Fluticasone Propionate vs. Fluticasone Furoate: What’s the Difference?

Fluticasone Propionate and Fluticasone Furoate: Ester Cousins

Fluticasone propionate (FP) and fluticasone fuorate (FF) are both synthetic glucocorticoid drugs used in the prevention of asthma exacerbations and for the treatment of allergy symptoms and rhinitis.  Chemically, they consist of a steroid base (fluticasone) and an ester substituent (furoate/propionate).

Based on limited evidence from clinical trials, FF and FP appear to have similar efficacy in treating rhinitis and controlling asthma exacerbations.1,2  One study found that the sensory attributes of the FF nasal spray were more pleasant than FP.3 Some differences in the physicochemical properties (and clinical trial evidence base) between FP and FF may be relevant when choosing a steroid for rhinitis or asthma control.

Key distinctions between FP and FF

  • FP nasal spray FDA approved for ages 4 and up, FF nasal spray approved for ages 2 and up
  • FP inhaled FDA approved for ages 4 and up, FF inhaled approved for ages 5 and up
  • FF higher affinity for glucocorticoid receptor -> ½-life of FF > 2-3 fold greater than FP
  • Once-daily dosing of inhaled FF vs. twice-daily FP
  • No generic versions of FF drugs
  • No topical formulation of FF

fluticasone_comparison

Figure 1. Summary of single-entity fluticasone propionate and fluticasone fuorate formulations.

References

  1. Biggadike K. Fluticasone furoate/fluticasone propionate – different drugs with different properties. The Clinical Respiratory Journal. 2011;5(3):183-184. doi:10.1111/j.1752-699X.2011.00244.x.
  2. Tomlinson R, Parks D, Martin A. Comparative Meta-Analysis of the Efficacy of Once-Daily Fluticasone Furoate 100 µG Versus Twice-Daily Fluticasone Propionate 250 µG in Adolescents and Adults with Persistent Asthma. Lung. 2017;195(5):571-574. doi:10.1007/s00408-017-0041-2.
  3. E.O. Meltzer, C. Andrews, G.E. Journeay, J. Lim, B.A. Prillaman, C. Garris, et al. Comparison of patient preference for sensory attributes of fluticasone furoate or fluticasone propionate in adults with seasonal allergic rhinitis: a randomized, placebo-controlled, double-blind trial. Ann Allergy Asthma Immunol, 104 (2010), pp. 331-338
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