Flixonase, 1 piece, 50 mcg/dose, metered nasal spray
Intranasally.
For adults and children over 12 years of age, for the prevention and treatment of allergic rhinitis, the recommended dose is 2 injections into each nasal passage once a day, preferably in the morning (total dose 200 mcg/day). Once symptom control is achieved, the dose can be reduced to 1 spray in each nostril once a day (100 mcg/day).
In some cases, 2 injections into each nasal passage 2 times a day (total dose 400 mcg/day) for a short time in order to achieve control of symptoms, after which the dose can be reduced.
The maximum daily dose (total dose 400 mcg/day) is no more than 4 injections into each nasal passage.
Elderly patients: Usual adult dose.
For children aged 4–12 years, for the prevention and treatment of seasonal allergic rhinitis - 1 injection (50 mcg) into each nasal passage 1 time per day. The maximum daily dose (total dose 200 mcg/day) is no more than 2 injections into each nasal passage.
To achieve the full therapeutic effect, regular use of the drug is important. The drug may not provide an immediate therapeutic effect; maximum relief occurs after 3-4 days of treatment.
Using an inhaler
Before use, shake the bottle carefully, take it by placing your index and middle fingers on either side of the tip, and your thumb under the bottom.
When using the drug for the first time or a break in its use for more than 1 week, you should check the serviceability of the sprayer: point the tip away from you, make several presses until a small cloud appears from the tip. Next, you need to clear your nose (blow your nose lightly). Close one nasal passage and insert the tip into the other nasal passage. Tilt your head slightly forward while continuing to hold the bottle vertically. Then you should begin to inhale through your nose and, continuing to inhale, press once with your fingers to spray the drug. Exhale through your mouth. Repeat the procedure for a second spray into the same nasal passage, if necessary. Next, repeat the described procedure completely, inserting the tip into the other nasal passage.
After use, blot the tip with a clean napkin or handkerchief and close it with the cap.
The sprayer should be washed at least once a week. To do this, carefully remove the tip and rinse it in warm water. Shake off excess water and leave to dry in a warm place. Avoid overheating. Then carefully place the tip in its original place at the top of the brown bottle. Put on a protective cap.
If the tip hole is clogged, the tip should be removed as described above and left in warm water for a while. Then rinse under running cold water, dry and put back on the bottle. Do not clean the tip hole with a pin or other sharp objects.
Flixonase
Flixonase is intended for intranasal use only. To achieve the full therapeutic effect, the drug should be used regularly.
Adults and children over 12 years old
Prescribe 100 mcg (2 doses) in each nostril 1 time/day (total dose 200 mcg/day), preferably in the morning. After achieving control of symptoms, you can prescribe 50 mcg (1 dose) in each nostril 1 time / day (total dose 100 mcg / day).
In some cases, it is necessary to use 100 mcg (2 doses) in each nostril 2 times / day (total dose 400 mcg / day) for a short time in order to achieve control of symptoms, after which the dose can be reduced. The maximum daily dose of the drug is 400 mcg (4 doses in each nostril).
Elderly patients
no dosage regimen adjustment is required.
Children aged 4-12 years
It is recommended to administer 50 mcg (1 dose) in each nostril 1 time/day. The maximum daily dose of the drug is 200 mcg (2 doses in each nostril).
The maximum therapeutic effect appears after 3-4 days of therapy. To achieve the full therapeutic effect, it is necessary to use the drug regularly.
Mode of application
Before use, shake the bottle carefully, take it by placing your index and middle fingers on either side of the tip, and your thumb under the bottom. When using the drug for the first time or a break in its use for more than 1 week, you should check the serviceability of the sprayer (pointing the tip away from you, make several presses until a small cloud appears from the tip).
Next you need:
- clear your nose (blow your nose lightly);
- close one nostril and insert the tip into the other nostril;
— tilt your head slightly forward, continuing to hold the aerosol bottle vertically;
- begin to inhale through your nose and, continuing to inhale, press once with your fingers to spray the drug;
- exhale through your mouth.
