Proper Use

Drug information provided by: IBM Micromedex

Inhaled fluticasone is used to prevent asthma attacks. It is not used to relieve an attack that has already started. For relief of an asthma attack that has already started, you should use another medicine. If you do not have another medicine to use for an attack or if you have any questions about this, check with your doctor.

Use this medicine only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. Also, do not stop using this medicine without telling your doctor. To do so may increase the chance of side effects. The full benefit of this medicine may take 1 to 2 weeks or longer to achieve.

Inhaled fluticasone comes with a patient information leaflet and patient instructions. Read these instructions carefully before using this medicine. If you do not understand the directions or you are not sure how to use the inhaler, ask your doctor to show you what to do. Also, ask your doctor to check regularly how you use the inhaler to make sure you are using it properly.

In order for this medicine to help prevent asthma attacks, it must be used every day in regularly spaced doses, as ordered by your doctor.

Gargling and rinsing your mouth with water after each dose may help prevent hoarseness, throat irritation, and infection in the mouth. However, do not swallow the water after rinsing.

To use the ArmonAir™ RespiClick® or ArmonAir® Digihaler™:

  • Take the inhaler out of the pouch before you use it for the first time.
  • Do not use the inhaler for this medicine with any other medicine.
  • This medicine does not require priming. Do not use it with a spacer or volume holding chamber.
  • Hold the inhaler upright and open the green cap all the way until it clicks. Do not open the green cap until you are ready to take a dose of this medicine.
  • To inhale this medicine, breathe out fully, trying to get as much air out of the lungs as possible. Put the mouthpiece fully into your mouth and close your lips around it. Do not block the mouthpiece with your teeth or tongue. Do not block the vent above the mouthpiece with your lips or fingers.
  • Breathe in through your mouth quickly and deeply as you can until you have taken a full deep breath. Hold your breath for about 10 seconds.
  • Close the green cap after each inhalation. Rinse your mouth with water without swallowing after each inhalation.
  • Keep the inhaler dry and clean at all times. Gently wipe the mouthpiece with a dry cloth or tissue as needed.
  • The inhaler has a window that shows the number of doses remaining. This tells you when you are getting low on medicine. The doses counting down from 20 to 0 will show up in red to remind you to refill your prescription. Throw away the inhaler when the dose counter displays 0, 30 days after opening the pouch.

To use the Arnuity® Ellipta®:

  • This medicine comes in foil tray. Peel back the lid to open.
  • Before you use this medicine, the counter should show the number 30. The counter counts down by 1 each time you open the cover.
  • Open the cover of the inhaler until you hear a clicking sound. The inhaler is now ready to use.
  • Do not close the cover until you have taken your dose. If you open and close the cover without inhaling the dose, you will lose the medicine.
  • Hold the inhaler away from your mouth and breathe out fully. Do not breathe out into the mouthpiece.
  • Close your lips around the mouthpiece. Do not cover the air holes on the side of the mouthpiece.
  • Breathe in through your mouth as steadily and as deeply as you can until you have taken a full deep breath. Do not breathe in through your nose.
  • Hold your breath and remove the mouthpiece from your mouth. Continue holding your breath as long as you can up to 3 to 4 seconds before breathing out. This gives the medicine time to settle in your airways and lungs.
  • Hold the inhaler well away from your mouth and breathe out slowly and gently.
  • You may clean the mouthpiece with a dry tissue before you close the cover.
  • When the dose counter reaches "10", call your doctor or pharmacist if refill is needed. Throw away the inhaler when the dose counter is at "0".

To use the Flovent® Diskus®:

  • Take the inhaler out of the pouch before you use it for the first time.
  • To open it, push the thumb grip away from you as far as it will go. You will hear a click and feel a snap. When open, the mouthpiece will appear.
  • Slide the mouthpiece lever away from you as far as it will go until it clicks. The inhaler is now ready to use. Do not close, tilt, or move the lever.
  • Turn your head away from the inhaler, and breathe out to the end of a normal breath. Do not breathe into the inhaler.
  • Breathe in through your mouth as deeply as you can until you have taken a full deep breath. Do not breathe through your nose.
  • Remove the mouthpiece from your mouth and hold your breath for about 10 seconds or for as long as you can, before breathing out slowly. This gives the medicine time to settle in your airways and lungs.
  • If your doctor has told you to take more than one inhalation of medicine at each dose, take the second inhalation using exactly the same steps you used for your first dose.
  • The inhaler will deliver your medicine as a very fine powder. Do not take another dose even if you cannot taste or feel it.
  • When you are finished, close the inhaler. Place your thumb on the thumb grip, and slide it back towards you as far as it will go. You will hear it click shut.
  • Rinse your mouth with water after breathing in the medicine. Do not swallow.
  • The inhaler has a window that shows the number of doses left. This tells you when you are getting low on medicine. When the inhaler has 5 doses left, the numbers from 5 to 0 will show up in red to remind you to refill your prescription.
  • Do not wash the inhaler. Always keep it dry. Do not use it with a spacer device.

