Buy Nasonex Nasal Spray

Pharmacodynamics Nasonex Nasal Spray

Mometasone furoate – a synthetic corticosteroids for topical application with a pronounced anti-inflammatory action. Local anti-inflammatory effects Mometasone furoate has at doses in the application of which there is no systemic corticosteroids effects. The mechanism of anti-inflammatory and antiallergic mometasone furoate is mainly due to its ability to inhibit release of mediators of allergic reactions. Mometasone furoate reduces the synthesis / release of leukotrienes from leukocytes in patients with allergic diseases. Mometasone furoate demonstrated in cell culture, high capacity (at least 10 times higher activity than other steroids including beclomethasone dipropionate, betamethasone, hydrocortisone and dexamethasone) inhibition of synthesis / release of interleukins (IL-1, IL-6) and necrosis factor tumors (TNF-α); it also greatly inhibits the formation of Th2-cytokines, IL-4 and IL-5 CD4 + T-cells. Mometasone furoate is also at least 6 times more actively inhibits production of IL-5 than beclomethasone dipropionate, and betamethasone.

In studies with provocative tests with the application of antigens on the nasal mucosa is set high anti-inflammatory activity of aqueous nasal spray Nasonex Nasal Spray both early and late stage allergic reaction. This is confirmed by decline (compared to placebo) the level of histamine and the activity of eosinophilic granulocytes, as well as a decrease (compared to baseline) the number of eosinophil and neutrophil granulocytes, and protein adhesion of epithelial cells.

Pronounced clinical effect in the first 12 hours after the use of water nasal spray Nazoneks was observed in 28% of patients with seasonal allergic rhinitis. 50% of patients improving occurred within an average of 35.9 h. In addition, when Nasonex noted significant efficacy in reducing symptoms of the organ of vision (red, watery eyes, itching) in patients with seasonal allergic rhinitis.
In clinical studies in patients with nasal polyps Nasonex Nasal Spray significantly effective compared with placebo with respect to reduction of nasal congestion, polyp size, restoring the sense of smell.

In clinical trials involving patients aged> 12 years Nasonex 200 mcg 2 times a day showed a high efficiency with respect to reduction of rhinosinusitis symptoms compared with placebo. Within 15 days of treatment for the symptoms of rhinosinusitis was evaluated on a scale of symptoms (MSS – Major Symptom Score) (a pain in the face, sensation of pressure and pain when pressing on the projections and paranasal sinuses, rhinorrhea, outflow of mucus on the back of the throat and nasal congestion) . Efficacy of amoxicillin 500 mg 3 times daily did not significantly differ from placebo with respect to reduction of rhinosinusitis symptoms on a scale of MSS. During the period of follow-up after completion of treatment, number of relapses in the group Nasonex Nasal Spray was lower and comparable to the group of amoxicillin and a placebo. The duration of treatment of acute rhinosinusitis> 15 days is not graded.

Pharmacokinetics Nasonex Nasal Spray

Mometasone furoate in the appointment of an aqueous nasal spray has a low bioavailability (≤ 0,1%), it is practically not detected in blood plasma, even when using the method of determining the threshold of sensitivity of 50 pg / ml. In this regard, the relevant pharmacokinetic data for the dosage form no. Small amount of mometasone furoate suspension, which can get into the gastrointestinal tract after intranasal administration, before excretion in urine or bile undergoes active primary metabolism.

INDICATIONS Nasonex Nasal Spray:

seasonal or perennial allergic rhinitis in adults and children aged ≥ 2 years; prophylactic treatment of allergic rhinitis with medium and severe, it is recommended for 2-4 weeks before the expected start of the season the appearance of pollen (allergens);
as an auxiliary therapeutic agent in antibiotic therapy of acute episodes of sinusitis in adults (including elderly patients) and in children aged ≥ 12 years;
treatment of acute rhinosinusitis without signs of severe bacterial infection in adults and children aged ≥ 12 years;
treatment of nasal polyps in patients aged ≥ 18 years of age and associated symptoms (including nasal congestion and anosmia).