Repeat the procedure for a second spray in the same nostril, if necessary. Next, repeat the described procedure completely, inserting the tip into the other nostril.
After use, blot the tip with a clean napkin or handkerchief and close it with the cap.
The sprayer should be washed at least once a week. For this purpose, you must carefully remove the tip and rinse it in warm water. Shake off excess water and leave to dry in a warm place. Avoid overheating. Then carefully place the tip in its original place at the top of the brown bottle. Put on the protective cap. If the tip hole is clogged, the tip should be removed as described above and left in warm water for a while. Then rinse under running cold water, dry and put back on the bottle. Do not clean the tip hole with a pin or other sharp objects.
Flixonase™ drug overdose, symptoms and treatment
Symptoms of acute or chronic overdose are not described. Intranasal administration of fluticasone propionate to healthy volunteers at a dose of 2 mg 2 times a day for 7 days did not affect the function of the hypothalamic-pituitary-adrenal system. Long-term use of large doses may lead to temporary suppression of adrenal function. In such patients, treatment with fluticasone propionate should be continued at doses sufficient to control symptoms. Adrenal function will recover in a few days, which can be checked by determining the level of cortisol in the blood plasma.
Pharmacological properties of the drug Flixonase™
Pharmacodynamics. Fluticasone propionate has a pronounced anti-inflammatory, anti-edema and anti-allergic effect. The anti-inflammatory effect is a consequence of the interaction of the drug with glucocorticoid receptors. Reduces the production of inflammatory mediators, prostaglandins, cytokinins and other biologically active substances during the early and late phases of the allergic reaction. Has a rapid anti-inflammatory effect on the nasal mucosa. The antiallergic effect is observed 2–4 hours after the first use. Reduces sneezing, rhinorrhea, nasal congestion, itching and discomfort in the nasal cavity, relieves eye symptoms associated with rhinitis. The reduction in symptoms persists for 24 hours after using the drug at a dose of 200 mcg. Improves the quality of life of patients. When used in recommended doses, it has no systemic effect and does not inhibit the hypothalamic-pituitary-adrenal system. Pharmacokinetics. With intranasal administration of fluticasone propionate at a dose of 200 mcg/day, the maximum concentration in the blood plasma is not detected in most cases (concentration ≤0.01 ng/ml). The degree of direct absorption of the drug in the nasal mucosa, as well as the total systemic absorption, even taking into account the absorption of the ingested drug, are insignificant. Fluticasone propionate has a large volume of distribution - about 318 l. Blood protein binding is moderately high - 91%. Fluticasone propionate is rapidly eliminated from the systemic circulation, primarily by hepatic metabolism as an inactive carboxyl metabolite via cytochrome CYP 3A4. The main route of drug elimination is excretion through the intestines, mainly unchanged. The renal clearance of fluticasone propionate is negligible (≤0.2%).
Special instructions for the use of Flixonase™
Infectious and inflammatory processes in the nasal cavity require appropriate treatment, but are not considered specific contraindications for prescribing Flixonase. If it is necessary to transfer patients from systemic therapy with GCS to the use of Flixonase, caution should be exercised, since there is reason to assume suppression of the function of the adrenal cortex. Long-term 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, he should consult a doctor. Continuous use of the drug for 6 months requires medical monitoring of the patient's condition. Although in most cases with seasonal allergic rhinitis, the administration of Flixonase nasal spray is sufficient, in severe cases of the disease (high concentrations of allergens in the summer), additional therapy may be necessary. Children. The use of the drug in children under 4 years of age is not recommended due to the lack of experience in using the drug in this age group. During pregnancy and breastfeeding. When prescribing the drug during pregnancy or breastfeeding, the ratio of the expected benefit to the mother and the potential risk to the child should be assessed. It is unlikely to affect the ability to drive vehicles or operate other machinery.
