II. Indications

  1. Inhaled Corticosteroids are the most important agent in Asthma Management
  2. Indicated as daily maintenance agents in all persistent Asthma
    1. Mild Persistent Asthma
    2. Moderate Persistent Asthma
    3. Severe Persistent Asthma

III. Dosing: Fluticasone Propionate (Flovent HFA, Flovent Discus, ArmonAir)

  1. Use child dosing for age 6 to 11 years old
  2. Dose per puff
    1. Flovent HFA 44, 110, 220 mcg/puff (120 puffs/Inhaler)
    2. Flovent Discus (dry powder) 50, 100, 250 mcg/puff (60 puffs/Inhaler)
    3. ArmonAir (dry powder) 55, 113, 232 mcg/puff (60 puffs/Inhaler)
  3. Low dose
    1. Adult: 220 mcg (e.g. 110 mcg Inhaler, 1 puff twice daily)
    2. Child: 88 mcg (e.g. 44 mcg Inhaler, 1 puff twice daily)
  4. Medium dose
    1. Adult: 440 mcg (e.g. 220 mcg Inhaler, 1 puff twice daily)
    2. Child: 220 mcg (e.g. 110 mcg Inhaler, 1 puff twice daily)
  5. High dose
    1. Adult: 880 mcg (e.g. 220 mcg Inhaler, 2 puffs twice daily)
    2. Child: 440 mcg (e.g. 220 mcg Inhaler, 1 puff twice daily)

IV. Dosing: Fluticasone Furoate DPI (Arnuity Ellipta)

  1. Use child dosing for age 6 to 11 years old
  2. Dose per puff
    1. Arnuity Ellipta (Dry Powder): 50, 100, 200 mcg/puff (14 and 30 Blister packs)
  3. Low to Medium Dose
    1. Adult: 100 mcg (e.g. 100 mcg Inhaler, 1 puff daily)
    2. Child: 50 mcg (e.g. 50 mcg Inhaler, 1 puff daily)
  4. High Dose
    1. Adult: 200 mcg (e.g. 200 mcg Inhaler, 1 puff daily)

V. Medications: Combinations

  1. Salmeterol/Fluticasone (Advair Diskus, Advair HFA, AirDuo Digihaler, AirDuo Respiclick, Wixela Inhub)
  2. Umeclidinium/Vilanterol/Fluticasone (Trelegy Ellipta)
  3. Vilanterol/Fluticasone (Breo Ellipta)

VI. Adverse Effects

  1. See Inhaled Corticosteroid
  2. Fluticasone propionate may have more systemic absorption than other steroid Inhalers (adrenal suppression risk)

VII. Efficacy

VIII. Safety

  1. Pregnancy Category C
  2. Unknown Safety in Lactation

X. References

  1. (2017) Presc Lett 24(10):58
  2. (2022) Comparison of Asthma Medications, Presc Lett, #381217
  3. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200

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Related Studies

Cost: Medications

flovent (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
FLOVENT 100 MCG DISKUS $3.27 each
FLOVENT 250 MCG DISKUS $4.38 each
FLOVENT 50 MCG DISKUS $3.11 each
FLOVENT HFA 110 MCG INHALER Generic $13.90 per gram
FLOVENT HFA 220 MCG INHALER Generic $21.32 per gram
FLOVENT HFA 44 MCG INHALER Generic $11.51 per gram
arnuity ellipta (on 7/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ARNUITY ELLIPTA 100 MCG INH $6.37 each
ARNUITY ELLIPTA 200 MCG INH $8.51 each
ARNUITY ELLIPTA 50 MCG INH $6.37 each