Nasonex spray: instructions for use, price, reviews from doctors and analogues

Nasonex is a topical hormonal drug used in the treatment of rhinitis of allergic etiology. It is also often prescribed for sinusitis or complicated runny nose.

This drug is highly effective and well tolerated. But if the patient is intolerant of the active substance, it is necessary to select an analogue of Nasonex or a cheaper replacement, since the cost of the original drug is quite high.

Release form

Dosed spray Nasonex Sinus. Polyethylene bottles 10 g, packaging No. 1. Each bottle is equipped with a protective cap and a spray nozzle. The contents of the bottle are designed for 60 doses, each of which contains 50 mcg of active substance.
Nasonex metered spray. Polyethylene bottles 18 g, packaging No. 1. Each bottle is equipped with a protective cap and a spray nozzle. The contents of the bottle are designed for 140 doses, each of which contains 50 mcg of active substance.

The contents of the bottle are an opaque suspension of almost white or off-white color.

Pharmacodynamics and pharmacokinetics

Nasonex - hormonal or not?

The active substance of the spray is a synthetic corticosteroid for local (inhalation) use, therefore, the drug Nasonex is hormonal .

Pharmacodynamics

A feature of mometasone furoate is its ability to relieve inflammation and inhibit the development of an allergic reaction , even when used in doses at which systemic effects do not develop.

The substance inhibits the release of inflammatory mediators, stimulates the production of lipomodulin, which is an inhibitor of phospholipase A. Due to this, the release of arachidonic acid is reduced and, accordingly, the synthesis of its metabolic products (Pg and endoperoxides) is suppressed.

Reduces the formation of a chemotaxis substance, influencing “late” (delayed) allergic reactions , and also prevents the development of an immediate allergic reaction .

Studies with provocative tests with the application of antigens to the nasal mucosa have shown that Nasonex nasal spray exhibits high anti-inflammatory activity both at the early and late stages of the development of an allergic reaction .

This is confirmed (compared to placebo) by a decrease in eosinophil and histamine , as well as a decrease (compared to the baseline) in the number of neutrophils , eosinophils and epithelial tissue cell adhesion proteins.

In approximately a third of patients (28%) with seasonal allergic rhinitis, a pronounced clinical effect was achieved within twelve hours after the first inhalation. In half of the patients, improvement occurred on average within 1.5 days (35.9 hours).

In addition, in patients suffering from seasonal rhinitis, the drug showed significant effectiveness in reducing the severity of eye symptoms (itching, lacrimation, redness).

Pharmacokinetics

The bioavailability of mometasone when applied topically is negligible (does not exceed 0.1%).

The substance is practically undetectable in blood plasma. The suspension is very poorly absorbed from the digestive canal, and the small amount that can be swallowed and has time to be absorbed undergoes active metabolism even before excretion.

Metabolites are excreted primarily in bile and, in small quantities, in urine.

The mechanism of action of the drug Nasonex

Mometasone inhibits the release of inflammatory mediators. At the same time, it activates the release of a blocker of the enzyme phospholipase A, which is responsible for the intensity of the immune reaction to antigens. When using a nasal spray, nasal discharge and accompanying other signs of allergy are reduced: conjunctivitis, lacrimation, swelling, itching, hyperemia.

The drug is effective against rapidly developing intolerance and helps prevent delayed allergies. Symptoms as a result of use are reduced at all stages of the pathology. They can be completely eliminated within 1–2 days from the start of treatment.

When applied topically, the drug substances are absorbed into the systemic bloodstream in a negligible concentration, without causing harm to the body.

Indications for use

Indications for use of Nasonex are:

allergic rhinitis (seasonal or year-round) in children, adolescents and adults;
exacerbation of chronic sinusitis (the drug is prescribed as an adjunct to antibiotic therapy) in adolescents and adults;
prevention of moderate/severe seasonal allergic rhinitis (it is considered optimal to start using the spray no later than 2 weeks before the expected start of the dusting period).

Children are prescribed Nasonex allergy from the age of two. For the treatment of sinusitis in pediatrics, it is used in children over twelve years of age.

Nasonex or Avamis - which is better?

Avamis is a substitute for Nazonex, which is closest to it in terms of its mechanism of action. It is also allowed to be used in the treatment of children over 2 years of age, and the list of indications, contraindications and possible side effects is the same.

Avamis is better for children due to the following advantages: low cost and effectiveness in the treatment of adenoiditis in children, which is manifested by stabilization of breathing, adenoids do not enlarge, the nasal mucosa does not dry out, so there is no nasal bleeding, which is often observed in childhood when using Nasonex.

