Exhausting allergies, chronic sinusitis, polyps in the nasal cavity... It’s not a pleasant set. But even with it one can and must fight. Most often, the attending physician prescribes Nasonex spray. The drug has anti-inflammatory and antiallergic effects. It is based on mometasone furoate, which belongs to the group of glucocorticoids and is considered a synthetic drug.
an analogue of adrenal hormones, corticosteroids (GCS) for topical use.
Nasonex copes well with allergic rhinitis
Mometasone suppresses inflammatory and allergic reactions of various types when used in doses at which systemic effects do not develop. The therapeutic effect is observed 12 hours after the start of use.
Despite the fact that Nasonex is a hormonal drug, it does not affect other organs and systems except the nose.
A small dosage and use only in the nasal area ensures a very low concentration of mometasone in the blood. Also, it is worth noting that Nasonex is not addictive.
Indications
The main indications for the use of Nasonex spray are:
- allergic rhinitis (seasonal or year-round), which is accompanied by constant rhinorrhea and swelling of the nasal mucosa;
- exacerbation of chronic sinusitis (the drug is prescribed as an adjunct to antibiotic therapy) in adolescents and adults;
- polyps of the nasal cavity, which lead to disruption of full respiratory function.
Children are prescribed Nasonex allergy spray from the age of two. For the treatment of sinusitis in pediatrics, it is used in children over twelve years of age.
Nasonex drops can be taken by children from 2 years of age
Also, the spray is used to prevent moderate/severe seasonal allergic rhinitis. Nasonex must be used 2 weeks before the expected start of the dusting period.
Contraindications
Before starting to use the drug, be sure to carefully read the instructions. The spray, since it is a medicinal product, has contraindications for use:
- recent surgical interventions on the nasal cavity;
- open wound surfaces, bleeding scratches and cracks in the nasal cavity;
- increased individual sensitivity to the components of the drug;
- children's age (for seasonal and year-round allergic rhinitis - up to 2 years, for acute sinusitis or exacerbation of chronic sinusitis - up to 12 years, for polyposis - up to 18 years) - due to the lack of relevant data.
The drug is used with caution in the following conditions:
- tuberculosis in active or latent form;
- viral, bacterial or fungal processes;
- herpetic infection in the nose;
- infection of unknown origin.
Special instructions for the use of Nasonex
The use of the drug in young children should be carried out with the help of adults. Nasonex should not be used in the presence of local infection involving the nasal mucosa. Due to the fact that corticosteroids slow down wound healing, the drug should not be prescribed to patients who have recently undergone surgery or nasal trauma until the wounds have completely healed. Nasonex should be prescribed with caution or not at all to patients with active or latent tuberculosis infection, as well as untreated fungal, bacterial, systemic viral infections, and ophthalmic infections caused by the herpes simplex virus. After 12 months of treatment with Nasonex, there was no atrophy of the nasal mucosa; In addition, when using mometasone furoate, there was a tendency towards normalization of the histological picture when examining biopsy samples of the nasal mucosa. However, patients who use Nasonex for several months or longer should undergo periodic examination to identify possible changes in the nasal mucosa. If a local fungal infection of the nose or pharynx develops, it may be necessary to discontinue Nasonex therapy and carry out special therapy. Irritation of the mucous membrane of the nasal cavity and pharynx, which persists for a long time, may also be an indication to discontinue treatment with Nasonex. With long-term treatment with Nasonex, no signs of suppression of the hypothalamic-pituitary-adrenal system were noted. Patients who switch to treatment with Nasonex after prolonged systemic therapy with GCS should be under medical supervision. Withdrawal of systemic corticosteroids in such patients may lead to insufficiency of adrenal cortex function, which may require appropriate measures. During the transition from treatment with systemic corticosteroids to treatment with Nasonex, some patients may experience symptoms of corticosteroid withdrawal (arthralgia, myalgia, fatigue and depression). A change in therapy may also reveal allergic diseases that were previously masked by the use of systemic GCS therapy (allergic conjunctivitis, eczema, etc.). Patients receiving GCS therapy have a potentially reduced immunological reactivity and should be warned about the increased risk of infection in case of contact with patients with certain infectious diseases (for example, chicken pox, measles), as well as the need to consult a doctor if such contact has occurred. Patients should be warned to seek immediate medical attention if signs or symptoms of a severe bacterial infection occur, such as fever, severe unilateral facial or toothache, orbital or periorbital swelling/edema, or worsening after initial improvement. Children. In placebo-controlled clinical studies in children in whom Nasonex was used at a daily dose of 100 mcg for 1 year, no growth retardation was observed. The safety and effectiveness of Nasonex in the treatment of nasal polyps in children and adolescents under 18 years of age, symptoms of rhinosinusitis in children under 12 years of age, and seasonal or year-round allergic rhinitis in children under 2 years of age have not been studied. Use during pregnancy and lactation. Special studies of the effect of the drug during pregnancy have not been conducted. After intranasal administration of the drug at the maximum therapeutic dose, mometasone is not detected in the blood plasma even at the minimum concentration. Therefore, it can be expected that the effect of the drug on the fetus will be insignificant, and the potential toxicity regarding reproductive function will be very low. However, like other corticosteroids for intranasal use, Nasonex should be prescribed during pregnancy or lactation only if the expected benefits of its use justify the potential risk to the mother, fetus or infant. Children whose mothers received corticosteroids during pregnancy should be examined to identify possible adrenal hypofunction.
