What are Nasonex drops from? General rules for using Nasonex

The drug is used intranasally.

Seasonal or year-round treatment allergic rhinitis

The recommended preventive and therapeutic dose of the drug is 2 inhalations (50 mcg each) into each nostril 1 time / day (total daily dose - 200 mcg). Upon reaching therapeutic effect for maintenance therapy, it is possible to reduce the dose to 1 inhalation in each nostril 1 time / day (total daily dose - 100 mcg).

If a reduction in the symptoms of the disease cannot be achieved by using the drug in the recommended therapeutic dose, the daily dose can be increased to 4 inhalations into each nostril 1 time / day (total daily dose - 400 mcg). After the symptoms of the disease decrease, a dose reduction is recommended.

The onset of action of the drug is usually observed clinically within 12 hours after the first use of the drug.

Children aged 2 to 11 years

For use of the drug in children younger age adult assistance required.

Adjuvant treatment of acute sinusitis or exacerbation of chronic sinusitis

Adults (including elderly patients) and adolescents from 12 years of age

If a reduction in the symptoms of the disease cannot be achieved by using the drug at the recommended therapeutic dose, the daily dose can be increased to 4 inhalations into each nostril 2 times a day (total daily dose - 800 mcg). After the symptoms of the disease decrease, a dose reduction is recommended.

Treatment of acute rhinosinusitis without signs of severe bacterial infection

Recommended dose for adults and teenagers is 2 inhalations of 50 mcg in each nasal passage 2 times a day (total daily dose 400 mcg). If symptoms worsen during treatment, consultation with a specialist is necessary.

Treatment of nasal polyposis

For adults (including elderly patients) over 18 years old The recommended therapeutic dose is 2 inhalations (50 mcg each) into each nostril 2 times a day (total daily dose - 400 mcg).

Rules for using the drug Nasonex

Inhalation of the suspension contained in the spray bottle is carried out using a special dispensing nozzle on the bottle.

Before using Nasonex nasal spray for the first time, it is necessary to calibrate it by pressing the dispensing device 6-7 times. After calibration, the stereotypical feed is established medicinal substance, in which with each press of the dosing device, approximately 100 mg of a suspension containing mometasone furoate (as monohydrate) in an amount equivalent to 50 μg of mometasone furoate anhydrous is released. If the nasal spray has not been used for 14 days or longer, recalibration is necessary before reuse.

Before each use, shake the bottle vigorously.

To quickly cure cough, bronchitis, pneumonia and strengthen the immune system, you just need...


Respiratory manifestations of allergies and rhinitis of various origins occur quite often, medication will help to cope with them local use Nasonex, instructions for use will help you become familiar with the drug.

International name (INN)– Mometasone.

Trade name of the drug- Nasonex.

Release form:

  1. Nasonex spray – 50 mcg/dose 120 doses in a bottle;
  2. Nasonex spray – 50 mcg/dose, 140 doses per bottle.

Composition of the drug

One dose of nasal spray contains:

  • Active ingredient – ​​50 mcg anhydrous mometasone;
  • Excipients: dispersed cellulose, glycerin, polysorbate-80, benzalkonium chloride solution, sodium citrate dihydrate, purified water, citric acid.

pharmachologic effect

The drug has an antiallergic effect and has anti-inflammatory activity.

Nasonex – hormonal or not?

Does it hormonal drug Nasonex? The active ingredient of the drug is a synthetic corticosteroid for inhalation (local) use; accordingly, Nasonex is a hormonal drug.

Indications for use

The drug Nasonex is used for the following pathologies:

  1. Allergic rhinitis (year-round or seasonal) in children, adolescents, adults;
  2. Prevention of seasonal allergic rhinitis;
  3. Exacerbation of chronic sinusitis (a vasoconstrictor drug is prescribed as part of complex therapy);
  4. Allergy medicine is used from 2 summer age. For the treatment of sinusitis, the drug is prescribed to children over 12 years of age.


Instructions for use Nasonex

The annotation states that Nasonex spray (drops) is presented in the pharmaceutical network in the form of a suspension. Before starting each procedure, the bottle must be shaken well to obtain a liquid of uniform consistency.

Inhalations of the nasopharynx are carried out using a spray nozzle by pressing the sprayer. With one press, the device releases about 100 mcg of the substance, 50 mcg of which active hormone mometasone furoate.

The nozzle of the device must be carefully looked after: rinse in running water, tightly close the protective cap of the bottle.

Do not clean the nozzle hole sharp objects, since changing the diameter of the hole can affect the dosage of the substance released.

For adults

Mode of application vasoconstrictor Nasonex for adults depends on the patient's condition. Its regimen and dosage is individual.

With exacerbation of chronic rhinitis

Along with taking antibacterial and anesthetic drugs, the nasal cavity is irrigated daily with Nasonex according to the following scheme: twice a day, 2 sprays onto the mucous membrane.

After the condition improves, the dose is gradually reduced. IN special cases It is allowed to exceed a single dose of the drug up to five times a day, with a reduction in dosage and a reduction in the number of doses.


For allergic rhinitis

For children over 12 years of age and adults, in order to eliminate symptoms, it is enough to use the medicine once a day for two irrigations.

A noticeable result when inhaling the spray appears after 12-14 hours, rarely later.

The maximum permissible dose of the drug is 400 mcg, a single dose is up to 200 mcg. With the disappearance of symptoms (runny nose, itching, sneezing), it is recommended to reduce the dose by half and continue to use the drug as maintenance therapy.

Nasonex for polyps

Nasonex drops for the spread of polyps are prescribed two procedures 2 times a day, reducing the dose to 2 procedures once a day.


Instructions for use for children

Nasonex for children is prescribed over the age of two years as maintenance and initial therapy: one inhalation daily. The total amount of medication per day should not exceed 100 mcg.

The drug does not have a very quick effect; the first signs of improvement are noticeable 12-14 hours after the first inhalation.

If you do not exceed the permissible daily dose of the drug, Nasonex does not adversely affect the development and growth rate of children. However, included in medicine hormone, involves monitoring the use of the drug.

Nasonex for infants

There is no information about the safety of the drug Nasonex, so the medicine is not prescribed to children under 2 years of age.

Medication regimen for children and adolescents:

  • For allergies, use is allowed from 2 years of age;
  • At acute sinusitis– indicated from 12 years of age;
  • For polyps - prescribed from the age of 18.

During pregnancy and lactation

The active substances of the drug penetrate into the bloodstream in minimum quantities and do not affect the woman’s body.

The decision about the possibility of taking the drug Nasonex can only be made by a specialist on an individual basis, taking into account the benefits for the mother’s body and harm to the unborn child.

For a baby whose mother used Nasonex during pregnancy, regular monitoring is recommended. hormonal levels, in particular the function of the adrenal glands (to avoid the development of hypofunction).

The extent of penetration of mometasone furoate during lactation is not known. The instructions indicate that when breastfeeding It is not recommended to take Nasonex. If this becomes necessary, you should seek advice from a specialist.


Contraindications

Contraindications to the use of Nasonex spray are:

  • Intolerance to one of the components included in the composition;
  • Presence of undertreated/untreated local infection provided that the nasal mucosa is involved in the process;
  • Untreated systemic viral, bacterial or mycotic infection, also infection caused by the herpes simplex virus;
  • Respiratory tract infection in active or latent form;
  • Recent nasal trauma or nasal surgery.

Side effects

The drug has some side effects, so you should consult a specialist before using it.

In adults, when treating allergic rhinitis, the following symptoms are possible:

  1. Nosebleeds;
  2. Irritation of the nasal mucosa;
  3. Burning in the nose;
  4. Pharyngitis.

In children during the treatment of allergic rhinitis the following were noted:

  • Irritation of the nasal mucosa;
  • Cough;
  • Sneezing;
  • Headache;
  • Nosebleeds.

Nosebleeds most often occur in mild form and stop on their own.

Nasonex analogues were used for active control; when used, the incidence of bleeding was no more than 15%.

When prescribing the drug for sinusitis/sinusitis, when the nasal drug was used as an auxiliary drug, adolescents and adults experienced side effects.

Such as:

  • Pharyngitis;
  • Burning and/or irritation of the nasal mucosa;
  • Headache.

Bleeding was moderately severe; extremely rarely, when using synthetic corticosteroids, cases of perforation of the nasal septum or the development of ocular hypertension were observed.

Video

Overdose

An overdose of mometasone may develop in the case of prolonged use of the drug in high doses or in the case of simultaneous administration several GCS at once.

The systemic bioavailability of mometasone is very low, so in case of accidental/intentional overdose of the drug, only patient monitoring will be required.

Interaction

Patients tolerate therapy with Loratadine well. The interaction of Nasonex with other drugs has not been studied.

What can replace Nasonex?

Effective analogues of the drug Nasonex with identical active ingredients:

  1. Reasonel,
  2. Dezrinit,
  3. Asmanex Twisthaler.

Analogues of the drug Nasonex with a similar mechanism of action (in the form of a spray):

  • Avamis,
  • Flutinex,
  • Nazonet,
  • Flixonase,
  • Lazolex,
  • Beklonasal,
  • Beclomethasone,
  • Paronex,
  • Fluticasone,
  • Nazarel,
  • Tafen,
  • Nazotec,
  • Rinoklenil,
  • Nasobek,
  • Budoster.

Price

Nazanex – this is a nasal spray, its price varies and depends on the region of sale, pharmacy chain and dosage.

Average cost of the drug – O t 390 to 970 rubles .

Best before date

The shelf life of the drug is 3 years.

The drug relieves itching in the nose, relieves congestion and a profuse runny nose, and makes it possible to breathe freely. This is how Nasonex spray is described by people suffering from hay fever, allergic rhinitis and sinusitis. Many will be interested to know that there are analogues cheaper than this Belgian remedy.

The spray for intranasal administration is produced in a plastic bottle with a micropump. The device is built into the nozzle and equipped with a valve that facilitates dosing of the product. Nasonex is produced in Belgium. Generics under other trade names are produced in India.

Nasonex contains only one active substance(DV) - mometasone furoate in the form of monohydrate. This prodrug breaks down in the body to release the glucocorticosteroid mometasone. The abbreviation GKS is often used to abbreviate the name of the entire group of drugs.

The practically insoluble prodrug forms a suspension with purified water and alcohols. The concentration of DV in 1 dose is the same, 50 mcg. They produce bottles with 120 and 60 doses.

Pharmacological properties

Mometasone has a local, fairly strong anti-inflammatory and anti-allergic effect on the nasal mucosa. The therapeutic effects of the drug are due to the binding of DV to glucocorticoid receptors. As a result, swelling decreases and inflammation of the nasal mucosa goes away.

"Nasonex" relieves symptoms that occur with allergies, sinusitis, hay fever (allergic rhinitis with conjunctivitis). Itching in the nasopharynx, sneezing, profuse runny nose. Improvement is noted within 3–4 hours.

The instructions for use indicate that the maximum therapeutic effect usually develops 12 to 48 hours after using the spray.

For what diseases is Nasonex indicated:

  • acute or chronic allergic rhinitis in children with preschool age and adults;
  • acute rhinosinusitis and sinusitis in patients over 12 years of age;
  • nasal polyposis in adults over 18 years of age.

The functions of the nasal mucosa are significantly impaired by inflammation. Nasonex eliminates swelling, reduces congestion, improves breathing through the nose and sense of smell. The drug helps relieve symptoms bronchial asthma, often accompanying allergic rhinosinusitis.

When applied topically, atrophy of the nasal mucosa does not occur. IN clinical practice There were no cases of development of drug resistance to DV if the drug was used for less than 12 months.

Instructions for use and dosage regimen of Nasonex spray

First, “calibration” is carried out for the same intake of DV with each “spray”. Shake the bottle vigorously and remove the dust cap. Thumb Place at the bottom of the bottle, with your index and middle fingers press 7–10 times on the plane of the nozzle next to the hole. This adjustment should be repeated every two weeks.

One injection is one dose of mometasone furoate.

For daily use, just shake the bottle, remove the cap, point the hole into one nasal passage and press. The suspension is ejected from the hole. Press the nostril with the finger of the other hand to the nasal septum and inject the medicine into the other nasal passage. The bottle is kept vertical at all times.

For children

Treatment of children with Nasonex is permitted from the age of two. The drug is prescribed to children from 2 to 11 years old. Indications for use in pediatrics: allergic rhinitis, exacerbations of sinusitis, adenoids (as part of complex therapy).

"Nasonex" for children is produced with an active ingredient content of 50 mcg. Children do not know how to do inhalations themselves; adults help them. The student can spray the spray into his nose on his own. For children under 12 years of age, one inhalation per day is sufficient.

It is necessary to gradually reduce the dose and shorten the course of treatment. GCS, when used systemically and locally, can slow down the growth of children. You cannot independently increase the number of uses of Nasonex or exceed the recommended dosages.

For adults

It is recommended to begin treatment of seasonal allergic diseases of the respiratory tract in advance. Nasonex is used 2–4 weeks before the allergenic plant begins to bloom and throughout the entire dusting period.

How to use the spray:

  1. Inject 2 times into each nasal passage once a day.
  2. If the symptoms persist, then you can spray the spray into each nostril 4 times once.
  3. After the manifestations of the disease subside, reduce the daily dose to 1 injection in each nasal passage.

Inhalations should be performed at the same time.
The effect of GCS appears on the first day. However, the maximum effect may be delayed for several days. In some cases, patients notice improvements in their condition only after a couple of weeks.

Nasonex is suitable for long-term use, unlike antihistamines.

Sinusitis is treated by spraying the spray 2 times into each nostril. In case of exacerbation of the disease, it is enough to use Nasonex once a day. If the effect is weak, then increase the dose to 4 inhalations in each nasal passage. Apply the product morning and evening. "Nasonex" is indicated for uncomplicated acute rhinosinusitis for symptomatic treatment. GCS should not be used if the disease is complicated by a bacterial infection.

The spray is used to treat nasal polyposis in persons over 18 years of age. The daily dose is 2 injections into each nostril in the morning and evening. After symptoms improve, inhalation is carried out only once a day. Every 14 days, clean the sprayer and protective cap from dust.

Use during pregnancy and lactation

Glucocorticoids are not usually used to treat pregnant or breastfeeding women. A doctor may prescribe Nasonex to a patient during pregnancy, carefully weighing the pros and cons. The expected benefit must outweigh possible risk for the body of the fetus or child.

Interaction with other drugs

It is known for sure that hormonal nasal spray with mometasone mutually enhances the effect antihistamine Loratadine. Combination with other drugs has not been studied. The effect may be enhanced with simultaneous therapy with other corticosteroids. Mometasone furoate is metabolized in the liver. Ketoconazole may increase the plasma concentration of this corticosteroid.

Contraindications, side effects and overdose

Nasonex nasal spray is not used:

  • if you are allergic to DV;
  • in case of hypersensitivity to excipients in the composition of the drug;
  • fungal, bacterial and viral infections are also contraindications;

Nasonex is not recommended for use for pulmonary tuberculosis, wounds and ulcers of the nasal cavity until they have healed.
The nasal spray is better tolerated compared to systemic corticosteroids and causes much less side effects. However, nosebleeds, sneezing, irritation, burning, inflammation of the nasopharynx, headache.

Most significant side effect"Nasonex" - mucosal atrophy after 12 months of continuous treatment.

An overdose is dangerous because the systemic effect of the nasal agent is enhanced, including Negative influence GCS on children's growth. In some cases there is an increase intraocular pressure, blurred vision.

Nasal spray analogues

Local treatment of GCS helps to get rid of the symptoms of allergic rhinitis and nasal polyposis. If the causes of the disease and the effect of the irritant persist, then exacerbations will follow in the future.

Complete analogues of Nasonex:

  • "Momat Reno";
  • "Nosephrine";
  • "Desrinit";
  • Mometasone Sandoz.

Beclomethasone in spray form also helps with allergic rhinitis. Trade names drugs: “Nasobek”, “Beclazon”. Spray and aerosol are prescribed for vasomotor rhinitis and asthma.

An analogue of Nasonex in terms of the mechanism of action is Tafen nasal spray. The drug contains the corticosteroid budesonide. It's safe and effective remedy when applied topically.

The differences in cost are significant:

  • “Nasobek” - 180 rubles;
  • “Tafen nasal” - 370 rubles;
  • “Desrinit” and “Momat Rino” - 400 rubles;
  • "Nasonex" - 800 rubles and more.

Allergic rhinitis with or without conjunctivitis is a common condition. Researchers note that in the development respiratory allergies important genetic predisposition and various external conditions. In industrial developed countries cases of hay fever are becoming more frequent. The cause of this disease is pollen; in every second case, the source of trouble is ragwort.

According to the results of another international study, nasal sprays with corticosteroids are the mainstay of treatment for respiratory allergies. ENT doctors and allergists prescribe such drugs to patients in almost 87% of cases.

Allergens should not be blamed for all troubles; for other people these are completely harmless substances. The problem is that the body develops increased sensitivity to the most common compounds or factors. For severe respiratory allergies and hay fever, you may need complex treatment(local and systemic).

Nasonex has advantages over corticosteroids taken orally and nasal allergy sprays with antihistamines. Local preparation causes fewer side effects. Nasal drops and sprays with an antihistamine composition are less effective and quickly become addictive. It is recommended to start using Nasonex or an analogue in advance for seasonal allergic rhinitis and hay fever. Then the irritants will not catch you immune system taken by surprise.

Pharmacodynamics. Mometasone furoate is a synthetic corticosteroid for local application 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 demonstrated high potential in cell culture (according to at least 10 times higher activity than other steroids, including beclomethasone dipropionate, betamethasone, hydrocortisone and dexamethasone) inhibition of the synthesis/release of interleukins (IL-1, IL-6) and tumor necrosis factor (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 aqueous nasal spray Nasonex was established in both early and late stages 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 efficiency regarding reduction of symptoms of rhinosinusitis compared with placebo. During 15 days of treatment, symptoms of rhinosinusitis were assessed according to the severity of symptoms (MSS - Major Symptom Score) (pain in the face, sensation of pressure and pain when pressing in the area and projection of the paranasal sinuses, rhinorrhea, discharge of mucus in back wall pharynx 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. In this regard, the relevant pharmacokinetic data for this dosage form No. 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.

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).

Use of the drug Nasonex

Before using Nasonex nasal spray for the first time, it is necessary to calibrate it by 6-7 presses of the dosing device. After calibration, a stereotypical delivery of the drug is established, in which approximately 50 mcg of chemically pure mometasone furoate (1 dose) is sprayed with each press. If the nasal spray has not been used for 14 days or longer, recalibration is necessary. Before each use, shake the bottle vigorously.
If the nozzle is clogged, you need to remove the plastic cap by carefully pressing the white ring, easily remove the nozzle and rinse it with cold running water, dry and install in its original place.
For seasonal or year-round allergic rhinitis for adult patients (including the elderly) and adolescents aged ≥12 years, the recommended prophylactic and therapeutic dose of the drug is 2 injections (50 mcg each) into each nasal passage once a day (total daily dose - 200 mcg). After achieving a therapeutic effect for maintenance therapy, it is advisable to reduce the dose to 1 injection into each nasal passage 1 time per day (total daily dose - 100 mcg). If the use of the drug at the recommended therapeutic dose is not effective enough, the daily dose can be increased to 4 injections into each nasal passage once a day (total daily dose - 400 mcg). After reducing the severity of the symptoms of the disease, a dose reduction is recommended. The onset of action of the drug is observed within 12 hours after the first use.
For children aged 2-11 years, the recommended therapeutic dose is 1 injection (50 mcg) into each nasal passage once a day (total daily dose - 100 mcg).
As an adjuvant therapy for acute episodes of sinusitis in adults (including the elderly) and children 12 years of age, the recommended therapeutic dose is prescribed - 2 injections (50 mcg) into each nasal passage 2 times a day (total daily dose - 400 mcg). If it is not possible to reduce the severity of symptoms of the disease using the drug at the recommended therapeutic dose, the daily dose of the drug can be increased to 4 injections into each nasal passage 2 times a day (total daily dose - 800 mcg). After reducing the severity of the symptoms of the disease, a dose reduction is recommended.
Acute rhinosinusitis. For adults and children aged 12 years, the recommended therapeutic dose is 2 injections (50 mcg) into each nasal passage 2 times a day (total daily dose - 400 mcg).
For nasal polyps in patients aged 18 years (including elderly people), the recommended dose is 2 injections of 50 mcg into each nasal passage 2 times a day (total daily dose - 400 mcg). After reaching clinical effect It is recommended to reduce the dose to 2 injections into each nasal passage 1 time per day (total daily dose - 200 mcg).

Contraindications to the use of Nasonex

Hypersensitivity to the active substance or any component of the drug.

Side effects of the drug Nasonex

In clinical studies of the drug for seasonal and year-round allergic rhinitis, the following side effects associated with the use of Nasonex were noted: headache (in 8% of cases), nosebleeds, as well as bloody mucous discharge or clots from the nasal cavity (in 8% of cases), pharyngitis (4%), burning sensation in the nose (2%), irritation (2%) and ulcerative changes (1%) of the nasal mucosa. The occurrence of such side effects is typical when using any nasal spray containing corticosteroids. Nosebleeds or bloody issues from the nose were not abundant and stopped on their own, occurring with a slightly higher frequency than when using placebo (5%), but less than when prescribing other GCS for intranasal use (for some of them, the incidence of nosebleeds was up to 15%). The incidence of all other side effects was comparable to that observed with placebo.
In children, the incidence of side effects, including nosebleeds (6%), headache (3%), nasal irritation (2%) and sneezing (2%), was comparable to the incidence of placebo.
Allergic reactions may rarely occur following intranasal administration of mometasone furoate. immediate type. Very rarely noted anaphylactic reactions and angioedema.
Reported isolated cases disturbances of taste and smell.
When using Nasonex nasal spray as aid in the treatment of exacerbations of sinusitis, the following side effects were noted, the incidence of which was comparable to that with placebo: headache (2%), pharyngitis (1%), burning sensation in the nose (1%) and irritation of the nasal mucosa (1% ). Nosebleeds were moderate and the incidence of nosebleeds with Nasonex spray was also comparable to the incidence of nosebleeds with placebo (5 and 4%, respectively).
In patients with nasal polyps, acute rhinosinusitis, when using Nasonex spray, the total number of the above side effects was comparable to that with placebo and similar to the amount observed in patients with allergic rhinitis.
Very rarely, with intranasal use of GCS, cases of perforation of the nasal septum or increased intraocular pressure were noted.

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 studying biopsy samples of the nasal mucosa. However, patients who use Nasonex for several months or longer should undergo periodic examination to detect possible changes mucous membrane of the nasal cavity. 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.
At long-term treatment Nasonex showed no signs of suppression of the hypothalamic-pituitary-adrenal system. 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 GCS treatment systemic action before treatment with Nasonex, some patients may experience symptoms of GCS withdrawal (arthralgia, myalgia, increased fatigue and depression). Changing therapy may also reveal allergic diseases, which were previously masked by the use systemic therapy GKS ( allergic conjunctivitis, eczema, etc.)
Patients receiving corticosteroid therapy have a potentially reduced immunological reactivity and should be warned about increased risk infection in case of contact with sick people infectious diseases(For example chicken pox, measles), as well as the need to consult a doctor if such contact occurs.
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 pain, or toothache, orbital or periorbital swelling/edema, or worsening after initial improvement.
Children. When conducting placebo-controlled clinical trials in children in whom Nasonex was used at a daily dose of 100 mcg for 1 year, growth retardation was not 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 The drug was not used during pregnancy. 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 is relatively reproductive function- 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.

Drug interactions Nasonex

Nasonex was used simultaneously with loratadine, and no effect was observed on the plasma concentrations of loratadine or its main metabolite, and mometasone furoate was not detected in plasma even at minimal concentrations. The patients tolerated combination therapy with these drugs well.
No data are provided regarding interactions with other drugs.

Nasonex drug overdose, symptoms and treatment

Unlikely due to low (≤0.1%) systemic bioavailability of the drug. In case of overdose, it is necessary to monitor the patient and then use the drug in the recommended dose.

Storage conditions for the drug Nasonex

At a temperature not higher than 25 °C. Do not freeze.

List of pharmacies where you can buy Nasonex:

  • Saint Petersburg

GCS for local use.
Drug: NASONEX®
Active substance of the drug: mometasone
ATX coding: R01AD09
KFG: GCS for intranasal use
Registration number: P No. 014744/01-2003
Registration date: 02/11/03
Owner reg. cert.: SCHERING-PLOUGH LABO N.V. (Belgium)

Nasonex release form, drug packaging and composition.

Nasal spray in the form of a white or almost white suspension.

1 dose
mometasone furoate (as monohydrate)
50 mcg

Excipients: dispersed cellulose BP 65 cps, glycerol, sodium citrate dihydrate, citric acid monohydrate, polysorbate 80, benzalkonium chloride, phenylethyl alcohol, purified water.

120 doses (18 g) - plastic bottles (1) complete with a sprayer and protective cap - cardboard packs.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action of Nasonex

GCS for local use. Has anti-inflammatory and anti-allergic effects. The local anti-inflammatory effect of the drug is manifested when it is used in doses at which systemic effects do not occur.

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 arachidonic acid metabolic products - cyclic endoperoxides, prostaglandins. Prevents the marginal accumulation of neutrophils, which reduces inflammatory exudate and the production of lymphokines, inhibits the migration of macrophages, and leads to a decrease in the processes of infiltration and granulation. Reduces inflammation by reducing the formation of a chemotaxis substance (impact on late allergy reactions), inhibits the development of an immediate allergic reaction (by inhibiting the formation of arachidonic acid metabolites and reducing the release of inflammatory mediators from mast cells).

In studies with provocative tests with the application of antigens to the nasal mucosa, high anti-inflammatory activity of the drug was demonstrated, both in early and late late stages allergic reaction. When compared with placebo, a decrease in the level of histamine and eosinophil activity was found, as well as a decrease (compared to the baseline) in the number of eosinophils, neutrophils and epithelial cell adhesion proteins.

Pharmacokinetics of the drug.

When administered intranasally, the systemic bioavailability of the drug is less than 0.1%. At the same time, mometasone furoate is practically not detected in blood plasma, even when using highly sensitive detection methods (with a sensitivity threshold of 50 pg/ml). A small amount of active substance, which can enter the gastrointestinal tract when administered intranasally, is absorbed to a small extent and is actively biotransformed during the “first pass” through the liver.

Indications for use:

Treatment of seasonal and year-round allergic rhinitis in adults, adolescents and children over 2 years of age;

Exacerbation of chronic sinusitis in adults (incl. old age) and children over 12 years of age (as an adjuvant as part of complex antibacterial therapy);

Prevention of moderate and severe seasonal allergic rhinitis severe course(recommended 2-4 weeks before the start of the dusting season).

Dosage and method of administration of the drug.

For the treatment of seasonal and year-round rhinitis, adults (including elderly people) and children over 12 years of age are prescribed 2 injections into each nostril 1 time per day (total daily dose - 200 mcg). After achieving the desired clinical effect, the dose of the drug for maintenance therapy is 100 mcg (1 injection into each nostril 1 time/day). If necessary, the dose of the drug can be increased to 4 injections into each nostril (total daily dose - 400 mcg). Children aged 2-11 years are prescribed 50 mcg (1 injection) into each nostril 1 time / day (total daily dose - 100 mcg).

Positive dynamics clinical symptoms observed, as a rule, within the first 12 hours after the first use of the drug.

For the treatment of exacerbations of chronic sinusitis as part of complex therapy with antibiotics, adults (including elderly people) and children over 12 years of age are prescribed 100 mcg (2 injections) into each nostril 2 times a day. The total daily dose is 400 mcg. If necessary, an increase is possible daily dose up to 800 mcg (4 injections into each nostril 2 times a day). After the symptoms of the disease decrease, a dose reduction is recommended.

Stereotypical presentation medicinal product(in which with each press of the button 100 mg of suspension is released, which corresponds to 50 mcg of pure mometasone furoate) is established after approximately 6-7 “calibration” presses. If the drug has not been used for 14 days or longer, then recalibration is necessary before use.

The bottle must be shaken vigorously before use.

Side effects of Nasonex:

Side effects observed in the treatment of seasonal and year-round allergic rhinitis: in adults - nosebleeds (i.e. obvious bleeding, as well as discharge of blood-stained mucus or blood clots), pharyngitis, burning sensation in the nose; irritation of the nasal mucosa. Nosebleeds, as a rule, stopped on their own and were not severe; they occurred with a frequency slightly higher than with placebo (5%), but equal to or less than with the administration of other intranasal corticosteroids studied, which were used as active controls (in some of them the frequency of nosebleeds was up to 15%) . The incidence of other side effects was comparable to that observed with placebo). In children - nosebleeds, headache, irritation in the nose, sneezing (the incidence is comparable to the incidence of side effects in children when using placebo).

Side effects observed when using Nasonex as an adjuvant for chronic sinusitis in adults and adolescents: headache, pharyngitis, burning sensation in the nose, irritation of the nasal mucosa. Nosebleeds were moderate, and the incidence of nosebleeds with Nasonex was comparable to the incidence of nosebleeds with placebo (5% and 4%, respectively).

Very rarely, with intranasal use of GCS, cases of perforation of the nasal septum or increased intraocular pressure have been reported.

Contraindications to the drug:

Children under 2 years of age;

Untreated infection involving the nasal mucosa;

Recently rescheduled surgery or nasal injury (before the wound heals);

Respiratory tuberculosis (including latent), untreated fungal, bacterial, systemic viral infection(including those caused by the Herpes simplex virus with eye damage);

Hypersensitivity to the drug.

Use during pregnancy and lactation.

There have been no special, well-controlled studies of the safety of Nasonex during pregnancy and lactation. 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, fetal exposure to the drug can be expected to be negligible and the potential for reproductive toxicity to be very low.

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

Special instructions for the use of Nasonex.

After using Nasonex for 12 months, there were no signs of atrophy of the nasal mucosa. A study of biopsy samples of the nasal mucosa revealed that mometasone furoate tended to normalize the histological picture.

When using the drug long time(as with any long-term treatment), periodic examination of the nasal mucosa by an ENT doctor is necessary. If a local bacterial or fungal infection of the nose or pharynx develops, it is recommended to stop treatment with the drug and begin specific therapy. Irritation of the mucous membrane of the nasal cavity and pharynx that persists for a long time is an indication for discontinuation of the drug.

At long-term use The drug showed no signs of suppression of the function of the hypothalamic-pituitary-adrenal system.

Patients who switch to treatment with Nasonex nasal spray after long-term therapy GCS of systemic action require special attention. Discontinuation of systemic GCS in such patients may lead to adrenal insufficiency, which may require appropriate measures.

During the transition from treatment with systemic corticosteroids to treatment with Nasonex nasal spray, some patients may experience withdrawal symptoms from the use of corticosteroids for systemic use(for example, joint and/or muscle pain, fatigue, depression), despite a decrease in the severity of symptoms associated with damage to the nasal mucosa; such patients must be specifically convinced of the advisability of continuing treatment with Nasonex nasal spray. Changing therapy may also reveal previously developed allergic diseases, such as allergic conjunctivitis and eczema, that were previously masked by systemic glucocorticoid therapy.

Patients who have undergone GCS therapy have a reduced immune reactivity and should be warned about the increased risk of infection when in contact with patients with infectious diseases (including chickenpox, measles).

Use in pediatrics

When conducting placebo-controlled clinical trials in children, when Nasonex was used at a dose of 100 mcg/day for a year, no growth retardation was observed.

There are no data on the use of the drug in children under 2 years of age, so Nasonex cannot be recommended for use in this age group.

Drug overdose:

The drug has low (0.1%) systemic bioavailability, so it is unlikely that in case of overdose, any special measures will be required other than observation and subsequent administration at the recommended dose.

With long-term use of GCS in high doses or with the simultaneous use of several GCS, suppression of the hypothalamic-pituitary-adrenal system is possible.

Interaction of Nasonex with other drugs.

The simultaneous use of Nasonex with loratadine did not lead to a change in the concentration of loratadine or its main metabolite in the blood plasma, and the presence of mometasone furoate in the plasma was not detected even at minimal concentrations.

Research drug interactions Nasonex has not been tested with other drugs.

Terms of sale in pharmacies.

The drug is available with a prescription.

Terms of storage conditions for the drug Nasonex.

The drug should be stored out of the reach of children at a temperature of 2° to 25°C. Shelf life: 3 years. Do not use after the expiration date stated on the package.