1. About inhaled fluticasone
Inhaled fluticasone is a medicine used for asthma and chronic obstructive pulmonary disease (COPD). You can take it using an inhaler (sometimes called a “puffer”) which is usually brown or beige. This is called a “preventer” inhaler because it helps to prevent you from getting symptoms.
If you have severe asthma or COPD, you may need to use a nebuliser. A nebuliser is a machine that helps you breathe in your medicine as a mist, using a mask or a mouthpiece. You can use a nebuliser in hospital, or you may be given one to manage your condition at home. Fluticasone nebuliser liquid comes in individual doses called nebules.
Fluticasone inhalers and nebules are available on prescription. Some inhalers contain fluticasone mixed with other medicines that help your breathing. Fluticasone is a type of medicine known as a steroid (also called a corticosteroid).
It also comes as a cream or ointment, nasal spray or nasal drops for treating other conditions. Read about:
- fluticasone cream or ointment – for skin conditions such as eczema
- fluticasone nose spray (nasal spray) – for hay fever and cold-like symptoms caused by common allergies (allergic rhinitis)
- fluticasone drops (nasal drops) – for nasal polyps
If you have a steroid inhaler or nebuliser, carry on using it as usual. Use it even if you have coronavirus (COVID-19) symptoms. It’s important to use your inhaler or nebuliser to help control your asthma or COPD.
2. Key facts
- You need to use your fluticasone inhaler every day for it to work, even if you do not have any symptoms.
- It’s important to rinse your mouth or brush your teeth after using a steroid preventer inhaler. This is to prevent infections and a sore mouth.
- You may get a blue steroid treatment card if you need a high dose of fluticasone to control your symptoms.
- You’ll usually be given another inhaler, called a “reliever”, to relieve your symptoms when they happen.
- When fluticasone comes mixed with other medicines, brand names include Flutiform, Seretide and Relvar.
3. Who can and cannot use fluticasone
Adults can use fluticasone inhalers and nebulisers. Children aged 5 years and older can use fluticasone inhalers. For severe asthma, they can use a nebuliser from the age of 4 years.
Fluticasone is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:
- have had an allergic reaction to fluticasone or any other medicines in the past
- are pregnant, or trying to get pregnant – your doctor may want to lower your dose
- are being treated for viral or fungal infections
- are taking or have recently taken other steroid medicines
- have ever had tuberculosis (TB)
4. How and when to use it
- The usual dose for the inhaler is 1 or 2 puffs, taken twice a day.
- It’s important to use your fluticasone inhaler or nebuliser regularly to manage your symptoms. Use it regularly, even if you do not have any symptoms. After using your inhaler, always put the lid back on to keep it clean.
- Fluticasone inhalers come in different strengths. Your doctor, asthma or respiratory nurse will tell you which strength is right for you. Always follow their instructions. They may tell you to have more than 2 puffs at a time from your inhaler. It depends on how bad your breathing is and which inhaler you’re using.
- The usual dose for the nebuliser is 1 or 2 nebules, breathed in from the nebuliser machine, twice a day. Your doctor or nurse will give you clear instructions on how to use the nebuliser.
Different types of inhalers
There are different types of fluticasone inhaler. It’s very important to use your inhaler properly. This is so you get the right amount of fluticasone into your lungs and the most benefit from your medicine.
Before using your inhaler, read the information leaflet that comes with it. This leaflet contains instructions and diagrams to show you how to use the inhaler, how to keep it clean, and how long to use it before getting a replacement.
Watch a video
Asthma UK has some short videos showing you how to use your inhaler to help you manage your symptoms. You can search by type of inhaler and by brand (such as Flixotide). If you use a pressurised metered-dose inhaler (pMDI), for example, you can watch the pMDI video.
Check your inhaler technique
To get the most from your inhaler, it’s important to have your technique checked regularly.
If you’re not sure how to use your inhaler, or your technique has not been checked for a year, ask your doctor, nurse or a pharmacist to watch you use it.
It’s very important to use your inhaler properly. This is so you get the right amount of fluticasone into your lungs and the most benefit from your medicine.
Using your inhaler with a spacer
If you or your child find it difficult to use an inhaler, your doctor or nurse may give you a spacer to use with it. Spacers can reduce the risk of side effects from the medicine affecting your mouth and throat. They are particularly useful for giving fluticasone to young children.
A spacer is a large plastic container with a mouthpiece and a hole for the inhaler. When used with the inhaler it makes it easier to get the right amount of fluticasone into your lungs.
Your doctor, nurse or a pharmacist can show you how to use a spacer with your inhaler.
Will my dose go up or down?
Your dose may go up or down depending on how bad your breathing is. You will be prescribed the lowest dose that controls your symptoms.