Side effects
When prescribing the drug, the following adverse reactions may occur:
- pharyngitis;
- headache;
- nosebleeds (bleeding may be obvious or blood may be present in the mucus released from the nose);
- irritation of the mucous membrane in the nasal cavity;
- burning sensation in the nose.
One of the side effects of Nasonex may be headache.
In children receiving Nasonex for the treatment of allergic rhinitis, the following was observed:
- nosebleeds;
- irritation of the nasal mucosa;
- headache;
- sneezing;
- very rarely: bronchospasm, shortness of breath, anaphylaxis, angioedema, disturbances of taste and smell, perforation of the nasal septum and increased intraocular pressure.
Adverse reactions when using Nasonex spray
During treatment with the drug, the following are occasionally observed:
- headache;
- a feeling of dryness, burning and itching of the mucous membrane in the sinuses and larynx;
- pharyngitis;
- bloody discharge from the nose;
- sneezing, coughing;
- increased lacrimation, photophobia.
Side effects in most cases are observed in the first 1–2 days of using the medication. Subsequently, unwanted reactions decrease and disappear on their own. If negative symptoms increase, additional consultation with an otolaryngologist and discontinuation of the drug are required.
How to take Nasonex
The drug is intended for intranasal administration of the suspension contained in the bottle through a dosing nozzle. The dose of the drug sprayed into the nasal cavity is determined by the doctor depending on the severity of the disease.
Before using the spray for the first time, it is “calibrated” by pressing the applicator 6-7 times. This action allows you to establish the delivery of the drug into the nasal cavity in a therapeutic dose of 100 mg.
Taking Nasonex
Before each use, the bottle must be shaken vigorously.
For direct use, the end of the dispensing nozzle must be inserted into the nasal passage and pressed on the applicator (1 press = 1 spray). The head and bottle with the drug must be kept strictly vertical.
If Nasonex has not been used for 14 days or more, it is necessary to re-calibrate by pressing the applicator 2 times. It is also important to clean the dispensing nozzle regularly to prevent it from malfunctioning.
The mechanism of action of the drug Nasonex
Mometasone inhibits the release of inflammatory mediators. At the same time, it activates the release of a blocker of the enzyme phospholipase A, which is responsible for the intensity of the immune reaction to antigens. When using a nasal spray, nasal discharge and accompanying other signs of allergy are reduced: conjunctivitis, lacrimation, swelling, itching, hyperemia.
The drug is effective against rapidly developing intolerance and helps prevent delayed allergies. Symptoms as a result of use are reduced at all stages of the pathology. They can be completely eliminated within 1–2 days from the start of treatment.
When applied topically, the drug substances are absorbed into the systemic bloodstream in a negligible concentration, without causing harm to the body.
Nasonex during pregnancy
Due to the fact that there are no clinically proven studies of the effect of the active substance - mometasone furoate - on the body of a pregnant woman, the fetus and during lactation, the drug is prescribed with caution starting from the second trimester, and only when the expected effect of therapy justifies the potential risk to the fetus/newborn .
