Abby asked
Since I take Flovent, can I take Flonase too? Is it safe to use them at the same time?
At a glance
- Flovent and Flonase both contain the drug fluticasone.
- Generally, you shouldn't combine medications with the same active ingredient but the use of Flovent and Flonase together is one of the exceptions.
- When used intranasally, fluticasone is not well-absorbed and very little reaches systemic circulation (i.e. is not absorbed into the bloodstream). For this reason, most individuals can use both Flonase and Flovent together safely.
Answer
Hello and thank you for reaching out to us!
This is a great question since both of the drugs here, Flovent and Flonase, contain the same active ingredient, fluticasone.
However, for the sake of being as specific as possible, there are two forms of fluticasone that are in question here, fluticasone propionate and fluticasone furoate.
Flovent comes in two forms:
- A 'Diskus' (Flovent Diskus) that contains fluticasone propionate in a powder form.
- An HFA inhaler (Flovent HFA) that contains fluticasone propionate in a pressurized aerosol form. It uses the same propellant as albuterol inhalers (HFA, hydrofluoroalkane).
Both of these Flovent products contain fluticasone propionate.
Flonase is also available in two forms:
- Flonase, which contains fluticasone propionate.
- Flonase Sensimist, which contains fluticasone furoate.
Fluticasone propionate and fluticasone furoate are very similar but have subtle differences.
For example, fluticasone furoate binds more strongly to its drug receptors in the body...this may make it more effective. We wrote an article discussing the difference between these different forms of fluticasone, which can be found here (Flonase Vs. Flonase Sensimist) if you are interested.
For the purposes of this question, it doesn't really matter if we are talking about Flonase or Flonase Sensimist with Flovent since the answer will be the same...yes, you can use them together.
This isn't usually the case though when you are talking about using the same active ingredient in two different products. This is commonly referred to as either an 'ingredient duplication' or 'therapeutic duplication'.
In fact, it usually is dangerous to consume the same exact drug ingredient from two different products.
For example, if you took Tylenol to help with some mild aches and pains and then took DayQuil too to help relieve cold symptoms, you would be getting acetaminophen (the active ingredient in Tylenol and an active ingredient in DayQuil) from both.
This may easily lead to you taking too much, increasing the risk of side effects.
The reason that taking Flonase and Flovent together doesn't really matter is because of the different routes of administration you use them by.
While Flovent, being inhaled into the lungs, is absorbed systemically (i.e. into the bloodstream), nasal administration of fluticasone does not result in an appreciable amount of systemic absorption.
The FDA-approved labeling for Flonase (i.e. prescribing information) states the following:
Indirect calculations indicate that fluticasone propionate delivered by the intranasal route has an absolute bioavailability averaging less than 2%.
Bioavailability is a 'pharmacokinetic' term that refers to both the 'rate' and 'extent' of drug absorption. If a drug has a high bioavailability, it is well absorbed and vice-versa.
The prescribing information goes on to say:
