Class Explorer · Respiratory
Inhaled corticosteroids
Topical anti-inflammatory therapy delivered to the airway, with high first-pass metabolism of whatever is swallowed so that systemic exposure stays low.
Members
Also in this class: Budesonide · Beclomethasone · Ciclesonide. Full pages arrive as the library grows.
Compare the members
Fluticasone
- Role
- Controller, alone or in combination
- Note
- Rinse after use; check technique
Shared across the class
- Indications
- Asthma, in every patient beyond the mildest · COPD in selected patients with exacerbations or eosinophilia
- Adverse effects
- Oral candidiasis · Dysphonia · Pneumonia risk in COPD · Systemic effects at high dose
- Contraindications
- Untreated respiratory tract infection, relative
- Monitoring
- Symptom control and exacerbation frequency · Inhaler technique at every single visit, because it is the commonest reason a regimen 'fails' · Mouth for candidiasis · Growth in children on long-term therapy
What makes each agent different
- Potency per microgram differs enough that doses are not interchangeable between molecules; equivalence tables exist for a reason.
- Ciclesonide is a prodrug activated in the lung, which reduces oropharyngeal effects.
Asthma is an inflammatory disease, so a patient using a reliever three or more times a week is under-treated on the controller, not under-supplied with the reliever. Short-acting-only asthma treatment is now considered unsafe.
Rinse and spit after every dose. Most candidiasis is a technique problem, not a drug problem.
Last reviewed 2026-08-16 · Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed.