New possibilities of fluticasone furoate (Avamys) in the treatment of allergic rhinitis

Avamis

The drug is used intranasally.

To achieve maximum therapeutic effect, it is necessary to adhere to a regular regimen of use. The onset of action can be observed within 8 hours after the first administration. It may take several days to achieve maximum effect. The reason for the lack of immediate effect should be carefully explained to the patient.

For the symptomatic treatment of seasonal and year-round allergic rhinitis in adults and adolescents aged 12 years and older, the recommended initial dose is 55 mcg (2 sprays) in each nostril 1 time / day (110 mcg / day).

Once adequate symptom control is achieved, dose reduction to 27.5 mcg (1 spray) in each nostril once a day (55 mcg/day) may be effective for maintenance treatment.

For children aged 2 to 11 years, the recommended initial dose is 27.5 mcg (1 spray) in each nostril 1 time / day (55 mcg / day).

If there is no desired effect at a dose of 27.5 mcg (1 spray) in each nostril 1 time/day, the dose can be increased to 55 mcg (2 sprays) in each nostril 1 time/day (110 mcg/day). When adequate control of symptoms is achieved, it is recommended to reduce the dose to 27.5 mcg (1 spray) in each nostril 1 time / day (55 mcg / day).

There is insufficient data to recommend the use of intranasal fluticasone furoate for the treatment of seasonal and perennial allergic rhinitis in children under 2 years of age.

Elderly patients do not require dose adjustment.

In patients with impaired renal function, no dose adjustment is required.

In patients with mild to moderate liver dysfunction, no dose adjustment is required. There are no data on use in patients with severe liver dysfunction.

Rules for use and handling of the drug

The indicator window in the plastic package allows you to control the level of the drug in the bottle. In 30- or 60-dose vials, the drug level will be visible immediately, and in 120-dose vials, the initial drug level is above the upper limit of the viewing window. The nasal spray is available in orange glass bottles, which are in plastic cases. To check the level of the drug in the bottle, you need to hold it up to the light. The level will be visible through the viewing window.

Preparation for use should be carried out when using the spray for the first time, as well as if the bottle was left open. Proper preparation for use will ensure that the required dose of the drug is injected.

1. Without removing the cap, shake the bottle well for 10 seconds. The drug is a rather thick suspension and becomes more liquid when shaken. Spraying is only possible after shaking.

2. Remove the cap by gently pulling it with your thumb and forefinger.

3. Hold the bottle vertically and point the tip away from you.

4. Press the button firmly and make several presses (minimum 6) until a small cloud appears from the tip (if you cannot press the button with one thumb, you should press it with the thumbs of both hands).

5. The spray is ready for use.

Using a nasal spray

1. Shake the bottle thoroughly.

2. Remove the cap.

3. Clear your nose and tilt your head slightly forward.

4. Insert the tip into one nostril, continuing to hold the bottle vertically.

5. Point the tip of the sprayer at the outer wall of the nose, not at the nasal septum. This will ensure proper injection of the drug.

6. Start inhaling through your nose and press once with your fingers to spray the drug.

7. Remove the atomizer from your nostril and exhale through your mouth.

8. If it is necessary to make two injections into each nostril (as prescribed by a doctor), you should repeat steps 4-6.

9. Repeat the procedure for the other nostril.

10. Close the bottle with a cap.

11. Avoid getting the spray in your eyes. If the drug gets into your eyes, rinse them thoroughly with water.

Sprayer care

After each use:

1. Blot the tip and the inner surface of the cap with a dry, clean cloth. Avoid contact with water.

2. Do not try to clean the tip hole with a pin or other sharp objects.

3. Always cap the bottle and keep it closed. The cap protects the sprayer from dust and clogging, seals the bottle, and prevents accidental pressing of the button.

If the sprayer does not work:

1. Check the level of the remaining drug in the bottle through the viewing window. If there is only a small amount of liquid left, it may not be enough to operate the sprayer.

