. Candida albicans infections of mouth and pharynx reported; treat and/or interrupt therapy if needed. Increased susceptibility to infections. May lead to serious/fatal course of chickenpox or measles; avoid exposure and, if exposed, consider prophylaxis/treatment. Caution with active/quiescent tuberculosis (TB), systemic fungal/bacterial/viral/parasitic infections, or ocular herpes simplex. Deaths due to adrenal insufficiency reported during and after transfer from systemic to inhaled corticosteroids; wean slowly from systemic corticosteroid use after transferring to therapy. Resume oral corticosteroids during periods of stress or a severe asthma attack in patients previously withdrawn from systemic corticosteroids. Transfer from systemic to inhaled corticosteroids may unmask allergic conditions previously suppressed by systemic therapy (eg, rhinitis, conjunctivitis, eczema). Monitor for systemic corticosteroid effects. Reduce dose slowly if hypercorticism and adrenal suppression/crisis occur. Immediate hypersensitivity reactions may occur. Decreases in bone mineral density (BMD) reported with long-term use; caution with major risk factors for decreased bone mineral content, including chronic use of drugs that can reduce bone mass (eg, anticonvulsants, oral corticosteroids). May cause reduction in growth velocity in pediatric patients; routinely monitor growth. Glaucoma, increased intraocular pressure (IOP), and cataracts reported with long-term use. Systemic eosinophilic conditions and vasculitis consistent with Churg-Strauss syndrome may occur. Paradoxical bronchospasm with immediate increase in wheezing may occur; treat immediately with an inhaled, short-acting bronchodilator; d/c and institute alternative therapy. Closely monitor patients with hepatic disease.

ADVERSE REACTIONS

Upper respiratory tract infection, throat irritation, headache, sinusitis, N/V, rhinitis, cough, muscle pain, oral candidiasis, arthralgia, fatigue, fever, nasal congestion, bronchitis, GI discomfort.

DRUG INTERACTIONS

Not recommended with strong CYP3A4 inhibitors (eg, ritonavir, clarithromycin, itraconazole); increased systemic corticosteroid adverse effects may occur. Ritonavir and ketoconazole may increase levels and reduce cortisol levels.

PREGNANCY AND LACTATION

Category C, caution in nursing.

MECHANISM OF ACTION

Corticosteroid; shown to have a wide range of actions on multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (eg, histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation.

PHARMACOKINETICS

Absorption: Absolute bioavailability (7.8%). Distribution: (IV) Vd=4.2L/kg; plasma protein binding (99%). Metabolism: Liver via CYP3A4; 17β-carboxylic acid derivative (metabolite). Elimination: Urine (<5% metabolites), feces (unchanged and metabolites); (IV) T1/2=7.8 hrs.

ASSESSMENT

Assess for hypersensitivity to drug or to milk proteins, status asthmaticus, acute bronchospasm, risk factors for decreased bone mineral content, history of increased IOP, glaucoma, cataracts, active/quiescent TB, ocular herpes simplex, systemic infections, hepatic impairment, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for signs of infections, systemic corticosteroid effects (eg, hypercorticism, adrenal suppression), hypersensitivity reactions, decreased BMD, glaucoma, increased IOP, cataracts, paradoxical bronchospasm, eosinophilic conditions, asthma instability, and other adverse reactions. Monitor growth of pediatric patients routinely. Closely monitor patients with hepatic disease.

PATIENT COUNSELING

Advise to contact physician if oropharyngeal candidiasis develops. Inform that product is not a bronchodilator and not intended for use as rescue medication for acute asthma exacerbations; instruct to contact physician immediately if deterioration of asthma occurs. Instruct to avoid exposure to chickenpox or measles and to consult physician without delay if exposed. Inform about risks of immunosuppression, hypercorticism, adrenal suppression, reduction in BMD, reduced growth velocity in pediatric patients, and ocular effects. Instruct to d/c therapy if immediate hypersensitivity reaction occurs. Instruct to use at regular intervals ud and not to stop use abruptly; advise to contact physician immediately if use is discontinued.

STORAGE

20-25°C (68-77°F); excursions permitted from 15-30°C (59-86°F). Store in a dry place away from direct heat or sunlight. Store inside unopened moisture-protective pouch and only remove immediately before initial use. Discard 6 weeks (50-mcg strength) or 2 months (100-mcg and 250-mcg strengths) after opening the foil pouch or when counter reads "0," whichever comes 1st.

TAGS

generic flovent 110 mcg, flovent hfa online pharmacy, generic flovent, flovent pump on line, cheap flovent, flovent no prescription online pharmacy, order flovent, flovent price, walmart pharmacy flovent cost, can you get flovent in canada, fluticasone nose spray, fluticasone spray, cheap flovent canada, flovent diskus coupon 2013, flovent mg, generic flovent cost, fluticasone online, flovent hfa, buy flovent diskus 100 mcg, generic flovent available, buy cheap flovent, flovent coupon 2013, flovent inhaler, buy flovent online canada, generic flovent hfa 220, buy flovent for cats, cheap flovent hfa, purchase flovent online, buy flovent cheap, flovent diskus 250 mg, flovent, flovent 220 mg side effects, price of flovent inhaler, buy fluticasone propionate, order flovent online, generic flovent inhaler, flovent inhaler price, flovent cost help, buy flovent online no prescription, buy flovent hfa 110 mcg, generic flovent hfa 110 mcg, flovent inhaler online, fluticasone propionate nasal, order flovent inhaler, buy flovent hfa online, cheaper alternative to flovent, flovent inhaler costco, order flovent inhaler online, fluticasone ointment, flovent online, buy flovent from canada, generic flovent 110, cheap fluticasone, flovent hfa 110 mg, cvs flovent price, is there a cheaper alternative to flovent, generic flovent 220 mcg inhaler, flovent cost, buy flovent online, generic for flovent hfa 110 mcg, buy flovent 220 mcg, purchase flovent, flovent propylene glycol, flovent for sale, where can i get flovent cheap, fluticasone salmeterol, buy fluticasone online, flovent 110 mg cost, buy flovent inhaler online, flovent hfa 250 mg, flovent hfa 110 mcg online, flovent inhaler for sale, flovent diskus online, flovent 110 mg, buy fluticasone propionate nasal spray, nasal spray fluticasone, buy flovent, fluticasone cream, flovent 110 mg price, purchase flovent inhaler, costco flovent price, flovent no prescription, mail order flovent, flovent diskus 100 mg, flovent diskus, how much is flovent without insurance, generic fluticasone, lowest price for flovent hfa 110 mcg, buy flovent hfa, buy fluticasone, generic flovent diskus, generic flovent canada, flovent for cats cheap, advair vs flovent cost, costco flovent, fluticasone nasal, fluticasone furoate, costco pharmacy flovent