Fluticasone propionate inhaler side effects
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Common Side Effects of Fluticasone Propionate Inhaler
Patients using fluticasone propionate inhalers most often report side effects that are localized to the mouth and throat. These include oropharyngeal itching, irritation, and other discomforts in the oropharynx and larynx. Such side effects are more pronounced with fluticasone propionate compared to some other inhaled corticosteroids, like ciclesonide, where patients reported less intense side effects overall 14. The frequency of these local side effects is generally low, with most studies reporting them in less than 15% of patients 34.
Systemic Side Effects and Cortisol Suppression
Repeated use of fluticasone propionate inhalers can lead to systemic absorption, which may suppress the body’s natural cortisol production. This effect is more noticeable with higher doses and repeated dosing, as fluticasone propionate accumulates in the body over time, leading to a marked decrease in plasma cortisol levels . However, in studies with moderate doses and durations, no clinically significant suppression of morning plasma cortisol was observed 34. In patients with chronic obstructive pulmonary disease (COPD), the systemic effects, including cortisol suppression, are less pronounced than in healthy individuals .
Risk of Adrenal Insufficiency in Children
High doses of fluticasone propionate in children have been associated with rare but serious side effects, such as adrenal insufficiency, which can present with symptoms like hypoglycemia. There have also been reports of growth retardation and adrenal suppression in children using high doses for extended periods . However, most studies in children and infants using standard or moderate doses found no significant side effects on growth, bone metabolism, or adrenal function 510.
Safety in Infants and Young Children
When used at recommended doses, fluticasone propionate inhalers are generally safe and effective for infants and young children with asthma. Studies show significant improvement in asthma symptoms without significant side effects, including no impact on growth or bone health over several months of use 510.
Comparison with Other Inhaled Corticosteroids
Compared to other inhaled corticosteroids, fluticasone propionate may have a slightly higher rate of local side effects but is considered to have low oral bioavailability, which reduces the risk of systemic side effects. Its safety profile is generally favorable, especially when used at recommended doses and for limited durations 19.
Conclusion
Fluticasone propionate inhalers are effective for managing asthma and are generally well tolerated. The most common side effects are mild and localized to the mouth and throat. Systemic side effects, such as cortisol suppression and adrenal insufficiency, are rare and usually associated with high doses or prolonged use, especially in children. When used as directed, fluticasone propionate is considered safe for both adults and children.
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