Flunisolide

Administration

• Type: Inhaled corticosteroid
• Dosage Forms: 80mcg/spray
• Routes of Administration: Inhalation
• Common Trade Names: Aerospan

Adult Dosing

• Inhalation: 2-4 puffs BID
  • Max: 640 mcg/day

Pediatric Dosing

• 6-11 yo: 1-2 puffs BID
  • Max: 320 mcg/day
• >12 yo: 2-4 puffs BID
  • Max: 640 mcg/day

Special Populations

• Pregnancy Rating: D; Possible risk of fetal adrenal suppression; Low risk of teratogenicity
• Lactation risk: L3; Safety unknown

Renal Dosing

• Adult: Not Defined
• Pediatric: Not Defined

Hepatic Dosing

• Adult: Not Defined
• Pediatric: Not Defined

Contraindications

• Allergy to class/drug
• Hypersensitivity to drug/class
• Status asthmaticus
• Asthma, acute
• Avoid abrupt withdrawal
• Bronchospasm, acute

Adverse Reactions

Serious

• Bronchospasm
• Adrenal suppression
• Hypercorticism
• Growth suppression (peds pts)
• Glaucoma
• Cataracts
• Osteoporosis
• erythema multiforme

Common

• URI
• Headache
• Nausea/vomiting
• Dyspepsia
• UTI
• Abdominal pain
• Chest pain
• Infection
• Neck pain
• Diarrhea
• Candidiasis, oral
• Edema
• Myalgia
• Dizziness
• Insomnia
• Voice changes
• Conjunctivitis
• Ear pain
• Taste changes
• Dysmenorrhea
• Vaginitis

Pharmacology

• Half-life: 1.3-1.7 hr
• Metabolism: Liver; CYP450: 3A4 substrate
• Excretion: Urine <1%

Mechanism of Action

Exact mechanism unknown. Inhibits multiple inflammatory cytokines and produces multiple glucocorticoid and mineralocorticoid effects.

See Also

Corticosteroids

References

Authors

Jonathan Warren, Ross Donaldson