However, Avamis cannot be used as a prophylactic agent, unlike Nasonex.

Contraindications

Contraindications to the use of Nasonex are:

intolerance to any of its constituent components;
the presence of an untreated/undertreated local infection, provided that the nasal mucosa is involved in the process;
active or latent tuberculosis infection of the respiratory tract;
untreated bacterial, systemic viral or mycotic infection , as well as an infection caused by the herpes simplex with eye damage (in some cases, the drug can be prescribed as an exception as directed by the attending physician).

If the patient has recently suffered a nasal injury or nasal surgery, the use of the spray is contraindicated until the wound has healed.

Substitutes in the form of a spray for children

On the pharmacological market there are substitutes for Nasonex for children in the form of a spray, which is very convenient and safe.

Avamis

Avamys is a medication that is manufactured in the form of a nasal spray, the active component of the drug is fluticasone furoate. Prescribed to eliminate the symptoms of allergic rhinitis.

Avamis is not used for the following reasons:

allergy to the composition;
age under 2 years;
after surgery of the nasopharynx;
liver and kidney dysfunction;
genetic predisposition to bleeding;
injuries to the face and nose;
pregnancy;
lactation period.
Lactation period

The standard scheme for using the spray for patients over 12 years old is 1 time in 24 hours, 2 injections in each stroke, for 2-12 years old – one injection into both nasal passages once a day.

The main negative reactions of the body to the medication are bleeding from the sinuses, discomfort and burning in the nasopharynx, allergic manifestations on the skin. Sometimes there may be:

increased blood pressure and headache;
dizziness and insomnia;
body fatigue;
visual impairment;
myopathy.

Flixonase

Flixonase belongs to the group of decongestant medications. The active component of the drug is fluticasone propionate, which quickly relieves swelling in the nasal passages and makes breathing easier. The effect occurs a couple of minutes after using the spray and lasts 24 hours.

Prescribed for the treatment and prevention of the following pathologies:

allergic or household runny nose (dust and animal hair), seasonal rhinitis;
for swelling of the nasal passages due to rhinitis.

Do not use the medicine if you are allergic to the components of the medicine, or for treating small children under 4 years of age.

During pregnancy and the lactation period, the drug is prescribed within therapeutic dosages.

Inject the medication 1 time into both nasal sinuses once a day. These are standard doses, the same for any age group. The permissible duration of a medication course for children 4-11 years old is up to 60 days, over 11 years old - up to six months.

Negative effects:

bronchospasms;
allergies – rash, itchy skin and redness of the skin;
shortness of breath, Quincke's edema;
oral candidiasis.
Oral candidiasis

Nasobek

Nasobek is a Nasonex substitute containing beclomethasone dipropionate as an active ingredient. Nasobek is prescribed for the treatment of such diseases:

rhinitis;
sinusitis;
infections in the nasopharynx.

Medicine is not prescribed for:

sensitivity to the drug;
hemorrhages on the skin;
nosebleeds;
age less than 6 years;
fungus in ENT organs;
candidiasis and herpes;
ORZ.

Prescribe with caution in such cases:

glaucoma and hyperthyroidism;
kidney and liver dysfunction;
myocardial infarction;
Myocardial infarction
surgical treatment and trauma of the nasopharynx;
pregnancy and lactation.

Before injecting the spray, you need to thoroughly clean the passages in your nose. Dosages depend on the age category of patients:

6-12 years – 1 spray in 2 strokes in the nose 2 times a day;
from 12 years – 1 injection into both nostrils 2-4 times a day.

The duration of the course of drug therapy is prescribed by the doctor based on the patient’s age, pathology and the severity of its development.

Negative reactions of the body to the use of Nasobek in therapy:

burning sensation in the nasopharynx and the development of infection;
dryness of the mucous membranes in the nose;
rhinorrhea;
conjunctivitis;
hives;
increased eye pressure;
headache and increased blood pressure;
fatigue and joint pain.

Side effects

When treating allergic rhinitis in adults, the following are possible:

pharyngitis;
nosebleeds (bleeding may be obvious or blood may be present in the mucus released from the nose);
irritation of the mucous membrane in the nasal cavity;
burning sensation in the nose.

In children receiving Nasonex for the treatment of allergic rhinitis , the following was observed:

nosebleeds;
irritation of the nasal mucosa;
headache;
sneezing.

Nosebleeds usually stop on their own and are not severe. They occur with a frequency comparable to the frequency of their occurrence when using placebo (5%), but less or equal than when using other glucocorticosteroids for intranasal use.

Nasonex analogues were used for active control; with their use, the incidence of nosebleeds was up to 15%.

