fluticason

Fluticasone, also spelled fluticason in some regions, is a synthetic corticosteroid used for its anti-inflammatory effects. There are two main chemical variants commonly used in therapy: fluticasone propionate and fluticasone furoate. They are formulated for inhalation, nasal spray, and topical dermatologic use, and are available in both brand-name and generic preparations in many countries.

Mechanism of action is through binding to glucocorticoid receptors, which leads to changes in gene transcription and a reduction in inflammatory mediators. This results in decreased airway inflammation, mucus production, and immune cell recruitment, helping to lessen symptoms and improve control in chronic inflammatory conditions.

Medical uses include inhaled forms for maintenance treatment of asthma and certain cases of chronic obstructive pulmonary disease (COPD), and nasal sprays for allergic and nonallergic rhinitis. Topical formulations of fluticasone propionate and related products are used for skin conditions such as eczema and dermatitis. Fluticasone should not be used as a rescue or quick-relief inhaler.

Safety and adverse effects vary by route of administration. Inhaled forms commonly cause throat irritation, hoarseness, or oral thrush; nasal sprays can cause nasal irritation or epistaxis. Long-term or high-dose use of any corticosteroid can lead to systemic effects, including suppression of the hypothalamic-pituitary-adrenal axis, growth effects in children, or bone density changes, though systemic exposure is lower with inhaled and nasal forms. Contraindications include active systemic fungal infections; use during pregnancy should be assessed by a clinician.

Pharmacokinetically, inhaled and nasal preparations have relatively low systemic bioavailability due to local metabolism and extensive first-pass clearance, with hepatic metabolism playing a major role in elimination.