The most common side effects of Flovent / fluticasone corticosteroid asthma inhalers and some solutions.
The doctor is in salutations friends this is your pal again dr sal and in today’s episode of dr secrets we look at fluticasone also known as flovent by its trade name it typically comes in a orange looking uh plastic container and it’s used as a preventative medication for asthma conditions it’s also sometimes used in copd as well so in this study of side effects
That are potential spin-offs from flowvin or fluticasone we look at a study that analyzed 366 users over the course of a year now on to the side effects okay so the four most common side effects while taking flovent number one was hoarseness or what we call medically dysphonia sound like you need a throat lozenge after using it that was about seven percent of
Cases the next one was oral thrush that was six percent of cases asthma with six percent of cases and that might seem a little strange but we’ll get back to that and then sore throats were seen in about four percent of cases now like i said it seems a little odd that you’re taking a medication to reduce asthma but yet it seems like it actually could promote it
In some unfortunate circumstances but if you notice here all of the side effects all come down to irritation of the airway so if you have more irritation the airway and somebody was unfortunate well that’s also going to stimulate more asthma in that individual now i used to believe that the reason for these airway disorders as a consequence of the fluteecazone
Is that the active ingredient fluticasone is a corticosteroid which means it’s immunosuppressant so i used to believe for example the thrush caused by candida was because you’re applying anti-inflammatory to the lining of the throat well and traditionally they always used to tell you to gargle after taking your inhaler with water to try to wash the chemicals off
To reduce the likelihood of sustaining these side effects however there’s something interesting if you look at another variant of fluticasone these uh numbers quoted here are for the propellant version the one that looks like this that has an aerosol that pushes the chemical out and assists you in delivering into the lungs as you breathe in but there’s another
Variation called a discus and with a disc the disc does not have a propellant in it it just has a chemical in a dry powder and then it relies on your inspiratory effort when you suck in to pull the chemical down into your lungs and that one looks quite different from this one that’s more of a circle it literally looks like a disc and one one side has an opening
Where you put your mouth on to inhale the powder through now if you look at the side effect profile for the disc versus the pump uh something strange occurs so with that one the incidence of hoarseness was 1.5 of users oh and by the way this study with the discus this was 443 people so n equals 443 so dramatically less hoarseness also for thresh less than
One percent for asthma one percent for sore throat less than one percent so what is going on here so it turns out it’s not the fluticasone that’s causing this irritation it’s actually the propellant in the puffer inside of the pumps so if you’re on a pump and you’re you notice that since you started it you’re actually getting more asthma than before you you
Began it you might want to talk to your doctor about this effect because the simple solution is actually not to increase the dose or tape more you may actually need to switch from the pump to the disc two other little words of wisdom one is that many people myself included um before i started med school i also had asthma i still do but not as bad as when i was
A kid but many people stop taking it because when you take it it feels like it’s done absolutely nothing the reason for that is it’s not meant as a treatment for asthma it’s meta as a preventative for asthma so it’s not a rescue puffer it takes hours for its onset of action but if you do take it religiously then it gives you sustained relief and you can see
This if you actually plot a diary of your symptomatology how often you get attacks and how often you have to rely then on your rescue or blue pump or ventlin or oxies or whatever you’re on so with the flowvent one of the tricks with it is you have to take it and have faith that it’s actually exhibiting exerting an effect if you take it as prescribed which is
Usually two inhalations twice a day you should get a lot less uh subsequent asthma tasks that require taking your rescue puffer so that’s one of the big tricks about it and i mean that fooled me when i was younger too the second uh piece of wisdom i’d like to pass on to you is a lot of people especially parents are often concerned about putting kids on it less
Often themselves but they’re usually worried about putting their children on it because when they understand that fluticasone is actually a glucocorticoid steroid they immediately start thinking of horrible specters like cushing’s disease weight gain loss in bone density but i’ll show you quickly why this is very unlikely to occur oops density now the reason
For that is that the dose is so minuscule um looking at the pharmacokinetics of it uh only about 7.8 to maybe about 10.9 percent is absorbed into the bloodstream from the lungs from the alveoli so if we round that off to that the expected amount you’re going to absorb into your bloodstream is about 10 well then when you consider that two puffs twice a day works
Out to 500 micrograms because the pumps are usually 125 micrograms for an adult 50 micrograms for a kid so you’ve got 500 micrograms which is equivalent to 0.5 milligrams and then on top of that you’re only getting 10 percent of that into your bloodstream whoops sorry you can’t see that they’re 0.5 milligrams and you’re only getting 10 of that into your
Bloodstream so you’re looking at a systemic load of only 0.05 milligrams now when we take it orally as prednisone typically for asthma exacerbation you’d be using something like 50 milligrams of prednisone so you’re looking at a pump for pound differential of like a hundred times difference so that’s why when you take oral prednisone you get these spectacular
And unpleasant side effects but that is completely implausible when you’re taking the puffer so you can rest assured it’s not going to cause things like growth retardation in your kids or any of these other mischief and in fact i’ve been using uh both prednisone and flutecazone since i was a small child because i had bad asthma i’ve been admitted to hospital
Two or three times and i’m six feet tall so it didn’t affect my growth one way or the other so you should feel reassured um if you have to take flutica zone or give it to your kids it works quite well and it’s a useful weapon in our arsenal against asthma attacks so that ladies and gentlemen is side effects of flovent in a nutshell thanks so much for watching
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Transcribed from video
Most Common Side Effects of Flovent / Fluticasone corticosteroid asthma inhaler use By DoctorSecrets
