Fliksonase - instructions for use, reviews, analogs and forms of release (nasal spray 60 doses or drops in the nose) of a hormonal drug for the treatment of allergic rhinitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Fliksonase. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Fliksonase in their practice. A big request to actively add your feedback on the hormonal 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 Fliksonase in the presence of existing structural analogues. Use for the treatment of allergic rhinitis in adults, children,as well as during pregnancy and lactation. Composition of the preparation.

Fliksonase - Glucocorticosteroid (GCS) for intranasal (in the nose) application. Has a pronounced anti-inflammatory, anti-edematous and anti-allergic effect.

Anti-inflammatory effect is realized as a result of interaction of the drug with receptors of glucocorticosteroids. Suppresses the proliferation of mast cells, eosinophils, lymphocytes, macrophages, neutrophils. Fluticasone propionate (the active substance of the preparation Fliksonase) reduces the production of inflammatory mediators and a number of biologically active substances (including histamine, prostaglandins, leukotrienes, cytokines) during the early and late phase of the allergic reaction. Has a quick anti-inflammatory effect on the nasal mucosa. Antiallergic effect manifests itself in 2-4 hours after the first application. Reduces sneezing, itching in the nose, rhinorrhea, nasal congestion, discomfort in the sinuses and a feeling of pressure around the nose and eyes. In addition, it alleviates eye symptoms associated with allergic rhinitis.Reduction of the severity of symptoms (especially nasal congestion) persists for 24 hours after a single application of a spray at a dose of 200 μg.

Fluticasone propionate improves the quality of life of patients, including physical and social activity.

When used in recommended doses, the drug has no systemic effect and practically does not inhibit the hypothalamic-pituitary-adrenal system.

Composition

Fluticasone propionate (micronized) + excipients.

Pharmacokinetics

Direct absorption from the mucous membrane of the nasal cavity is negligible due to the low solubility of the drug in water, as a result, most of the dose is eventually swallowed. With oral administration of fluticasone propionate, less than 1% of the dose is absorbed into the blood due to low absorption and presystemic metabolism. These reasons are due to an extremely low total absorption from the nasal cavity and gastrointestinal tract (swallowed drug). Binding to plasma proteins is about 91%. Fluticasone propionate undergoes the "first pass" effect through the liver, is metabolized with the participation of the CYP3A4 isoenzyme with the formation of an inactive carboxyl metabolite.It is excreted mainly with bile in unchanged form and in the form of metabolites.

Indications

• prevention and treatment of seasonal allergic rhinitis (common cold);
• prevention and treatment of year-round allergic rhinitis.

Forms of release

Spray nasal dosed (60 doses in a vial) (sometimes mistakenly called drops in the nose).

Instructions for use and how to use them

Fliksonase is intended only for intranasal use. To achieve full therapeutic effect the drug should be used regularly.

Adults and children over 12 years of age are prescribed 100 μg (2 doses) per nostril once a day (total dose of 200 μg per day), preferably in the morning. After reaching the control of symptoms, you can appoint 50 μg (1 dose) to each nostril 1 time per day (total dose of 100 μg per day).

In some cases, 100 μg (2 doses) should be applied to each nostril 2 times a day (total dose of 400 μg per day) for a short time to achieve symptom control, after which the dose can be reduced. The maximum daily dose of the drug is 400 μg (4 doses per nostril).

Older patients do not need a dosage adjustment.

Children aged 4-12 years are recommended to appoint 50 μg (1 dose) to each nostril once a day.The maximum daily dose of the drug is 200 μg (2 doses per each nostril).

The maximum therapeutic effect is manifested after 3-4 days of therapy. To achieve the full therapeutic effect, it is necessary to regularly apply the drug.

Mode of application

Before use, you should gently shake the bottle, take it by placing the index and middle fingers on either side of the tip, and the thumb under the bottom. At the first use of the drug or a break in its use for more than 1 week, it is necessary to check the serviceability of the nebulizer (pointing the tip away from yourself, making a few taps until a small cloud appears from the tip).

Then you need:

1. clean your nose (blow your nose slightly);
2. close one nostril and insert the tip into the other nostril;
3. Tilt his head slightly forward, continuing to hold the aerosol bottle vertically;
4. start breathing in through your nose and, continuing to inhale, press once with your fingers to spray the drug;
5. exhale through the mouth.

Repeat the procedure for the second spray in the same nostril if necessary. Then repeat the above procedure completely by inserting the tip into the other nostril.

After use, the tip should be soaked with a clean cloth or a handkerchief and cover it with a cap.