To use the Flovent® HFA:

  • When you use the inhaler for the first time, or if you have not used it for 4 weeks or longer, it may not deliver the right amount of medicine with the first puff. Test or prime it first by spraying the medicine into the air 4 times, away from your face. Spray the inhaler once into the air if it has not been used in 1 to 3 weeks. The inhaler will now be ready to give the right amount of medicine when you use it.
  • Shake the inhaler well for 5 seconds immediately before each use.
  • Take the cap off the mouthpiece (the strap will stay attached to the actuator). Inspect the mouthpiece for the presence of foreign objects and make sure that the canister is fully and firmly inserted into the actuator.
  • Breathe out fully through your mouth, expelling as much air from your lungs as possible. Place the mouthpiece fully into your mouth, holding the inhaler in the mouthpiece-down position and closing your lips around it.
  • While breathing in deeply and slowly through your mouth, fully depress the top of the metal canister with your finger. Immediately after the puff is delivered, release your finger from the canister and remove the inhaler from your mouth.
  • Hold your breath for about 10 seconds or for as long as you can, before breathing out slowly. This gives the medicine time to settle in your airway and lungs.
  • If your doctor has told you to inhale more than one puff or inhalation , wait about 30 seconds, then gently shake the inhaler for 5 seconds. Take the second inhalation using exactly the same steps you used for your first dose.
  • Rinse your mouth with water after breathing in the medicine. Do not swallow.
  • Replace the cap on the mouthpiece after each use.
  • Clean the actuator or mouthpiece at least once a week. Gently wipe the small circular opening where the medicine is sprayed out with a clean cotton swab dampened with water. Wipe the inside of the mouthpiece with a clean tissue dampened with water. Let it air dry overnight.
  • The inhaler has a dose counter that keeps track of how many more times you can use it before you need to open a new one. When the dose counter reaches "020", call your doctor or pharmacist if refill is needed.
  • If the dose counter is not working correctly, do not use the inhaler and return it to your pharmacy or doctor. Do not change the numbers or remove the counter from the canister. .

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For maintenance treatment of asthma:
    • For inhalation dosage form (ArmonAir® Digihaler™):
      • Adults and children 12 years of age and older—At first, 113 or 232 mcg two times a day (about 12 hours apart). Some patients may start on 55 mcg two times a day. Your doctor may adjust your dose as needed.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
  • For preventing an asthma attack:
    • For inhalation dosage form (aerosol):
      • Adults and children 12 years of age and older—At first, 88 micrograms (mcg) 2 times a day (about 12 hours apart). Your doctor may adjust your dose as needed. However, the dose is usually not more than 880 mcg 2 times a day.
      • Children 4 to 11 years of age—88 mcg 2 times a day (about 12 hours apart).
      • Children younger than 4 years of age—Use and dose must be determined by your doctor. .
    • For inhalation dosage form (ArmonAir™ RespiClick® inhalation powder):
      • Adults and children 12 years of age and older—At first, 55 mcg two times a day (about 12 hours apart). Your doctor may adjust your dose as needed. Do not use this medicine more than 2 times every 24 hours.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    • For inhalation dosage form (Arnuity® Ellipta® inhalation powder):
      • Adults and children 12 years of age and older— At first, 100 micrograms (mcg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mcg per day.
      • Children 5 to 11 years of age—50 mcg once a day.
      • Children younger than 5 years of age—Use and dose must be determined by your doctor.
    • For inhalation dosage form (Flovent® Diskus® inhalation powder):
      • Adults and children 12 years of age and older—At first, 100 mcg two times a day (about 12 hours apart). Your doctor may adjust your dose as needed. However, the dose is usually not more than 1000 mcg two times per day.
      • Children 4 to 11 years of age—At first, 50 mcg two times a day (about 12 hours apart). Your doctor may increase your dose as needed. However, the dose is usually not more than 100 mcg two times per day.
      • Children younger than 4 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of ArmonAir™ Respiclick®, Flovent® Diskus®, or Flovent® HFA, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.

Store the canister at room temperature, away from heat and direct light. Do not freeze. Do not keep this medicine inside a car where it could be exposed to extreme heat or cold. Do not poke holes in the canister or throw it into a fire, even if the canister is empty.

Store the Flovent® HFA inhaler with the mouthpiece down.