Flunisolide (inhalation)

Overview

As an inflammatory disease, asthma prevents the airways to the lungs from working normally. Whilst many patients suffer from on-going or constant symptoms, they are also at risk from acute asthma attacks. During an attack, the patient's symptoms can worsen significantly and, due to the sudden onset, an attack can be life-threatening if appropriate treatment isn't administered.

As well as providing medication to reduce the intensity of an attack, doctors often prescribe medicine to improve the patient's lung function. If successful, this treatment can improve the patient's symptoms and reduce the frequency and severity of acute asthma attacks.

Flunisolide, a corticosteroid, is used for this purpose and should normally be used on an on-going basis. Whilst it will not cure asthma, it can significantly improve the patient's symptoms and, therefore, their quality of life.

When inhaled, Flunisolide activates the glucocorticoid receptors and instigates an anti-inflammatory response. As asthma is associated with increased inflammation in the patient's airways, the anti-inflammatory action of Flunisolide helps to counteract the causes and symptoms of asthma.

When used consistently, Flunisolide can, therefore, help to reduce shortness of breath, chest tightness and wheezing. However, corticosteroids, such as Flunisolide, do not have an immediate effect. In fact, the patient may need to use the medication for a number of weeks until they get the full benefit and notice a significant reduction in their symptoms.

Due to this, Flunisolide is not normally the only medicine prescribed to asthmatic patients. Whilst Flunisolide is effective in reducing long-term symptoms and the frequency of attacks, it should not be used to control an acute asthma attack once it has started. Patients should be prescribed additional medicine for this purpose and should consult their physician immediately if they do not have medication to control a potential asthma attack.

Although Flunisolide is not appropriate for use during an asthma attack, it can be extremely beneficial when used on a long-term basis. Over time, Flunisolide will effectively reduce inflammation and, therefore, the symptoms associated with asthma.

Conditions Treated

  • Asthma

Type Of Medicine

  • Corticosteroid
  • Side-Effects

When patients start using a new medicine, they may notice side-effects occurring. This is not uncommon and most patients will only experience relatively mild side-effects when using medications. The following side-effects may occur when patients first start using Flunisolide, for example:

  • Stomach or abdominal fullness
  • Sour or acid stomach
  • Unusual, unpleasant or bad taste
  • Appetite changes
  • Dry, itching or burning eyes
  • Belching
  • Changes in taste
  • Blemishes on the skin
  • Difficulty moving
  • Constipation
  • Lightheadedness or dizziness
  • Cramps
  • Excessive tearing or discharge
  • Pain in ear(s)
  • Gas
  • Fear
  • Severe and/or throbbing headache
  • Feeling of constant movement of surroundings or self
  • Indigestion
  • Heartburn
  • Loss of taste or smell
  • Heavy bleeding
  • Pain in neck
  • Itching of the genital area or vagina
  • Pain during sexual intercourse
  • Restlessness
  • Trouble sitting still
  • Muscle cramping or aching
  • Sensation of spinning
  • Muscle stiffness
  • Upset stomach
  • Shakiness
  • Pimples
  • Swollen joints
  • Swelling, pain or redness of the eyelid, eye or inner lining of the eyelid
  • Rash on the skin which may be scaly, oozing and encrusted
  • Thick, white vaginal discharge which may have a mild odor or no odor
  • Stomach pain, upset or discomfort

If patients do experience these adverse effects when they begin using Flunisolide, they will normally be relieved over time. However, if patients are concerned about any side-effect, they should seek medical help.

