Fluticasone

Pregnancy

MotherToBaby summarizes fluticasone across inhaled, nasal, and topical routes, but the underlying studies are route-specific. Charlton et al. (2015) studied first-trimester inhaled fluticasone propionate in a UK cohort. The study identified 14,654 mother-infant pairs and found no increase in overall major birth defects compared with other inhaled corticosteroids. Bjørn et al. (2013) used a Danish nested case-control design with 10,974 miscarriages and 109,740 controls. Inhaled corticosteroid use was associated with early miscarriage (OR 1.22, 95% CI 1.01 to 1.49), but the study did not isolate fluticasone and the authors said noncausal explanations were possible. Wu et al. (2025) studied 4,538 pregnancies with asthma in Taiwan; 521 of 1,713 inhaled corticosteroid users used fluticasone. Overall inhaled corticosteroid or long-acting beta2-agonist use was not associated with adverse fetal outcomes. High-dose inhaled corticosteroid use, defined as more than 800 micrograms per day in budesonide equivalents, was associated with congenital anomalies (aOR 3.87, 95% CI 1.29 to 11.60); the high-dose group included 37 people before weighting, and this result was not fluticasone-specific. Suh et al. (2026) compared first-trimester continuation and discontinuation in a Korean cohort of 6,105 people with prepregnancy inhaled corticosteroid use. The study included live births only and found no increased maternal or newborn outcomes with continuation; the weighted relative risk for preterm birth was 0.95 (95% CI 0.82 to 1.11), and for congenital malformations it was 1.22 (95% CI 0.94 to 1.56). An October 2026 correction changed an author's degrees, not the findings. Lee et al. (2025) studied 40,196 pregnant women with asthma in the UK and found reduced inhaled corticosteroid use was associated with more asthma exacerbations (adjusted OR 2.29, 95% CI 2.12 to 2.47); it did not show that fluticasone lowered preterm birth. A 2026 systematic review included 14 studies and found contradictory results for preterm birth and low birth weight in asthma; it did not establish a fluticasone-specific preterm benefit. For topical use, Andersson et al. (2021) studied 60,497 exposed and 241,986 matched unexposed pregnancies. Topical fluticasone propionate was not associated with small-for-gestational-age birth (RR 1.00, 95% CI 0.76 to 1.32) or low birth weight (RR 1.10, 95% CI 0.71 to 1.71). The Cochrane review (2015) reported a probable association between low birth weight and potent or very potent topical corticosteroids, especially after very large cumulative use; the estimate was imprecise, and the later large cohort did not find an increase. The prescription nasal-spray label says human pregnancy data are insufficient to estimate a drug-related risk. It describes animal findings at exposures that also affected the mother and reports fluticasone in cord blood after inhaled exposure. These animal findings are not human outcome data.

Breastfeeding

LactMed's inhaled fluticasone record, revised April 15, 2026, reports no published maternal or infant drug levels. It says no effects were reported with any corticosteroid, which is not specific to fluticasone, and expert opinion considers inhaled, nasal, and oral corticosteroids acceptable during breastfeeding. MotherToBaby says the amount passing into milk after inhaled, nasal, or topical use is likely small, but also says fluticasone has not been studied during breastfeeding. NHS Specialist Pharmacy Service considers inhaled and topical corticosteroids compatible for full-term, healthy infants, while noting that published evidence is limited. Direct fluticasone milk concentration and infant-outcome data were not identified. For topical treatment, these sources emphasize avoiding infant contact with treated skin and cleaning the breast area before nursing if medicine is applied there.

What was tested

Pregnancy evidence includes observational studies of first-trimester inhaled fluticasone propionate, inhaled corticosteroids as a class, and topical corticosteroids. The topical studies mainly assessed birth size, not birth defects. The Korean continuation cohort included live births only. No direct human measurements of fluticasone in milk or fluticasone-specific infant outcomes were identified. No randomized trial of fluticasone during pregnancy or breastfeeding was identified.