Flixotide

Flixotide is a medicine that contains the glucocorticosteroid fluticasone. It is used in the treatment of asthma and chronic obstructive pulmonary disease (COPD).

Indications Flixotide

Flixotide is used to treat the following conditions:

1. Asthma: Flixotide is used as a control medication to treat asthma in adults and children. It helps reduce airway inflammation and control asthma symptoms such as wheezing, coughing, and wheezing. The drug can be used either daily to maintain asthma control or during exacerbations.
2. Chronic obstructive pulmonary disease (COPD): Flixotide is also used to treat COPD in adult patients. It helps to reduce inflammation and improve lung function, resulting in a reduction in the frequency and severity of exacerbations.

Release form

Flixotide is available in several dosage forms, including:

1. Inhalation aerosol: Flixotide is supplied as an inhalation aerosol that is intended for use with a special inhaler. This form allows direct delivery of the drug dose into the respiratory tract, maximizing the therapeutic effect.
2. Dosed suspension for inhalation: Flixotide is also available as a dosed suspension for inhalation for use with a nebulizer. The nebulizer turns the medication into thin droplets that the patient inhales through a special mask or mouthpiece.

Each of these release forms has its own advantages and may be more convenient for certain categories of patients or depending on their individual needs. Your doctor can help you determine the most appropriate form of Flixotide for your specific case.

Pharmacodynamics

The pharmacodynamics of flixotide is based on its ability to reduce inflammation in the airways, thereby relieving symptoms and improving lung function.

Mechanism of action

Fluticasone propionate, the active ingredient in Flixotide, has a pronounced anti-inflammatory effect in the lungs, resulting in improved symptoms and reduced frequency of asthma and COPD exacerbations. Here are the main aspects of its action:

• Anti-inflammatory action: Fluticasone inhibits the release of inflammatory mediators from cells such as mastocytes, eosinophils and lymphocytes. This reduces inflammation, edema and airway hyperresponsiveness.
• Reducing mucus production: Fluticasone reduces mucus production in the airways, which makes breathing easier.
• Restoration of lung function: Regular use leads to improvement of lung function, reduction of frequency and severity of choking attacks, coughing and wheezing.

Applications and effects

• Long-term control: Flixotide is intended for regular use for long-term control of asthma and COPD, not for relief of acute attacks.
• Reducing the risk of exacerbations: When used regularly, flixotide can reduce the risk and frequency of exacerbations.
• Improvedquality of life: Improved symptom control leads to improved overall quality of life for patients.

Pharmacokinetics

The pharmacokinetics of Flixotide depend on its dosage form. Here are the main aspects of pharmacokinetics for each form of Flixotide:

1. Inhalation Aerosol:

   • Absorption: Fluticasone, the active ingredient of Flixotide, is largely absorbed in the lungs after inhalation. The systemic bioavailability of fluticasone after inhalation is low, as most of the active ingredient remains in the lungs and has a local effect.
   • Metabolism and excretion: Fluticasone is metabolized in the liver to form inactive metabolites. It is excreted mainly through the kidneys as metabolites. The elimination half-life of fluticasone from the body is about 10 hours.

2. Dosed suspension for inhalation:

   • Absorption: Fluticasone is also absorbed in the lungs after inhalation of the dosed suspension. Systemic bioavailability remains low due to localized exposure to the drug.
   • Metabolism and excretion: The metabolism and excretion processes of fluticasone are also similar to its inhaled aerosol form.

In general, the pharmacokinetics of Flixotide is characterized by rapid absorption in the lungs after inhalation and lack of significant systemic exposure due to low systemic bioavailability. This allows to minimize the risk of systemic side effects and ensure maximum therapeutic effect in the treatment of asthma and COPD.

Dosing and administration

The method of use and dosage of Flixotide may vary slightly depending on the form of the drug release (inhalation aerosol or dosed suspension for inhalation). Usually the dosage and regimen are determined by a doctor individually for each patient, depending on the severity of the disease and other factors. Below are general recommendations for the use and dosage of Flixotide:

1. Inhalation Aerosol:

   • For adults and children over 16 years of age, it is usually recommended to use 2 times a day. The dose may vary from 100 to 1000 mcg per day, depending on the severity of the disease.
   • For children between 4 and 16 years of age, it is generally recommended to use 1 to 2 times daily. The dose may vary from 50 to 200 mcg per day.
   • For children under 4 years of age, the optimal dosage should be determined by a physician.

2. Dosed suspension for inhalation:

   • For adults and children over 16 years of age, it is usually recommended to use 2 times a day. The dose may vary from 100 to 1000 mcg per day, depending on the severity of the disease.
   • For children between 4 and 16 years of age, it is generally recommended to use 1 to 2 times daily. The dose may vary from 50 to 200 mcg per day.
   • For children under 4 years of age, the optimal dosage should be determined by a physician.

General application guidelines:

• Before using the inhalation aerosol or metered dose suspension for inhalation, shake the cylinder or vial to distribute the medicine evenly.
• It is important to use your inhaler or nebulizer correctly, following the manufacturer's instructions.
• Patients should rinse their mouth with water after each use of Flixotide to prevent fungal infections in the mouth.

Use Flixotide during pregnancy

The use of Flixotide during pregnancy should be carried out under the supervision of a doctor and strictly for medical indications. It is necessary to take into account the potential risks to the mother and fetus, as well as the benefits of treatment.

Currently, there is insufficient data on the safety of Flixotide for pregnant women, so its use during this period should be limited to those cases when the expected benefit of treatment exceeds the potential risks to the mother and fetus.