APPLICATION Nasonex Nasal Spray:

before the first use of a nasal spray Nasonex necessary to calibrate it by 7.6 taps dispensing unit. After the calibration is established stereotype of the drug supply, in which each click is sprayed about 50 micrograms of mometasone furoate chemically pure (1 dose). If the nasal spray was not used for 14 days or longer require a recalibration. Before each use, must vigorously shake the bottle.
If the nozzle is clogged, remove the plastic cap, gently pressing on the white ring, it is easy to detach the attachment and rinse with cold running water, dry it and install in its place.

With seasonal or perennial allergic rhinitis in adult patients (including elderly) and adolescents aged ≥ 12 years recommended preventive and therapeutic dose of 2 injections (50 mg) in each nostril one time a day (total daily dose – 200 mcg). After achieving the therapeutic effect for maintenance therapy appropriate dose reduction to 1 injection into each nostril once a day (total daily dose – 100 micrograms). If the use of the drug at the recommended therapeutic dose is not enough effective daily dose can be increased up to 4 injections in each nostril one time a day (total daily dose – 400 micrograms). After reducing the severity of symptoms is recommended lowering the dose. Onset of action of the drug noted for 12 hours after the first application.

For children aged 2-11 years the recommended therapeutic dose is 1 injection (50 mcg) in each nostril one time a day (total daily dose – 100 micrograms).

As adjuvant therapy for acute episodes of sinusitis in adults (including elderly) and children> 12 years prescribed in the recommended therapeutic dose – 2 injection (50 mcg) in each nostril 2 times daily (total daily dose – 400 micrograms) . If reducing the severity of symptoms using the drug at the recommended therapeutic dose can not be reached, the daily dose may be increased up to 4 injections in each nostril 2 times daily (total daily dose – 800 micrograms). After reducing the severity of symptoms is recommended lowering the dose.
Acute rhinosinusitis. Adults and children aged> 12 years, the recommended therapeutic dose of 2 injections (50 mg) in each nostril 2 times daily (total daily dose – 400 micrograms).

When nasal polyps in patients aged> 18 years (including the elderly), the recommended dose is two injections of 50 micrograms in each nostril 2 times daily (total daily dose – 400 micrograms). After the clinical efficacy, it is recommended to reduce the dose to 2 injections in each nostril one time a day (total daily dose – 200 micrograms).

CONTRAINDICATIONS Nasonex Nasal Spray:

Hypersensitivity to active substance or any component of the drug.

SIDE EFFECTS Nasonex Nasal Spray:

in clinical trials of the drug for seasonal and perennial allergic rhinitis have noted side effects associated with Nasonex Nasal Spray : headache (8% of cases), epistaxis, and bloody mucus or clots from the nasal cavity (8% of cases), pharyngitis (4%), burning sensation in the nose (2%), irritation (2%) and ulcerative changes (1%), nasal mucosa. The emergence of such side effects are typically in the application of any nasal spray containing corticosteroids. Nosebleeds or bleeding from the nose were not abundant and were stopped on their own, appeared with slightly greater frequency than with placebo (5%) but lower than that in the appointment of other corticosteroids for intranasal use (some of which the incidence of nasal bleeding was up to 15%). The incidence of all other side effects was comparable with the frequency of their occurrence in the appointment of a placebo.

In children, the incidence of side effects, including nasal bleeding (6%), headache (3%), feelings of irritation in the nose (2%) and sneezing (2%) was comparable with the frequency of their occurrence when using placebo.

Following intranasal administration of mometasone furoate can rarely be allergic reactions of immediate type. Very rarely observed anaphylactic reaction and angioedema.

Reported isolated cases of violations of taste and smell.

When using a nasal spray Nasonex  as an aid in the treatment of sinusitis exacerbations noted the following side effects, the incidence of which was comparable to that for placebo: headache (2%), pharyngitis (1%), burning sensation in the nose (1%) and irritation of the mucous membrane of the nasal cavity (1%). Epistaxis were moderately expressed, and their frequency in the application of spray Nasonex Nasal Spray was also comparable to the frequency of nasal bleeding for placebo (5 and 4% respectively).