Similarly, patients are always advised to obtain medical assistance if they experience any of the following side-effects whilst using Flunisolide:

  • Body pain or aches
  • Fever
  • Congestion
  • Headache
  • Cough
  • Soreness or dryness of the throat
  • Hoarseness
  • Tenderness or pain around the eyes and cheekbones
  • Sneezing
  • Troubled breathing
  • Runny or stuffy nose
  • Swollen, tender glands in the neck
  • Wheezing
  • Tightness of the chest
  • Trouble swallowing
  • Changes to voice
  • Shortness of breath
  • Bladder pain
  • Loosening, peeling and/or blistering of the skin
  • Chills
  • Swelling or bloating of the arms, face, hands, feet or lower legs
  • Bloody nose
  • Chest pain
  • Blurred vision
  • Cloudy or bloody urine
  • Diarrhea
  • Cough producing mucus
  • Burning, painful or difficult urination
  • Hives
  • Dizziness
  • Itching
  • Pounding, racing, fast or irregular pulse or heartbeat
  • Muscle or joint pain
  • Frequent urge to urinate
  • Pain in lower back or side
  • General feeling of illness or discomfort
  • Pounding in the ears
  • Nervousness
  • Rash on the skin
  • Swelling or puffiness around the eyes or of the eyelids, lips, face or tongue
  • Irritated, red eyes
  • Rapid weight gain
  • Sore tongue or mouth
  • Unusual weakness or tiredness
  • Slow heartbeat
  • White spots, ulcers or sores on the lips or in the mouth
  • Sweating
  • Tingling of the feet and/or hands
  • Swelling
  • Unusual weight loss or gain
  • Darkening of the skin
  • White, creamy, curd-like patches in the throat or mouth
  • Discouragement
  • Irritability
  • Fainting
  • Loss of appetite
  • Feeling empty or sad
  • Nausea
  • Loss of pleasure or interest
  • Trouble sleeping
  • Pain when swallowing or eating
  • Loss of energy or strength
  • Trouble concentrating
  • Vomiting

Whilst the above side-effects will not necessarily prevent Flunisolide from being used, the patient should be assessed by a doctor if they experience any of these adverse effects. In addition to this, patients should obtain medical advice or assistance if they experience any side-effects which are not listed above when using Flunisolide.

Dosage

When patients are prescribed Flunisolide, it is very important that they follow their doctor's dosage instructions. As well as being told how much medicine to use, patients should be shown how to administer the medication and told when is the best time to use it.

Generally, patients over the age of twelve years are advised to take two puffs of Flunisolide, twice per day. If necessary, the patient's dose can be increased but patients are not normally instructed to take more than four puffs of Flunisolide, twice per day. Each puff should contain 80mcg of Flunisolide.

If children between the ages of six and eleven are treated with Flunisolide, however, their dose is likely to be less. Typically, patients within this age range are instructed to take one puff of Flunisolide, twice per day. Although this dose can be increased if necessary, patients within this age group are not normally advised to use more than two puffs of Flunisolide, twice per day.

If children under the age of six are instructed to use Flunisolide, doctors will determine the appropriate dose based on their weight.

In order to gain any benefit from Flunisolide, patients must ensure that they know how to use the inhaler and that they're able to administer the medicine effectively. Flunisolide is generally prescribed in an inhaler with a built-in spacer. This makes the inhaler easier to use and ensures that patients are able to administer the correct dose of medicine.

When using Flunisolide, patients should open the inhaler by pulling the actuator out of the spacer. Patients should then breathe out to empty their lungs and then place the mouthpiece in the front of their mouth, being careful not to block it with their teeth or tongue. Patients can then press firmly on the top of the inhaler to release a puff of Flunisolide. Patients should then breathe in as deeply as they can and hold their breath for approximately ten seconds. Following this, patients should breathe out as slowly as possible. This ensures that the Flunisolide has the opportunity to take effect on the lungs and airways.

If patients have been advised to administer two puffs of Flunisolide, they should wait at least twenty seconds before administering the second puff of medicine. Patients can then push the actuator back into the spacer and place their inhaler in a safe location, ready to administer their next dose when it is due. Patients may wish to rinse their mouth and/or brush their teeth after administering a dose of Flunisolide.

If the patient is using Flunisolide for the first time or if they have not used their inhaler for approximately two weeks, they should prime the inhaler to ensure it is working properly. In order to do this, patients should shake the inhaler and press down on the canister twice. This will release two test sprays of Flunisolide and should be done away from the face and eyes. If the test sprays confirm that the inhaler is working correctly, patients can then administer the medicine as normal.