Nasonex during pregnancy
When using the drug during pregnancy, newborns should be carefully monitored for adrenal hypofunction.
Composition and dosage form of the drug
The active component of the drug is mometasone furoate, a hormonal substance with a pronounced antiallergic effect. The therapeutic effect is observed when using microscopically small doses that are unable to influence the body systemically.
Nasonex is available in the form of a nasal spray: in plastic bottles of 18 g each, equipped with a dispenser nozzle. One package of the drug is designed for 140 doses. Nasonex Sinus spray of identical composition is produced in 10 g bottles containing about 60 therapeutic doses.
The solution is a liquid, opaque, whitish suspension with a concentration of 50 mcg of glucocorticosteroid per dose. Spray excipients: citric acid, glycerin, polysorbate, distilled water and others.
Nasonex for children
According to the instructions for use, Nasonex spray can be used by children from 2 years of age. The prescription of the drug depends not only on the age of the child, but also on the disease being diagnosed.
- seasonal and year-round allergic rhinitis - for children from 2 years of age;
- acute sinusitis or exacerbation of chronic sinusitis - from 12 years of age;
- acute rhinosinusitis with mild and moderate symptoms without signs of severe bacterial infection - from 12 years of age;
- preventive treatment of moderate and severe seasonal allergic rhinitis - from 12 years of age (recommended two to four weeks before the expected start of the dust season);
- Nasal polyposis, accompanied by impaired nasal breathing and sense of smell, is not prescribed for children.
Nasonex for allergies
Nasonex is used to treat seasonal or year-round allergic rhinitis in adults and adolescents over 12 years of age. The recommended preventive and therapeutic dose of the drug is 2 inhalations (50 mcg each) into each nasal passage once (total daily dose of mometasone - 200 mcg/day). Clinical improvement after the first use of Nasonex is observed within 12 hours.
After achieving the desired therapeutic effect and to maintain it, the dose is reduced to 100 mcg/day. (one inhalation into each nostril once).
If the symptoms of the disease do not decrease, then, in agreement with the attending physician, it is possible to increase the daily dose to 400 mcg/day. When the patient's condition improves, the dose of the drug must be reduced.
For children aged 2-11 years with allergies, it is recommended to take one inhalation in each nasal passage once. The total dose is 100 mcg/day.
Indications for use of the drug Nasonex
- seasonal or perennial allergic rhinitis in adults and children aged ≥2 years;
- as an adjuvant therapeutic agent in antibiotic therapy for 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 and associated symptoms (including nasal congestion and loss of smell).
Nasonex for adenoids
Enlarged adenoids are a fairly common complication of allergic rhinitis. Nasonex relieves swelling and often prevents the need for surgery.
A similar effect is achieved by suppressing lymphoid tissue. But it should be borne in mind that in case of severe inflammation, Nasonex is ineffective. Also, the hormonal nature of the drug suppresses the immune system to some extent, so after discontinuation of the drug, inflammation in the adenoids may resume (especially in children). To relieve this condition, it is recommended to undergo a course of anti-inflammatory treatment of adenoid vegetations. And also strengthen your immune system, eat right, walk in the fresh air, play sports and have as little contact with household chemicals and dust as possible.
Analogs of the drug Nasonex
Synonyms for Nasonex spray with the same active ingredient are: Desrinit, Rizonel, Asmanex Twistheiler, Momat Rino and Nosephrine.
Nasonex spray analogues
Analogues of Nasonex with a similar therapeutic effect (dosage form: spray): Flutinex, Avamis, Flixonase, Beclonazal, Beclomethasone, Fluticasone, Tafen, Rinoklenil, Polydexa, Nasobek, Nazarel, Budoster, Aldecin.
Nasal drops with GCS: Benacap, Benarin.
Before replacing Nasonex, you should definitely consult with your doctor regarding contraindications, dosage and duration of therapy.
Nasonex or Avamis?
Nasonex and Avamis have similar therapeutic effects, routes of administration and indications. The active component of Avamis spray is fluticasone furoate, Nasonex is mometasone furoate. Both substances are characterized by a very high degree of affinity for GCS receptors and exceptional local activity. However, among all existing corticosteroids for intranasal administration, mometasone has the lowest bioavailability and the fastest development of the therapeutic effect. In addition, Nasonex based on mometasone is approved for use in children from the age of two, while Avamis in pediatric practice is used only for the treatment of children over six years of age. Mometasone furoate has a more gentle effect on the body and does not have a negative effect.