The following points should be considered when prescribing Flixotide to pregnant women:

1. Indications: Flixotide is usually used to control symptoms of asthma or COPD. If a pregnant woman has severe asthma attacks or an exacerbation of COPD, her doctor may decide that treatment with Flixotide is necessary to ensure adequate control of the condition.
2. Minimum effective dose: The doctor tries to choose the minimum effective dose of Flixotide that will be sufficient to control symptoms while minimizing potential risks to the mother and fetus.
3. Monitoring: Pregnant women taking Flixotide should be monitored regularly by a doctor to monitor their asthma or COPD and to evaluate possible side effects of the medication.
4. Safety in different periods of pregnancy: The use of Flixotide may be particularly justified during the second and third trimesters of pregnancy, when the risk to the fetus from medication is generally lower than in the first trimester.

Before starting or continuing treatment with Flixotide during pregnancy, you should always consult your doctor to assess the risks and benefits of the drug in each case.

Contraindications

1. Allergy to fluticasone propionate or other components of the drug: Patients with a known allergy to fluticasone propionate or any other component in Flixotide should not use this drug as it may cause allergic reactions ranging from mild to severe.
2. Untreated localized infection caused by fungi, bacteria, viruses or parasites in the respiratory tract: Use of Flixotide may aggravate respiratory tract infections due to its immunosuppressive effect.
3. Pediatric age up to a certain limit: A physician should assess the age threshold for the use of Flixotide, as it may be contraindicated in younger children due to potential effects on growth and development.
4. Acute asthma attacks or COPD exacerbations: Flixotide is intended for long-term control and is ineffective for acute asthma attacks or COPD exacerbations requiring fast-acting bronchodilators.
5. Active or latent lung infections: Patients with active or recent lung infections should be cautious when using Flixotide, as corticosteroids may mask symptoms of infection.
6. Respiratory tuberculosis in active phase or history: Use of Flixotide may worsen the course of tuberculosis due to its effect on the immune system.

Side effects Flixotide

Flixotide is usually well tolerated by patients, but like any medication, it can cause some side effects. Here are some of them:

1. Fungal infections in the mouth: Some people, especially with prolonged use or if the inhaler is used incorrectly, may develop a fungal infection in the mouth (called thrush).
2. Cough and voice changes: Flixotide may cause coughing or voice changes in some patients. This is usually temporary and usually stops after dose adjustment or discontinuation of treatment.
3. Dry and irritated throat: Dry and irritated throat may occur with Flixotide. This may be due to the medicine itself or the inhalation technique.
4. Headache: Some patients may experience headache while using Flixotide.
5. Undesirable skin reactions: In rare cases, various allergic skin reactions such as skin rash, itching or redness may occur.
6. Rare: In rare cases, more serious side effects such as allergic reactions, heart problems (such as rapid heartbeat or arrhythmias), breathing problems, and others may occur.

Overdose

Overdose of Flixotide, like other glucocorticosteroids for inhalation, is mainly associated with prolonged use of high doses or accidental exceeding of the recommended dose. Overdose may result in an increased risk of glucocorticosteroid-related side effects such as decreased adrenal function, osteoporosis, hypertension, increased effects on the oral and throat mucosa (fungal infections), and an increased likelihood of systemic side effects.

Interactions with other drugs

Main interactions of Flixotide with other drugs:

1. Strong CYP3A4 inhibitors: Drugs such as ketoconazole, itraconazole, and some other antifungal agents, as well as some types of antibiotics (e.g. Clarithromycin) and HIV protease inhibitors may significantly increase plasma concentrations of fluticasone. This may lead to increased systemic effects of fluticasone, including possible suppression of adrenal function.
2. Other corticosteroids: Co-administration with other corticosteroids, whether systemic or topical (e.g., nasal, inhaled, or oral forms), may result in increased systemic effects of corticosteroids, including possible suppression of adrenal function and increased side effects.
3. Beta-adrenoblockers: The use of beta-adrenoblockers (including eye drops for the treatment of glaucoma) may not only reduce the efficacy of Flixotide, but may also lead to increased bronchospasm in patients with asthma.
4. Diuretics (diuretics): Especially potassium-saving diuretics may interact with corticosteroids, increasing the possible risk of hypokalemia (low blood potassium levels), which can be dangerous to the heart.
5. Cytochrome P450 3A4 (CYP3A4) substrates: Since fluticasone is metabolized by CYP3A4 enzyme, there is a potential possibility of interaction with other drugs metabolized by the same enzyme. However, due to the topical application of fluticasone and low systemic bioavailability, such interactions are less likely compared to systemic corticosteroids.

Storage conditions

Storage conditions of Flixotide may vary slightly depending on the form of the drug release (inhalation aerosol or metered suspension for inhalation), but generally storage recommendations are as follows:

1. Inhalation Aerosol:

   • The Flixotide inhalation aerosol cylinder should be stored at a temperature not exceeding 30°C.
   • Avoid direct sunlight on the cylinder.
   • Keep the cylinder away from sources of heat and fire.
   • Do not expose the cylinder to mechanical damage.

2. Dosed suspension for inhalation:

   • The vial containing Flixotide Dose Suspension should also be stored at a temperature not exceeding 30°C.
   • Store the vial in a place protected from light.
   • Avoid freezing the suspension.

It is important to follow the storage instructions on the drug package or in the enclosed instructions for use. Improper storage may result in loss of effectiveness of the medicine or even spoilage.