2. Check the bottle for damage.

3. Check if the tip hole is clogged. Do not attempt to clean the tip hole with a pin or other sharp object.

4. Try to activate the device by repeating the procedure for preparing the nasal spray for use.

Overdose

Symptoms: In a bioavailability study, doses 24 times higher than the recommended adult dose were used intranasally for more than 3 days, and no adverse systemic reactions were observed.

Treatment: Acute overdose is unlikely to require treatment other than medical supervision.

Compound

Active ingredient: Fluticasone furoate, 27.5 mcg (0.0275 mg) per dose. Belongs to the class of new generation corticosteroids for topical use.

Excipients: dextrose - 2750 mcg, dispersible cellulose - 825 mcg, polysorbate 80 - 13.75 mcg, benzalkonium chloride solution - 16.5 mcg, disodium edetate - 8.12 mcg, purified water - up to 50 mcg.

Avamys antibiotic or not? No, this drug is not an antibacterial agent, although it has pronounced anti-inflammatory activity. This effect is achieved due to the combination of properties inherent in all steroid hormones.

Storage conditions and shelf life

The drug is valid for 3 years from the production date indicated on the packaging. Keep the spray out of the reach of children at a temperature not exceeding 25-30 C. Avoid freezing.

Can Avamis be used if the expiration date has expired? No, it must be disposed of. Storage conditions after opening remain the same. Actions for mandatory care of the bottle and sprayer are added.

How long can Avamys be kept open? The shelf life after opening does not decrease from the total. There is no urgent need to keep the medicine in the refrigerator.

Interaction with other drugs

Available theoretical data exclude the possibility of Avamis interacting with other drugs that are broken down similarly to fluticasone furoate. The drugs are based on rapid elimination after metabolization by the liver of the ingested part as a result of intranasal use. Thus, no real studies have been conducted examining the interaction of Avamys and other drugs.

Intranasal glucocorticoids can be combined with non-hormonal nasal drops, both in the treatment of allergic rhinitis and in the complex treatment of ENT infections. For example, sea water Quix and Avamis are used alternately. First, the nose is toileted, the nostrils are washed, and then the main product is sprayed.

Avamis and Suprastin are prescribed together as mandatory medications in the treatment of acute manifestations of allergies or adenoiditis. For children, it is better to use antihistamines not in tablets, but in syrup or drops.

For severe nasal congestion, Avamis and Otrivin are used. To relieve edema, a vasoconstrictor is administered, then a glucocorticoid. But, having a cumulative effect, the hormone is able to completely eliminate dependence on regular drops.

Is it possible to have Avamis and IRS 19 together? Yes, it is allowed, if necessary, to relieve swelling with hormonal drugs and boost the immunity of the nasal mucosa with beneficial bacteria. It is optimal to use IRS 19 15-20 minutes after the fluticasone furoate spray.

Avamys and antibiotics are used in the complex treatment of paranasal sinus infections. The hormone will reduce inflammation, relieve swelling, and the antibacterial drug will destroy the cause of the disease. Moreover, for sinusitis and ethmoiditis, Avamis will only be effective with antibiotics.

There is no need to use local glucocorticoids on your own for every runny nose. Hormone therapy has pros and cons; its peculiarity is to suppress the immune system. In case of viral or bacterial infection, reduced natural defense will only increase the proliferation of the pathogen. Sometimes, if you take Avamis irrationally for a long time, you have to treat fungi in both the nose and mouth.

There is no data on the negative effects of Avamis and birth control pills on the body. The types of hormones contained in the composition act differently and do not reduce each other’s effectiveness.

special instructions

Children receiving 110 mcg of fluticasone furoate every day for a year were diagnosed with growth retardation. But the information does not describe the exact statistics of the development of the pathology, since there is no data on the final indicators. If long-term use of Avamis is necessary, it is important to regularly monitor the child’s health and whether the growth rate meets the norms.