Interactions of the drug Flixonase™
Given the very low plasma concentrations of fluticasone propionate after intranasal administration due to extensive first-pass metabolism in the liver and high systemic clearance of the drug due to cytochrome P450 3A4 in the liver and intestine, a clinically significant interaction is unlikely. With simultaneous use of Flixonase with ritanavir (a strong inhibitor of cytochrome P450 3A4) it can significantly increase the concentration of fluticasone propionate in plasma, which leads to a significant decrease in the concentration of cortisol in the blood serum, side effects due to the systemic action of corticosteroids develop, including Cushing's syndrome and suppression of adrenal cortex function . Therefore, it is necessary to avoid the simultaneous use of fluticasone propionate and ritanavir, except in cases where the benefits of use will outweigh the risk of systemic effects of corticosteroids. Concomitant use of Flixonase with other cytochrome P450 3A4 inhibitors leads to a slight (erythromycin) or small (ketoconazole) effect on increasing the systemic concentration of fluticasone propionate in the blood serum without a significant decrease in cortisol concentration. However, with the simultaneous use of fluticasone propionate and strong inhibitors of cytochrome P450 3A4 (for example, ketoconazole), caution must be exercised, given the possibility of increased systemic exposure to fluticasone propionate.
Flixonase nasal spray 50 mcg 120 doses (Glaxo)
Flixonase is intended for intranasal use only. To achieve the full therapeutic effect, the drug should be used regularly. For the prevention and treatment of seasonal allergic rhinitis and year-round allergic rhinitis, adults and children over 12 years of age are prescribed 100 mcg (2 doses) in each nostril 1 time per day (total dose 200 mcg/day), preferably in the morning. After achieving control of symptoms, you can prescribe 50 mcg (1 dose) in each nostril 1 time / day (total dose 100 mcg / day). In some cases, it is necessary to use 100 mcg (2 doses) in each nostril 2 times / day (total dose 400 mcg / day) for a short time in order to achieve control of symptoms, after which the dose can be reduced. The maximum daily dose of the drug is 400 mcg (4 doses in each nostril). Elderly patients do not require dosage adjustment. For the prevention and treatment of seasonal allergic rhinitis, it is recommended that children aged 4-12 years be prescribed 50 mcg (1 dose) in each nostril 1 time/day. The maximum daily dose of the drug is 200 mcg (2 doses in each nostril). The maximum therapeutic effect appears after 3-4 days of therapy. To achieve the full therapeutic effect, it is necessary to use the drug regularly. Directions for use: Before use, carefully shake the bottle and take it by placing your index and middle fingers on either side of the tip, and your thumb under the bottom. When using the drug for the first time or a break in its use for more than 1 week, you should check the serviceability of the sprayer (pointing the tip away from you, make several presses until a small cloud appears from the tip). Next you need to: Repeat the procedure for a second spray in the same nostril, if necessary. Next, repeat the described procedure completely, inserting the tip into the other nostril. After use, blot the tip with a clean napkin or handkerchief and close it with the cap. The sprayer should be washed at least once a week. For this purpose, you must carefully remove the tip and rinse it in warm water. Shake off excess water and leave to dry in a warm place. Avoid overheating. Then carefully place the tip in its original place at the top of the brown bottle. Put on the protective cap. If the tip hole is clogged, the tip should be removed as described above and left in warm water for a while. Then rinse under running cold water, dry and put back on the bottle. Do not clean the tip hole with a pin or other sharp objects.
Side effects of Flixonase™
Immune system disorders Very rare: hypersensitivity reactions, anaphylaxis/anaphylactic reactions, bronchospasm, skin rashes, swelling of the face or tongue. From the nervous system : often: headache, unpleasant taste and smell. On the part of the organ of vision Very rarely: glaucoma, increased intraocular pressure, cataracts. From the respiratory system and chest organs Very often: nosebleeds. Common: dryness and irritation of the mucous membrane of the nasal cavity and throat. Very rare: perforation of the nasal septum.