If you have agreed on a personal action plan with your doctor or nurse, follow your action plan.
What if I forget to use it?
Use your inhaler or nebuliser as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next dose as usual. Do not take a double dose to make up for a forgotten dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.
Do not stop using fluticasone suddenly, even if you feel better, without speaking to your doctor or nurse first.
What if I take too much?
Taking too much fluticasone by accident is unlikely to harm you. If you’re worried, talk to your doctor or a pharmacist.
If you take more than 400 micrograms of fluticasone a day (for example, if your dose is 250 micrograms, twice a day), ask your doctor, nurse or a pharmacist if you need to carry a blue steroid card.
If you need any medical or dental treatment, show your blue steroid card to the doctor, dentist or pharmacist so they know that you’re taking fluticasone.
5. Side effects
Like all medicines, fluticasone can cause side effects, although not everyone gets them. With inhaled fluticasone very little medicine gets into the rest of your body, so it’s unlikely to give you side effects.
Common side effects
These common side effects may happen in more than 1 in 100 people.
Keep taking the medicine but talk to your doctor if these side effects bother you or do not go away:
- oral thrush – a fungal infection that causes white patches, redness and soreness in your mouth
- dry or sore throat, or hoarse voice
Serious side effects
It’s unusual to have any serious side effects when using a fluticasone inhaler. You are more likely to get serious side effects if you’re taking a high dose of fluticasone for a long time (more than a few months).
Tell a doctor immediately if you get:
- a high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm) or a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
- “moon face” (a puffy, rounded face), weight gain in your upper back or belly – this happens gradually and can be a signs of Cushing’s syndrome
- a very upset stomach or you’re being sick (vomiting), very bad dizziness or passing out, muscle weakness, very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
- changes in your eyesight, such as blurred vision or a cloudy lens in your eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract
Serious allergic reaction
It happens rarely but it is possible to have a serious allergic reaction (anaphylaxis) to fluticasone. This is different to an asthma attack. If you or your child have asthma symptoms, such as wheezing or have tightness in the chest or throat, use a reliever inhaler. If the symptoms do not improve or get worse, call 999 or go to A&E.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
Children and teenagers
Taking fluticasone at high doses for a long time can slow down the normal growth of children and teenagers. Your child’s doctor will monitor their height and weight carefully for as long as they’re taking this medicine. This will help them to know if your child’s growth is slowing down and change the treatment if needed.
Even if your child’s growth does slow down, this does not seem to have much effect on their adult height. Talk to your doctor if you’re worried. They will be able to explain the benefits and risks of giving your child fluticasone.
You can report any suspected side effect to the UK safety scheme. These are not all the side effects of fluticasone. For a full list see the leaflet inside your medicines packet.
6. How to cope with side effects
What to do about:
- oral thrush – try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening. If you get oral thrush, ask a pharmacist to recommend a suitable treatment, such as a mouth gel, and get them to check that you’re using your inhaler correctly. They may suggest that you see your doctor to discuss the best treatment.
- dry or sore throat, or hoarse voice – try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening. Using a spacer with your inhaler can also help.
7. Pregnancy and breastfeeding
Fluticasone and pregnancy
It’s important to manage your asthma or COPD while you’re pregnant. Having uncontrolled breathing can be dangerous for you and your unborn baby. You can use a fluticasone inhaler in pregnancy. There is no evidence that it will harm your baby.
Always tell your doctor if you are pregnant. For safety, they will only prescribe fluticasone in pregnancy if the benefits outweigh the risks. They will prescribe the lowest dose that works for you.
If you become pregnant while using fluticasone, do not stop using your inhaler without talking to your doctor first.
Find out more about using steroid inhalers during pregnancy on the Best Use of Medicines in Pregnancy (BUMPS) website.
Fluticasone and breastfeeding
It’s generally OK to use your fluticasone inhaler as normal while you’re breastfeeding. However, always check with your doctor first. Your baby may need extra monitoring if you use high doses of the inhaler.
Non-urgent advice: Talk to your doctor if you’re:
- trying to get pregnant
8. Cautions with other medicines
Some medicines and fluticasone interfere with each other. This can increase your chance of side effects, or it may mean changing your dose of fluticasone.
Check with a pharmacist or your doctor if you’re taking:
- medicines used to treat HIV, such as ritonavir or cobicistat
- medicines to treat fungal infections, such as ketoconazole or itraconazole
- other medicines that contain steroids, such as eczema creams, other asthma inhalers, tablets, injections, nasal sprays, eye or nose drops
Mixing fluticasone with herbal remedies or supplements
There’s very little information about taking herbal remedies and supplements while taking or using fluticasone. Ask a pharmacist for advice.
9. Common questions
How does fluticasone work?
