Key points
- Advair Diskus pairs fluticasone propionate with salmeterol, a long-acting bronchodilator, in three strengths (100, 250 and 500 mcg); Dymista pairs it with azelastine, an antihistamine, in a single spray.
- Fluticasone propionate is broken down by the CYP3A4 enzyme, so taking strong CYP3A4 inhibitors such as ritonavir, itraconazole or clarithromycin alongside it is not recommended, because increased systemic corticosteroid effects may occur.
- Chickenpox and measles can take a more serious or even fatal course in susceptible children or adults using corticosteroids; avoid exposure if you have not had these diseases or been properly immunised.
How does Fluticasone Propionate work?
Fluticasone propionate is a synthetic corticosteroid that calms inflammation where it is delivered. Given by inhalation, it acts on the airways, reducing the swelling and mucus that trigger asthma symptoms and flare-ups, with fewer whole-body side effects than a corticosteroid tablet.
For the nasal spray, the label states that the precise mechanism by which fluticasone propionate affects rhinitis symptoms is not known, though it reduces the inflammatory response in the nasal lining. An inhaled dose reaches the bloodstream at about 5 to 11% of the amount delivered, depending on the device used, which is why local action dominates over systemic effects.
The form determines where the drug lands and what else travels with it. Advair Diskus is an inhalation powder you breathe into the lungs; Flonase and Dymista are metered nasal sprays that coat the nasal lining. A reader who knows the molecule by another name may recognise the fluticasone-salmeterol combination as Seretide in the UK, or the inhaled corticosteroid alone as Flovent. Flonase is the brand name attached to the single-ingredient 50 mcg nasal spray. Dymista, marketed by Meda Pharmaceuticals, is the only product here that adds a second active molecule to fluticasone propionate. All three fall within the Allergy Relief or respiratory categories depending on the product.
Further reading