But Avamis has fewer contraindications than Nasonex spray.
Do not forget that, despite the similarity of these two medications, only the attending physician can prescribe or replace one drug with another.
Nasonex or Desrinit?
The main differences between Nasonex and Dezrinit are price and manufacturer. Nasonex is an original drug produced in Belgium. And Dezrinit is a generic produced in Israel. The original drug always contains components of a higher degree of purification. Therefore, its effectiveness is higher and its tolerability is better. The active substance of the drugs is identical - mometasone. The composition contains minor differences in auxiliary components that do not affect the overall therapeutic effect.
Nasonex is more often used for children, because the drug has less side effects than its analogue.
Remember that even if the composition is the same, taking medications must be coordinated with your doctor, who will suggest the optimal solution for a specific disease.
Pharmacological properties of the drug Nasonex
Pharmacodynamics. Mometasone furoate is a synthetic corticosteroid for topical use with a pronounced anti-inflammatory effect. Mometasone furoate has a local anti-inflammatory effect in doses, the use of which does not cause systemic GCS effects. The mechanism of anti-inflammatory and antiallergic action of mometasone furoate is mainly associated with its ability to inhibit the release of mediators of allergic reactions. Mometasone furoate significantly reduces the synthesis/release of leukotrienes from leukocytes in patients with allergic diseases. Mometasone furoate has demonstrated in cell culture a high potential (at least 10 times higher activity than other steroids, including beclomethasone dipropionate, betamethasone, hydrocortisone and dexamethasone) to inhibit the synthesis/release of interleukins (IL-1, IL-6) and necrosis factor tumors (TNF-α); it also significantly inhibits the production of Th2 cytokines, IL-4 and IL-5 by CD4+ T cells. Mometasone furoate is also at least 6 times more potent in inhibiting IL-5 production than beclomethasone dipropionate and betamethasone. In studies with provocative tests with the application of antigens to the mucous membrane of the nasal cavity, the high anti-inflammatory activity of the Nasonex aqueous nasal spray was established in both the early and late stages of the allergic reaction. This was confirmed by a decrease (compared to placebo) in histamine levels and eosinophilic granulocyte activity, as well as a decrease (compared to baseline) in the number of eosinophilic and neutrophilic granulocytes and epithelial cell adhesion proteins. A pronounced clinical effect in the first 12 hours after using Nasonex aqueous nasal spray was observed in 28% of patients with seasonal allergic rhinitis. In 50% of patients, improvement occurred on average within 35.9 hours. In addition, when using Nasonex, significant effectiveness was noted in reducing the severity of visual symptoms (redness, lacrimation, itching) in patients with seasonal allergic rhinitis. In clinical studies in patients with nasal polyps, Nasonex was significantly effective compared to placebo in reducing nasal congestion, polyp size, and restoring the sense of smell. In clinical studies involving patients aged 12 years, the use of Nasonex 200 mcg 2 times a day demonstrated high effectiveness in reducing the symptoms of rhinosinusitis compared to placebo. During 15 days of treatment, symptoms of rhinosinusitis were assessed using the Major Symptom Score (MSS - pain in the face, sensation of pressure and pain when pressing in the area and projection of the paranasal sinuses, rhinorrhea, mucus flow down the back of the throat and nasal congestion) . The effectiveness of amoxicillin 500 mg 3 times a day was not significantly different from placebo in reducing symptoms of rhinosinusitis according to the MSS scale. During the follow-up period after completion of treatment, the number of relapses in the Nasonex group was lower and comparable to the amoxicillin and placebo groups. The duration of treatment for acute rhinosinusitis beyond 15 days has not been assessed. Pharmacokinetics. Mometasone furoate, when administered as an aqueous nasal spray, has low bioavailability (≤0.1%), it is practically undetectable in blood plasma, even when using a detection method with a sensitivity threshold of 50 pg/ml. Therefore, there are no relevant pharmacokinetic data for this dosage form. A small amount of mometasone furoate suspension, which can enter the gastrointestinal tract after intranasal administration, undergoes active primary metabolism even before excretion in urine or bile.
