Health Centres - Flixotide
How does it work?
Flixotide evohaler, accuhaler, diskhaler and nebules all contain the active ingredient fluticasone propionate, which is a type of medicine known as a corticosteroid.
Corticosteroids are hormones that are produced naturally by the adrenal glands. They have many important functions, including control of inflammatory responses. Fluticasone is a synthetic corticosteroid and is used to decrease inflammation in the lungs. (NB. Corticosteroids are often simply called steroids, but it should be noted that they are very different from another group of steroids, called anabolic steroids, which have gained notoriety because of their abuse by some athletes and body builders.)
When fluticasone is inhaled into the lungs it is absorbed into the cells of the lungs and airways. Here it works by preventing the release of certain chemicals from the cells. These chemicals are important in the immune system and are normally involved in producing immune and allergic responses that result in inflammation. By decreasing the release of these chemicals in the lungs and airways, inflammation is reduced.
In asthma, the airways tighten due to inflammation and can also be blocked by mucus. This makes it difficult for air to get in and out of the lungs. By preventing the inflammation and excess mucus formation, fluticasone helps prevent asthma attacks. It is not used to treat an asthma attack.
Fluticasone is taken using an inhaler device to treat asthma. Inhaling the medicine delivers it directly to the lungs where it is needed. It also reduces the potential for side effects occurring in other parts of the body, as the amount of medicine absorbed into the blood from the lungs is lower than if it was taken by mouth. Flixotide is available as three different types of inhaler device: a cfc-free metered dose inhaler called the evohaler, and the breath-actuated accuhaler and diskhaler. Flixotide nebules are used with a machine called a nebuliser that converts the liquid medicine inside the nebules into particles that can be inhaled. It is used to deliver higher doses of the medicine than other inhalers.
Fluticasone taken by inhalation is known as a 'preventer'. This is because it is taken regularly every day to reduce the inflammation in the lungs and prevent asthma attacks. Symptoms usually start to get better between four to seven days after starting treatment. However, it is important to keep using this medicine regularly, even after your asthma symptoms have improved, in order to prevent them coming back.
What is it used for?
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Asthma
Warning!
- This medicine is known as a preventer and it should be taken regularly to prevent asthma attacks. It should not be used to relieve an asthma attack, as it will not work for this purpose. An asthma attack needs to be treated with a medicine that quickly opens the airways, such as salbutamol or terbutaline. These are known as relievers, and you should make sure you carry your reliever inhaler with you at all times to relieve an asthma attack if it happens. Consult your doctor if you need to use your reliever more frequently than normal, or if it becomes less effective at treating attacks, as this may indicate that your asthma is getting worse and your doctor may need to prescribe you another medicine.
Use with caution in
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Active or inactive tuberculosis infection
Not to be used in
- Known sensitivity or allergy to any ingredient.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
- It is important that asthma is well controlled in pregnant women. Wherever possible, asthma medications should be taken by inhaler, as this minimises the amount of medicine that enters the bloodstream and crosses the placenta. This medicine should be used with caution during pregnancy. Seek medical advice from your doctor.
Label warnings
- Do not stop taking this medication except on your doctor's advice.
- Do not exceed the dose of this medicine that your doctor has prescribed for you.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise, as your asthma symptoms are likely to return.
- Inhalers may cause an unexpected increase in wheezing and difficulty breathing (paradoxical bronchospasm) straight after using them. If this happens, don't use the inhaler again, use your reliever inhaler to open your airways and consult your doctor.
- Inhaled corticosteroids can sometimes cause a fungal infection in the mouth called oral thrush. To minimise the chances of this you should rinse your mouth with water or clean your teeth after inhaling each dose. Using a spacer device can also help avoid this problem.
- Inhaled corticosteroids have considerably fewer side effects than steroids taken by mouth. However, when taken for long periods of time at high doses, inhaled steroids do have the potential to cause side effects such as glaucoma, cataracts, thinning of the bones (osteoporosis), slowed growth in children and adolescents, and to suppress the functioning of the adrenal glands (glands that produce natural steroid hormones). For this reason your doctor will prescribe the lowest effective dose to control your symptoms, and monitor for these side effects. It is recommended that children receiving long-term treatment with corticosteroids have their growth monitored. If a child's growth appears to be slowed your doctor may refer them to a specialist respiratory paediatrician. For further information talk to your doctor or pharmacist.
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Diabetes
- Flixotide preparations are not licensed for children under four years of age. In addition, the higher strength preparations (Flixotide accuhaler 250mcg and 500mcg, Flixotide diskhaler 250mcg and 500mcg, Flixotide evohaler 125mcg and 250 mcg, and Flixotide nebules 2mg/2ml) are not licensed for children under 16 years of age.
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- In general, the amount of corticosteroid that passes into the breast milk after using an inhaler is negligable and probably too small to be harmful to the baby. However, it is not known if fluticasone passes into breast milk and you should seek medical advice from your doctor before breastfeeding while using this medicine.
- Follow the printed instructions you have been given with this medication.
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