NAZONEX - instructions for use, analogs, testimonials and release forms (spray or nasal drops) of a medicament for the treatment of rhinitis, sinusitis, adenoids and polyps in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Nazonex. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of NAZONEX in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Nazonex in the presence of existing structural analogues. Use for the treatment of rhinitis, sinusitis, adenoids and polyps in adults, children, as well as during pregnancy and lactation.

Nazonex - Glucocorticosteroid for topical application. Has anti-inflammatory and anti-allergic effect. The local anti-inflammatory effect of the drug is manifested when it is used in doses, in which no systemic effects occur.

It inhibits the release of inflammatory mediators. Increases the production of lipomodulin, which is an inhibitor of phospholipase A, which causes a decrease in the release of arachidonic acid and, accordingly, inhibition of the synthesis of metabolic products of arachidonic acid-cyclic endoperoxides, prostaglandins. It prevents the accumulation of neutrophils, which reduces inflammatory exudate and production of lymphokines, inhibits the migration of macrophages, leads to a decrease in the processes of infiltration and granulation. Reduces inflammation due to decreased formation of chemotaxis substance (influence on late allergy reactions), inhibits the development of an immediate allergic reaction (by inhibiting the formation of metabolites of arachidonic acid and reducing the release of inflammatory mediators from mast cells).

In studies withprovocative tests with the application of antigens to the nasal mucosa showed high anti-inflammatory activity of the drug, both at early and late stages of the allergic reaction. When compared with placebo, there was a decrease in histamine and eosinophil activity, as well as a decrease in the amount of eosinophils, neutrophils and adhesion proteins of epithelial cells (compared to the initial one).

Pharmacokinetics

With intranasal application systemic bioavailability of the drug is less than 0.1%. In this case, mometasone furoate (an active substance of the drug NAZONEX) is practically not detected in the blood plasma. A small amount of active substance that can enter the digestive tract with intranasal application, is absorbed to an insignificant degree and is actively biotransformed when "first passed" through the liver.

Indications

• treatment of seasonal and all-year-round allergic rhinitis in adults, adolescents and children from 2 years;
• exacerbation of chronic sinusitis in adults (including senile age) and children from 12 years of age (as an adjuvant in the complex antibacterial therapy);
• prevention of seasonal allergic rhinitis of moderate and severe course (recommended 2-4 weeks before the beginning of the dusting season).

Forms of release

Spray nasal dosed (sometimes called mistakenly drops in the nose).

Instructions for use and how to use them

For the treatment of seasonal and year-round rhinitis, adults (including those of senile age) and children from 12 years of age are prescribed 2 injections in each nostril once a day (total daily dose of 200 μg). After achieving the desired clinical effect, the dose of maintenance drug is 100 μg (1 injection into each nostril once a day). If necessary, the dose of the drug can be increased to 4 injections in each nostril (total daily dose - 400 mcg). Children aged 2-11 years are prescribed 50 μg (1 injection) in each nostril once a day (total daily dose is 100 μg).

The positive dynamics of clinical symptoms is noted, as a rule, within the first 12 hours after the first use of the drug.

To treat exacerbations of chronic sinusitis as part of complex therapy with antibiotics, adults (including those of senile age) and children from 12 years of age are prescribed 100 μg (2 injections) per nostril 2 times a day. The total daily dose is 400 mcg.If necessary, it is possible to increase the daily dose to 800 mcg (4 injections per nostril 2 times a day). After reducing the symptoms of the disease, a dose reduction is recommended.

The stereotyped drug delivery (at which each injection of a button releases 100 mg of suspension, corresponding to 50 μg of pure mometasone furoate) is established after approximately 6-7 "calibration" pressures. If the drug has not been used for 14 days or longer, a "calibration" is required before use.

Before use, the vial should be vigorously shaken.

Side effect

• nosebleeds (ie, obvious bleeding, as well as secretions of blood-colored mucus or blood clots);
• pharyngitis;
• a burning sensation in the nose;
• irritation of the mucous membrane of the nasal cavity;
• headache;
• perforation of the nasal septum;
• increased intraocular pressure.

Contraindications

• children under 2 years;
• An untreated infection involving the nasal cavity in the mucosa process;
• recent surgery or trauma to the nose (before wound healing);
• tuberculosis of the respiratory system (incl.latent), untreated fungal, bacterial, systemic viral infection (including caused by the Herpes simplex virus with eye damage);
• hypersensitivity to the drug.

Application in pregnancy and lactation

Special, well-controlled studies of the safety of the use of Nazonex during pregnancy and lactation were not conducted. After intranasal use 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 negligible, and the potential toxicity with respect to reproductive performance is very low.

Nevertheless, during pregnancy and lactation, as well as in women of childbearing age, Nazonex should be prescribed if the expected benefit from its use justifies the potential risk to the fetus and newborn. Newborns whose mothers used SCS during pregnancy should be carefully examined to identify possible hypofunction of the adrenal glands.

special instructions

After applying NAZONEX within 12 months, no signs of atrophy of the nasal mucosa were noted.When studying the biopsy specimens of the nasal mucosa, it was found that mometasone furoate showed a tendency to normalize the histological pattern.

When applying the drug for a long time (as with any long-term treatment) periodic inspection of the nasal mucosa by the ENT doctor is necessary. With the development of a local bacterial or fungal infection of the nose or throat, treatment with the drug is recommended to stop and begin to conduct specific therapy. The long-term irritation of the mucous membrane of the nasal cavity and pharynx is an indication for the withdrawal of the drug.

With prolonged use of the drug, signs of suppression of the hypothalamic-pituitary-adrenal system were not observed.

Patients who switch to Nazonex nasal spray treatment after long-term therapy with SCS of systemic action require special attention. The abolition of SCS systemic action in such patients can lead to adrenal insufficiency, which may require appropriate measures.

During the transition from treatment of SCS to systemic action to treatmentNasonex nasal spray in some patients may have symptoms of withdrawal of SCS for systemic use (eg, joint and / or muscle pain, fatigue, depression), despite a decrease in the severity of symptoms associated with nasal mucosa; such patients need to specifically convince in the advisability of continuing treatment with nasal spray Nazoneks. Changing therapy may also reveal previously developed allergic diseases, such as allergic conjunctivitis and eczema, which were previously masked by systemic glucocorticoid therapy.

Patients undergoing GCS therapy have a reduced immune reactivity and should be warned about an increased risk of infection when communicating with infectious diseases (including chicken pox, measles).

Use in Pediatrics

In the placebo-controlled clinical trials in children, when Nazonex was used at a dose of 100 mcg per day during the year, there was no growth retardation.

Data on the use of the drug in children under the age of 2 years are absent, therefore Nazonex can not be recommended for use in this age group.

Drug Interactions

Simultaneous use of NAZONEX with loratadine did not lead to a change in the concentration of loratadine or its main metabolite in the blood plasma, while the presence of mometasone furoate was not detected in plasma even at the minimum concentration.

Studies of drug interactions between Nazonex and other drugs have not been conducted.

Analogues of the medicament Nazonex

Structural analogs for the active substance:

• Avecourt;
• Asmaneks Twistheiler;
• Gistan-N;
• Momat;
• Mometasone furoate;
• Monovo;
• Silkarene;
• Uniderm;
• Elokom;
• Elok Lotion.

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