Fluticasone furoate spray should be used with caution in patients with significant adrenal dysfunction. Combined treatment with ritonavir and Avamys is not recommended due to the high risk of increasing systemic concentrations of the hormone. Both warnings are based on studies of the effects of other glucocorticosteroids, but broken down similarly to fluticasone furoate.

Pharmacological properties

Fluticasone furoate is a synthetic glucocorticosteroid, code ATX (ATC) R01A D12. In combination with salmeterol, the drug belongs to the group of drugs included in the list of essential drugs. Developed for the symptomatic treatment of allergic and vasomotor rhinitis, relieving edema and other inflammatory diseases.

The principle of action of Avamis is based on the versatile effects of glucocorticoids on the human body. Fluticasone furoate is characterized by powerful anti-inflammatory and antiallergic activity. By inhibiting the synthesis of potent inflammatory mediators, the drug effectively relieves the symptoms of allergic rhinitis.

The mechanism of action of Avamis is distinguished by its clear affinity for GC receptors. The high pharmacodynamic activity of fluticasone furoate provides excellent therapeutic results in the lowest possible dose compared to other glucocorticoids.

Being a trifluorinated derivative, honey has low absorption when applied topically. Only 0.5% of the daily dose (from 2640 mcg) administered intranasally enters the systemic circulation. This low bioavailability rarely causes structural complications.

The low load of nasal spray on the body is due to its significant binding ability. Fluticasone furoate can bind to proteins contained in blood plasma by 99% or more. The volume of distribution of the drug is 608 l.

Avamys is metabolized primarily in the liver, through the formation of inactive metabolites of 17-carboxylic acid. Accordingly, excretion occurs through the intestines with feces. The half-life is 10-11 hours.

How long does it take for Avamys to start working? It takes several days to achieve results and relieve congestion. The appearance of the therapeutic effect depends on the chosen dose.

The drug acts most quickly 8 hours after the first use of the nasal aerosol, when using a concentration of 110 mcg. At a dosage of 55 mcg, improvement is observed after 24 hours.

Contraindications

In case of hypersensitivity or individual intolerance to fluticasone furoate or any other component of the composition indicated in the annotation to the instructions, Avamis should not be used. Do not prescribe hormonal sprays and drops for a runny nose in children under 2 years of age.

Among the general contraindications to the use of hormonal drugs are:

• herpes viruses, especially type 4, which causes mononucleosis;
• respiratory tuberculosis;
• recent therapy with Ritonavir (in patients with HIV infection);
• surgical interventions on the nasopharynx.

These conditions severely suppress the immune system. Corticosteroids have immunosuppressive properties, which are the key to treating true allergies. But increasing this load on the body has a negative impact on health.

Is it possible to have Avamis at a fever? There is no reliable data on the effect of the drug in hyperthermia. In order to reduce fever, hormonal intranasal sprays are not used.

Use during pregnancy and lactation

There is no exact data on the effect of fluticasone furoate on the body of pregnant and breastfeeding women. There are no data on the effects of Avamys on human fertility.

Available information comes from animal studies. In experimental subjects carrying offspring, drugs from the group of corticosteroids caused intrauterine malformations. The release of the active substance into breast milk has not been studied.

The use of Avamis for the treatment of women during pregnancy and lactation is permissible only if the possible benefit to the mother is higher than the risk to the child.

Release form

Avamys is produced in the form of a dosed nasal spray. The modern release form makes it possible to conveniently deliver the medicine to its destination. One spray corresponds to a single dose of the active substance - 27.5 mcg of fluticasone furoate.

What does Avamis look like? The medicine is presented as a white homogeneous suspension, placed in a special package - a bottle and a case. The vial is made of a specific orange glass and is placed inside a plastic case. It is equipped with a valve, a spray mechanism, an indicator window and a cap-shaped limiter. 1 package can contain a volume of 30, 60 or 120 doses.