Fluticasone is a type of medicine called a steroid (also called a corticosteroid). Steroids closely copy the effects of natural hormones produced in your adrenal glands. The adrenal glands are next to your kidneys.
Fluticasone works by calming your immune system. This reduces the swelling in your lungs that makes it difficult to breathe. It also stops symptoms such as wheezing and coughing developing. It does not help to treat an asthma attack when you suddenly get coughing, wheezing and breathlessness.
How long does fluticasone take to work?
Fluticasone does not work immediately for asthma or COPD. You’ll usually start to wheeze less often after you have been using fluticasone for 3 to 7 days. Once your symptoms have improved, you may find you use your other inhaler (called a “reliever”) less often.
If your shortness of breath or wheezing does not get better after 7 days of using fluticasone, or if it gets worse, let your doctor or nurse know as soon as possible.
How long will I use fluticasone for?
You’ll usually use fluticasone for a long time. It helps prevent your asthma or COPD getting worse. It’s important to keep using your inhaler or nebuliser even if you feel better.
Is it safe to use for a long time?
If you use your inhaler or nebuliser as recommended by your doctor, nurse or pharmacist, you’re unlikely to get any lasting side effects. Inhalers generally deliver a small amount of steroid medicine exactly where you need it. This limits the amount of steroid reaching the rest of your body. It also keeps the risk of side effects as low as possible.
However, for children and teenagers using a high dose steroid inhaler, their height and weight needs to be monitored carefully. This is to make sure the steroid is not affecting their growth. Talk to their doctor if you’re worried. They will be able to explain the benefits and risks of giving your child fluticasone.
Equally, adults taking high doses (either using an inhaler or nebuliser) have an increased risk of getting adrenal gland problems or weak bones (osteoporosis) over time. This is because more of the corticosteroid gets into your body.
Your doctor will monitor you closely and may prescribe medicines to help strengthen your bones. Calcium-rich foods (such as milk and cheese, or non-dairy milks with added calcium) and regular exercise can also help keep bones healthy.
What will happen if I stop taking fluticasone?
Do not stop using your inhaled fluticasone without speaking to your doctor first. If you have an inhaler or nebuliser to control asthma or COPD, your breathing problems may return if you suddenly stop using it.
You might feel wheezy or short of breath. Your chest may feel tight and you could start to cough.
Is there anything I need to know about taking fluticasone and having surgery?
You do not need to stop fluticasone before surgery. Suddenly stopping treatment can make you feel unwell and may give you symptoms. If you are having surgery or having emergency treatment, for example after an accident, tell the person treating you that you are taking fluticasone. Your doctor may decide you need extra steroids for a while.
If you have been given a blue steroid treatment card, show your card to anyone treating you so they can plan your treatment.
How does it compare with other inhalers?
Fluticasone inhalers are used to help prevent symptoms in people with asthma and COPD. There are similar “preventer” inhalers that contain other steroids, such as beclometasone, budesonide and mometasone. They can look very different and some are for adults only.
It’s important to only use your own fluticasone inhaler. Your inhaler may be different to a friend or relative’s. Their inhaler might contain a different dose of fluticasone. Preventer inhalers are different from the inhalers used during asthma attacks. These are called bronchodilators or “reliever” inhalers.
Will it affect my fertility?
There’s no clear evidence to suggest that taking fluticasone will reduce fertility in either men or women.
However, speak to a pharmacist or your doctor if you are trying to get pregnant.
Will it affect my contraception?
Fluticasone does not affect any type of contraception including the combined pill and emergency contraception.
Can I drink alcohol with it?
Yes, you can drink alcohol while taking fluticasone.
Can I smoke if I use fluticasone?
Try not to smoke. Smoking irritates the lungs and will make your breathing problem worse. Fluticasone will also work better if you do not smoke. Speak to your doctor, nurse or pharmacist if you’re finding it hard to stop smoking. Stop smoking treatments are available on the NHS.
Can I drive or ride a bike?
For most people, using inhaled fluticasone will not affect their ability to drive a car or cycle.
Can lifestyle changes help with my breathing?
There are several things you can do to help your condition when you’re living with asthma or COPD. These include:
stopping smoking – not smoking can significantly reduce how severe and frequent your symptoms are
exercising regularly – exercise is unlikely to trigger your symptoms once you’re getting appropriate treatment
healthy eating – aim for a healthy, balanced diet and lose excess weight if you need to
getting vaccinated – it’s a good idea to have the annual flu jab and the pneumococcal vaccination
Some people say that using an air filter or air purifier helps with their asthma symptoms. However, there needs to be more research into this.
- Tell your doctor or a pharmacist if you’re taking any other medicines, including herbal remedies, vitamins or supplements.
- If you are coughing, wheezing or breathless, use your reliever inhaler.