Flunisolide Oral Inhalation

WHY is this medicine prescribed?

Flunisolide oral inhalation is used to prevent difficulty breathing, chest tightness, wheezing, and coughing caused by asthma in adults and children 6 years of age and older. It is in a class of medications called corticosteroids. Flunisolide works by decreasing swelling and irritation in the airways to allow for easier breathing.

HOW should this medicine be used?

Flunisolide comes as an aerosol to inhale by mouth. It usually is inhaled twice daily. Try to use flunisolide at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use flunisolide exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Talk to your doctor about how you should use your other oral and inhaled medications for asthma during your treatment with flunisolide inhalation. If you are using any other inhaled medications, ask your doctor if you should inhale these medications a certain amount of time before and after you inhale flunisolide inhalation. If you were taking an oral steroid such as dexamethasone, methylprednisolone (Medrol), or prednisone (Rayos), your doctor may want to gradually decrease your steroid dose starting at least one week after you begin to use flunisolide inhalation.

Flunisolide inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Do not use flunisolide inhalation during an asthma attack. Your doctor will prescribe a short-acting inhaler to use during asthma attacks.

Your doctor will probably start you on an average dose of flunisolide inhalation. Your doctor may increase it if your symptoms have not improved after at least 4 weeks and later may decrease your dose when your symptoms are controlled.

Flunisolide inhalation controls asthma but does not cure it. It may take 2 to 4 weeks or longer before you feel the full benefit of the medication. Continue to use flunisolide inhalation even if you feel well. Do not stop using flunisolide inhalation without talking to your doctor.

Tell your doctor if your asthma worsens during your treatment. Call your doctor if you have an asthma attack that does not stop when you use your fast-acting asthma medication, or if you need to use more of your fast-acting medication than usual.

Each canister of flunisolide aerosol is designed to provide 60 or 120 inhalations, depending on its size. After the labeled number of inhalations has been used, later inhalations may not contain the correct amount of medication. You should also keep track of the number of inhalations you use each day to know the exact amount of sprays that remain in your inhaler. Throw away the canister after you have used the labeled number of inhalations even if it still contains some liquid and continues to release a spray when it is pressed. If your inhaler is dropped, do not use the number on the counter to predict the number of sprays left in your inhaler.

Before you use your flunisolide aerosol inhaler the first time, read the written instructions that come with it. Look at the diagrams carefully and be sure that you recognize all the parts of the inhaler. Ask your doctor, pharmacist, or respiratory therapist to show you how to use it.

Do not use your flunisolide inhaler while you are near an open flame or a heat source. The inhaler may explode if it is exposed to very high temperatures.

To use the aerosol inhaler, follow these steps. Do not use the inhaler with any additional spacers.:

• Be sure that the inhaler is at room temperature.
• If you are using the inhaler for the first time or if you have not used the inhaler in more than 14 days, prime it by releasing 2 test sprays into the air, away from your face. Be careful not to spray the medication into your eyes or face.
• Place the bottom of the gray spacer on the base of your thumb and your index finger on the canister. Check to make sure that the canister is placed into the purple actuator.
• Hold the canister between your thumb and index finger and shake the inhaler.
• Breathe in and out through your mouth.
• After breathing out, place the mouthpiece in your mouth and close your lips around it.
• Breathe in deeply and slowly through your mouth. At the same time, press down firmly on the center of the dose indicator at the top of the canister with your index finger. Remove your index finger as soon as the spray is released.
• When you have breathed in fully for at least 3 seconds, remove the inhaler from your mouth and close your mouth.
• Try to hold your breath for about 10 seconds, then breathe out gently and then breathe normally.
• If your doctor has told you to take more than one puffs per treatment, repeat steps 4 through 9.
• Press the actuator back into the straight position.
• Rinse your mouth with water and spit the water out. Do not swallow the water.

Are there OTHER USES for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before using flunisolide inhalation,

• tell your doctor and pharmacist if you are allergic to flunisolide, any other medications, or any of the ingredients in flunisolide inhalation. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using flunisolide inhalation. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• do not use flunisolide during an asthma attack. Your doctor will prescribe a short-acting inhaler to use during asthma attacks. Call your doctor if you have an asthma attack that does not stop when using the fast-acting asthma medication, or if you need to use more of the fast-acting medication than usual.
• tell your doctor if you have been on bedrest or unable to move around for a long time, or if you or anyone in your family has or has ever had osteoporosis (a condition in which the bones become thin and weak and break easily). Tell your doctor if you have or have ever had tuberculosis (TB: a type of lung infection), cataracts (clouding of the lens of the eye), or glaucoma (an eye disease). Also tell your doctor if you have any type of untreated infection anywhere in your body or a herpes eye infection (a type of infection that causes a sore on the eyelid or eye surface).
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using flunisolide, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using flunisolide inhalation.
• if you have any other medical conditions, such as asthma, arthritis, or eczema (a skin disease), they may worsen when your oral steroid dose is decreased. Tell your doctor if this happens or if you experience any of the following symptoms during this time: extreme tiredness, muscle weakness, or pain; sudden pain in stomach, lower body, or legs; loss of appetite; weight loss; upset stomach; vomiting; diarrhea; dizziness; fainting; depression; irritability; and darkening of skin. Your body may be less able to cope with stress such as surgery, illness, severe asthma attack, or injury during this time. Call your doctor right away if you get sick and be sure that all healthcare providers who treat you know that you recently replaced your oral steroid with flunisolide inhalation. Carry a card or wear a medical identification bracelet to let emergency personnel know that you may need to be treated with steroids in an emergency.
• tell your doctor if you have never had chickenpox or measles and you have not been vaccinated against these infections. Stay away from people who are sick, especially people who have chickenpox or measles. If you are exposed to one of these infections or if you develop symptoms of one of these infections, call your doctor right away. You may need treatment to protect you from these infections.
• you should know that flunisolide inhalation sometimes causes wheezing and difficulty breathing immediately after it is inhaled. If this happens, use your fast-acting (rescue) asthma medication right away and call your doctor. Do not use flunisolide inhalation again unless your doctor tells you that you should.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Flunisolide inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• painful white patches in the mouth or throat
• headache
• sore throat
• stuffy or runny nose
• swelling of nose, throat, and sinuses
• cough
• nose bleeds
• pain during urination

Some side effects can be serious. If you experience any of the following symptoms or those in the SPECIAL PRECAUTIONS section, call your doctor immediately or get emergency medical treatment:

• hives
• rash
• itching
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing
• chest pain or tightness
• vision problems
• fever, aches, or chills

Flunisolide inhalation may cause children to grow more slowly. Your child's doctor will watch your child's growth carefully while your child is using flunisolide inhalation. Talk to your child's doctor about the risks of giving this medication to your child.

In rare cases, people who used flunisolide inhalation for a long time developed glaucoma or cataracts. Talk to your doctor about the risks of using flunisolide inhalation and how often you should have your eyes examined during your treatment.

Flunisolide inhalation may increase your risk of developing osteoporosis. Talk to your doctor about the risks of using this medication.

Flunisolide inhalation may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Store your flunisolide inhaler out of reach of children, at room temperature, and away from excess heat and moisture (not in the bathroom). Do not store the inhaler near a heat source or an open flame. Protect the inhaler from freezing and direct sunlight. Do not puncture the aerosol container and do not throw it away in an incinerator or fire.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: November 15, 2015.