If patients are unsure how to use their inhaler, they should seek advice from their physician or pharmacist. In addition to this, patients should seek medical advice if their inhaler does not appear to be working properly.

If patients forget to administer a dose of Flunisolide, they should do so as soon as they remember to. However, if their next dose of Flunisolide is due relatively soon, patients should skip the missed dose. It is not appropriate to take a double dose of Flunisolide, even if a previous dose has been missed.

Potential Drug Interactions:

If patients are taking or using more than one medication, there may be a risk of an interaction occurring. Due to this, some medicines will not be prescribed at the same time as Flunisolide. If patients are taking any of the following medicines, for example, their doctor may not prescribe Flunisolide as well:

  • Bemiparin
  • Nadroparin
  • Bupropion
  • Pixantrone

In some cases, however, doctors may prescribe Flunisolide in conjunction with the above medicines. If so, the patient's dose may be reduced or altered in order to prevent an interaction occurring.

As well as monitoring interactions between prescription medicines, doctors may advise patients not to use certain over-the-counter medicines, vitamins and/or supplements whilst they are using Flunisolide. In addition to this, patients should seek medical advice before using a new over-the-counter medicine, supplement or vitamin when they are taking Flunisolide. By seeking medical advice, patients can ensure that the medicine, supplement or vitamin they intend to take will not interact with Flunisolide and that it is safe for them to use.

Warnings

Before being treated with Flunisolide, patients should discuss their medical history and current conditions with their physician. There are some situations in which treatment with Flunisolide may not be appropriate. If patients have any of the following conditions, for example, Flunisolide may not be prescribed or an altered treatment regime may be advisable:

  • Tuberculosis
  • Measles
  • Glaucoma
  • Infection
  • Surgery
  • Stress
  • Trauma
  • Herpes simplex viral infection of the eye
  • Bacterial, viral, fungal and/or parasitic infections
  • Cataracts
  • Bone problems, including osteoporosis
  • Bronchospasms
  • Chickenpox (including recent exposure to the virus)
  • Asthma attack

Although Flunisolide can be prescribed to children, the safety of this medication has not been tested on patients under the age of four years. Due to this, patients who are under the age of four years may not be treated with Flunisolide and may be prescribed an alternative medication. Similarly, Flunisolide is not usually indicated for use in patients under the age of six years. As a result, patients under the age of six years may be prescribed an alternative to Flunisolide for the long-term management of asthma. However, if patients under the age of six years are treated with Flunisolide, their parents, guardians and/or caregivers should be made aware of the possible risks associated with treatment.

Flunisolide can be prescribed to geriatric patients and is not thought to cause any specific problems when used by older patients. However, geriatric patients may have existing age-related heart, kidney and/or liver problems and this can increase the time it takes for the body to process medicines. Due to this, a lower than average starting dose of Flunisolide may be prescribed. Following this, physicians may increase the patient's dose, once their response to the medicine has been assessed.

When patients begin taking Flunisolide they should notice an improvement in their symptoms within two to four weeks. If symptoms do not improve or if they worsen, patients should consult their doctor.

In some cases, Flunisolide may cause a fungal infection, thrush, in the mouth and/or throat. If patients experience pain when swallowing or eating or have white patches in the throat or mouth, they should contact their physician.

When patients are receiving treatment with Flunisolide, they may also be provided with an identification card. This can be used to notify relevant medical practitioners that the patient is taking Flunisolide and that they may require additional medication during a sudden illness, in the event of an asthma attack or if the patient suffers trauma and/or stress.

Patients should take Flunisolide as instructed by their doctor and should not stop taking the medication or alter the dose unless advised to do so.

Using Flunisolide at a high dose and/or taking Flunisolide for long periods of time may increase the patient's risk of developing problems with their adrenal glands. If patients exhibit any of the following symptoms, they should contact their physician for advice:

  • Loss of appetite
  • Diarrhea
  • Darkening of the skin
  • Nausea
  • Fainting
  • Unusual weakness or tiredness
  • Rash on the skin
  • Vomiting
  • Depression
  • Dizziness

Flunisolide may cause the patient's bone mineral density to decrease when it is used for long periods of time. When bone mineral density is low, patients may suffer from weak bones and/or osteoporosis. Patients should consult their doctor if they are concerned about this complication or if they experience bone or joint pain while taking Flunisolide.

