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Differences in lung bioavailability between different propellants for fluticasone propionate.

A M Wilson, E J Sims, L C Orr

    Lancet (London, England)
    |October 26, 1999
    PubMed
    Summary
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    Switching fluticasone propionate inhalers may be risky. Newer hydrofluoroalkane formulations show lower lung bioavailability than older chlorofluorocarbon ones, potentially impacting treatment effectiveness.

    Area of Science:

    • Pharmacology
    • Respiratory Medicine
    • Drug Delivery Systems

    Background:

    • Fluticasone propionate is a widely used inhaled corticosteroid for respiratory conditions.
    • Previous inhaler formulations utilized chlorofluorocarbons (CFCs) as propellants.
    • Current formulations predominantly use hydrofluoroalkanes (HFAs) as propellants due to environmental regulations.

    Purpose of the Study:

    • To compare the lung bioavailability of fluticasone propionate between CFC- and HFA-based inhaler formulations.
    • To assess the clinical implications of switching between these different inhaler types.

    Main Methods:

    • Lung bioavailability was indirectly assessed by measuring adrenal suppression, a known pharmacodynamic effect of systemically absorbed fluticasone propionate.
    • Patients or study design details were not specified in the abstract.

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    Main Results:

    • Lung bioavailability, indicated by adrenal suppression, was approximately twofold greater with the chlorofluorocarbon (CFC) propellant formulation compared to the hydrofluoroalkane (HFA) propellant formulation.
    • This suggests significantly less drug reaching the lungs with the HFA formulation.

    Conclusions:

    • Directly switching between fluticasone propionate inhaler formulations on a microgram-equivalent basis may be inadvisable due to significant differences in lung bioavailability.
    • Patients and healthcare providers should be aware of potential therapeutic equivalency issues when changing inhaler types.
    • Further studies may be needed to establish appropriate dose adjustments when switching from CFC to HFA formulations.