Fluticasone
Fluticasone is a potent synthetic glucocorticoid used primarily via inhalation to manage chronic airway inflammation in veterinary medicine, such as feline asthma and canine chronic bronchitis. **Clinical Pearl:** Inhaled administration delivers the drug directly to the respiratory mucosa, significantly minimizing systemic absorption and the adverse side effects typically associated with oral corticosteroids.
Mechanism: Binds to specific **glucocorticoid nuclear receptors** → alters gene transcription → suppresses multiple inflammatory pathways, decreasing the production of inflammatory cytokines and inhibiting inflammatory cells such as eosinophils and macrophages.
Routes of administration
Contraindications
- Status asthmaticus (not for acute bronchospasm relief)
- Untreated respiratory tract infections
- Known hypersensitivity to fluticasone
Adverse effects
- Pharyngeal candidiasis (rare)
- Mild systemic adrenal suppression (at very high doses)
- Coughing or gagging during administration
Drug interactions
- Ketoconazole · May increase systemic fluticasone exposure by inhibiting CYP3A4 metabolism · moderate
- Itraconazole · May increase systemic fluticasone exposure by inhibiting CYP3A4 metabolism · moderate
Monitoring
- Clinical signs of respiratory disease (coughing frequency, wheezing, respiratory rate and effort)
- Signs of systemic corticosteroid excess (PU/PD, polyphagia) if on high doses
Overdose
Systemic toxicity is highly unlikely with acute overdose due to poor oral bioavailability. Chronic massive overdose may lead to iatrogenic hyperadrenocorticism (Cushing's syndrome) or hypothalamic-pituitary-adrenal (HPA) axis suppression.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.