When prescribed to pediatric patients, Flunisolide may cause them to grow more slowly than average. Children may not grow taller or gain weight when using Flunisolide, for example. Due to this, patients should be monitored regularly when using Flunisolide and patients should seek advice from the patient's physician if they are concerned.

If the patient experiences any changes to their vision when using Flunisolide, they should contact their doctor immediately. These changes may include blurred vision and/or difficulty in reading. In some cases, patients may be referred to an ophthalmologist for further assessment.

In some cases, Flunisolide could cause patients to experience paradoxical bronchospasm. This can be life-threatening and patients should seek immediate assistance if they experience the following symptoms:

  • Shortness of breath
  • Difficulty breathing
  • Wheezing
  • Cough

Patients may be more susceptible to infections when they are using Flunisolide. Due to this, patients should inform their physician if they have been exposed someone with measles or chickenpox and should obtain immediate medical help if they think they have contracted an illness.

Flunisolide should not be used during an asthma attack. Instead, patients should be prescribed an alternative medicine to be used at the onset of an attack or during an attack.

If Flunisolide is used by pregnant patients, it may pose a risk to the unborn fetus. Due to this, Flunisolide is not usually prescribed to pregnant patients, unless it is absolutely necessary. If no alternative is available, patients should be made aware of the risks before being prescribed.

If patients become pregnant whilst using Flunisolide, they should contact their doctor for advice. Similarly, if patients plan to become pregnant, they should seek medical advice first as treatment with Flunisolide may be suspended. However, patients should not simply abandon treatment with if they are trying to conceive. Instead, they should discuss the potential risks with their physician and obtain an alternative medicine, if necessary.

Currently, it is not known if breastfeeding whilst using Flunisolide carries a risk to the infant. Due to this, patients are normally advised not to breastfeed whilst they are using Flunisolide. Patients should discuss the possible risks with their physician before breastfeeding, even if they have not used Flunisolide for some time.

Before being treated with Flunisolide, patients should inform their doctor of any allergies they have. In rare cases, patients may exhibit an allergic reaction when using Flunisolide and, if so, they will need urgent medical treatment. An allergic reaction may cause the following symptoms:

  • Wheezing
  • Difficulty breathing
  • Hives
  • Difficulty swallowing
  • Itching
  • Hoarseness
  • Swelling of the tongue, lips, throat, mouth, face and/or hands

Storage

As most patients are advised to use Flunisolide on a daily basis, they will need to keep their inhaler at home or with them. In most cases, Flunisolide can be kept at room temperature but it should not be exposed to extreme heat, direct light or extreme cold. This means that patients should not keep their inhaler in certain places, such as inside a car, as the temperature may rise or fall rapidly.

When keeping medicine at home, patients should ensure that children and/or pets cannot gain access to it. Often, a lockable cabinet or medicine box offers sufficient security.

If patients are advised to stop using Flunisolide or if the medicine reaches its use-by date, patients will need to dispose of the inhaler. However, medicine should never be thrown out with regular household waste as it could pose a risk to other people.

In addition to this, inhalers typically use canisters and these are flammable. Due to this, patients should never make a hole in the canister or place it on a fire, even if the canister is empty.

In order to dispose of an inhaler, canister or medicine, patients should seek advice from their physician's office or pharmacist.

Summary

When patients are diagnosed with asthma, a treatment plan should be put in place. As well as providing medicine to help minimize symptoms during an acute attack, physicians should prescribe medication to help reduce the patient's long-term symptoms, such as chest tightness, shortness of breath and wheezing.

Providing Flunisolide is used regularly, it can successfully reduce the patient's on-going symptoms and can also decrease the frequency of acute attacks. Although Flunisolide will not cure asthma, it can be used to control the condition and to improve the patient's symptoms. Due to this, Flunisolide is the first-choice treatment when it comes to managing asthma and can be used to treat the vast majority of patients.