In patients with nasal polyps, acute rhinosinusitis when applying spray Nasonex total number of the above side effects was comparable to that for placebo and a similar amount, which was detected in patients with allergic rhinitis.

It is very rare for intranasal application of corticosteroids noted cases of perforation of nasal septum or an increase in intraocular pressure.

SPECIAL INSTRUCTIONS Nasonex Nasal Spray:

use of the drug in younger children should be conducted with the help of adults.
Nasonex Nasal Spray can not be applied in the presence of local infection with involvement in the process of nasal mucosa. Due to the fact that corticosteroids slow the healing of wounds, the drug should not assign patients who have recently suffered surgical interventions or trauma of the nose to complete healing of wounds.

Nasonex be used with caution or not at all to assign patients with active or latent TB infection, as well as in untreated fungal, bacterial, systemic viral infections, ocular infections caused by herpes simplex virus.

After 12 months of treatment does not arise Nasonex atrophy of nasal mucosa, in addition, the application of mometasone furoate was a trend to normalization of histology in the study of biopsies of nasal mucosa. Nevertheless, patients who use Nasonex Nasal Spray for several months or longer must pass periodic inspections to identify possible changes in nasal mucosa. In the case of a local fungal infection of the nose or throat may need to stop therapy Nazoneksom and the special treatment. Irritation of the mucous membrane of the nasal cavity and pharynx, which persists for an extended period of time, can also be an indication for cessation of treatment Nasonex.

With long-term treatment of symptoms Nasonex oppression of the hypothalamic-pituitary-adrenal axis was observed. Patients who go for treatment Nasonex after prolonged systemic treatment with corticosteroids, should be under medical supervision. Cancel systemic corticosteroids in these patients may lead to insufficiency of the adrenal cortex, which may require an appropriate action. The transition from treating systemic corticosteroids for treatment Nasonex some patients may experience withdrawal symptoms SSC (arthralgia, myalgia, fatigue and depression). Change in therapy may also identify allergic diseases, which were previously masked by the use of systemic corticosteroids therapy (allergic conjunctivitis, eczema, etc.).

Patients who receive therapy with corticosteroids, with potentially reduced immunological reactivity and should be warned of an increased risk of infection in case of contact with patients with some infectious diseases (eg chickenpox, measles), and the need to consult a doctor if such contact occurred.

Should warn patients about the need for immediate treatment to the doctor in case of signs or symptoms of severe bacterial infection such as fever, severe unilateral pain in the face or toothache, orbital or periorbital swelling / edema, or deterioration after initial improvement.
Children. When a placebo-controlled clinical trials in children who have Nasonex Nasal Spray used in a daily dose of 100 mcg for 1 year, growth retardation was observed.

Not studied the safety and efficacy Nasonex Nasal Spray in the treatment of nasal polyps in children and adolescents under the age of 18 years, symptoms of rhinosinusitis – children under the age of 12 years, seasonal or perennial allergic rhinitis – in children younger than 2 years.
Use during pregnancy and lactation. Special studies of the drug during pregnancy was not performed. Following intranasal administration of drugs for the maximum therapeutic dose of mometasone are not determined in blood plasma, even in minimal concentrations. Consequently, we can expect that the effect of the drug on the fetus will be negligible, and the potential toxicity on reproductive function – is very low. Nevertheless, like other corticosteroids for intranasal use, Nasonex should be prescribed in pregnancy or lactation only if the expected benefits of its use justifies the potential risk to the mother, fetus or infant. Children whose mothers during pregnancy received corticosteroids should be screened to identify possible hypoadrenalism.

INTERACTION Nasonex Nasal Spray:

Nasonex Nasal Spray used in combination with loratadine, while not noted any effect on the concentration in blood plasma loratadine or its major metabolite, and mometasone furoate was not determined in blood plasma, even in minimal concentrations. Combined therapy of patients with these drugs is well tolerated.

Data regarding the interaction with other drugs has been submitted.

OVERDOSE Nasonex Nasal Spray:

unlikely because of the low (≤ 0,1%) systemic bioavailability of the drug. In case of overdose should monitor patients with the subsequent use of the drug at the recommended dose.