The sprayer should be washed at least once a week. For this purpose, it is necessary to carefully remove the tip, rinse it in warm water. Shake off excess water and leave to dry in a warm place. Avoid overheating. Then gently place the tip on the same place in the top of the brown bottle. Put the protective cap on. If the tip of the tip is clogged, the tip should be removed as described above and left for some time in warm water. Then rinse under a stream of cold water, dry and re-put on the bottle. Do not clean the tip of the tip with a pin or other sharp objects.

Side effect

• dryness and irritation of the nasopharynx;
• unpleasant aftertaste and smell;
• nasal bleeding;
• burning sensation, nasal congestion;
• perforation of the nasal septum (especially with surgical interventions in the nasal cavity in the anamnesis);
• skin rash;
• swelling of the face and tongue;
• anaphylactic reactions;
• bronchospasm;
• headache.

Contraindications

• children under 4 years;
• hypersensitivity to fluticasone propionate and other components of the drug.

Application in pregnancy and lactation

It is not recommended to prescribe Fliksonase during pregnancy. If it is necessary to use the drug in this category of patients, the prospective benefit of therapy for the mother and the potential risk to the fetus should be taken into account.

Application in elderly patients

Older patients do not need a dosage adjustment.

Use in children

Children aged 4-12 years are recommended to appoint 50 μg (1 dose) to each nostril once a day. The maximum daily dose of the drug is 200 μg (2 doses per each nostril). Contraindicated in children under 4 years.

special instructions

Care should be taken when transferring patients with systemic corticosteroid therapy to treatment with Fliksonase if there is reason to suspect a violation of adrenal function.

With prolonged use of the drug requires regular monitoring of the function of the adrenal cortex.

The patient should be warned that if there is no improvement after 7 days of continuous use of the drug, you should consult a doctor.

With continuous use of the drug for more than 6 months, medical monitoring of the patient's condition is necessary.

In most cases, the use of Fliksonase can successfully control the symptoms of seasonal allergic rhinitis, but in some cases, with very high concentrations in the air of allergens in the summer, additional therapy may be required.

To stop ophthalmic manifestations against the background of successful therapy of seasonal allergic rhinitis, additional treatment may be required.

Caution should be applied to the preparation in the presence of herpes, as well as infections of the nasal cavity or paranasal sinuses. With infectious diseases of the nose, appropriate treatment is required. Infectious diseases of the nose are not a contraindication for the use of Fliksonase.

Caution should be given to the drug after a recent injury to the nose or after surgery in the nasal cavity, as well as in the presence of ulcerative lesions of the nasal mucosa.

Caution should be given to the drug simultaneously with other medicinal forms of corticosteroids, including tablets, creams, ointments, agents for the treatment of bronchial asthma,similar nasal sprays and ophthalmic or nasal drops.

Drug Interactions

Due to very low concentrations of fluticasone propionate in the blood plasma after application of Fliksonase, clinically significant interaction is unlikely.

With the simultaneous use of fliksonase with ritonavir, which is a strong inhibitor of the isoenzyme CYP3A4, a significant increase in the concentration of fluticasone propionate in the blood plasma is possible. As a result, a sharp decrease in the concentration of cortisol in the serum occurs, and side effects due to the systemic action of corticosteroids, including Cushing's syndrome and suppression of the function of the adrenal cortex, develop.

With the simultaneous use of Fliksonase with other inhibitors of the isoenzyme CYP3A4, an insignificant (with erythromycin) or insignificant (with ketoconazole) increase in the concentrations of fluticasone propionate in the blood plasma is observed, which does not cause a noticeable decrease in the concentrations of cortisol in the serum.

Analogues of the drug Fliksonase

Structural analogs for the active substance:

• Kutiweit;
• Nazarel;
• Fliksotid;
• Fluticasone propionate.

Analogues for the pharmacological group (glucocorticosteroids):

• Avamis;
• Advantan;
• Acriderm;
• Aldecin;
• Beklazone;
• Beclodget 250;
• Beclomethasone;
• Baconase;
• Benacorte;
• Betamethasone;
• Budesonide;
• Hydrocortisone;
• Decortin;
• Dexazone;
• Dexamethasone;
• Dexon;
• Depot Medrol;
• Diprosalic;
• Diprospan;
• Ingaksort;
• Kenakorth;
• Kenalog;
• Cortef;
• Cortisone;
• Kutiweit;
• Latticort;
• Lokoid lipocream;
• Lokoid;
• Lorinden;
• Medrol;
• Mikozolone;
• Nazarel;
• Nazonex;
• Oxycort;
• Polidex;
• Polcortolone;
• Prednisol;
• Prednisolone;
• Proctosedil;
• Pulmicort;
• Sinaflan;
• The Synoderm;
• Solu Medrol;
• Sofradex;
• Tebridex;
• Triamsinolone;
• Ultraproject;
• Flosteron;
• Flukort;
• Flucinar;
• Celestoderm B;
• Celeston;
• Elokom;
• Etreex.

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