Other adverse reactions in the group of patients receiving mometasone developed with the same frequency as in patients who received placebo.

When prescribing the drug for sinusitis / sinusitis , when Nasonex is used as an adjuvant to relieve swelling of the drainage holes, reduce secretion production and facilitate the discharge of mucus from the paranasal sinuses, the following were recorded in adolescents and adults:

pharyngitis;
headache;
irritation and/or burning of the nasal mucosa.

Bleeding was moderate, and the frequency of its occurrence when using the spray was only slightly higher than the frequency of its occurrence when using placebo (5% and 4%, respectively, for Nasonex and placebo).

Cases of development of ocular hypertension or perforation of the nasal septum have been reported extremely rarely when using endonasal corticosteroids.

Who is Nasonex indicated for?

The use of the drug to prevent the appearance or exacerbation of allergic rhinitis is allowed for adults and children over 2 years of age. Nasonex helps:

with allergic mucus discharge from the nose;
with pathological reactions to pollen during flowering of plants, animal hair, exposure to other antigens.

In complex therapy, the drug is used to eliminate acute and chronic sinusitis. In these cases, its use is indicated for patients over 12 years of age.

Nasonex spray: instructions for use

General recommendations

The drug is intended for intranasal administration (used in the form of inhalations) of the suspension contained in the bottle. The procedure is carried out using a dosing nozzle, which is supplied with each bottle of Nasonex.

Before using the spray for the first time, it is “calibrated” by pressing the dosing device 6-7 times. “Calibration” allows you to establish a stereotypical supply of medicine. In this case, each press of the dosing device ensures the release of 100 mg of suspension into the nasal cavity, which contains 50 mcg of a chemically pure active substance.

Before use, the bottle must be shaken vigorously each time.

Instructions for use of Nasonex/Nasonex Sinus for allergic rhinitis

The standard prophylactic/therapeutic dose for adolescents over the age of twelve and adult patients (including the elderly) is two inhalations into each nasal passage as a single dose (200 mcg of mometasone per day).

After achieving the desired therapeutic effect, the dose is reduced to 100 mcg/day. (one inhalation in each nasal passage once).

If it was not possible to achieve the desired effect when using a therapeutic dose, the dose can be increased to 400 mcg/day. That is, the patient should take up to four inhalations once in each nasal passage. Reducing the severity of symptoms of allergic rhinitis is an indication for dose reduction.

Clinical improvement after the first use of mometasone is usually noticeable within 12 hours after the first inhalation.

For children under 11 years of age, it is recommended to take one inhalation into each nasal passage once for allergies. The total dose is 100 mcg/day.

Since Nasonex is not a nasal drop, but a spray, when inhaling, you should keep your head straight, without throwing it back.

Instructions for Nasonex Sinus and Nasonex for exacerbation of sinusitis

For patients over twelve years of age, including the elderly, the recommended therapeutic dose is two inhalations into each nostril, 2 times a day. The total dose is 400 mcg/day.

The drug is used as an adjuvant, complementing the main treatment.

If clinical improvement cannot be achieved using the drug at a standard dosage, the dose may be increased to 800 mcg/day. (four inhalations into each nasal passage, 2 times a day). After the severity of symptoms decreases, the dose should be reduced.

After 12 months of use of Nasonex, there were no signs of atrophy of the nasal mucosa; in addition, mometasone tended to improve the histological picture when examining a tissue sample of the nasal mucosa.

Nasonex for adenoids

Enlarged adenoids are a fairly common complication of allergic rhinitis in young children. Prescribing Nasonex to children with adenoids can relieve swelling and often prevent the need for surgical intervention.

Reviews of Nasonex for adenoids indicate that the effect is achieved by suppressing lymphoid tissue, but it takes quite a long time to achieve it. In addition, in cases of severe inflammation, the drug is not very effective.

As a hormonal agent, the spray also additionally suppresses local immunity, and therefore, after its discontinuation, inflammation in the adenoids may resume. External manifestations of inflammation are the appearance of mucus flowing down the back wall of the throat.

To relieve this condition, doctors recommend taking a course of anti-inflammatory treatment for adenoid vegetations . In this case, inhalations through a nebulizer with Cycloferon , supplemented by rinsing the nasopharynx using the nasopharyngeal shower method, which are carried out in an ENT office, may be effective.

Dr. Komarovsky recommends, as an addition to the treatment of adenoids, to reconsider the organization of the child’s lifestyle. Since one of the causes of enlarged adenoids is decreased immunity, it is very important that the immune system functions as well as possible.

To minimize the risk of an increase in the size of the pharyngeal tonsils , the child should eat properly, walk in the fresh air, harden, play sports and have as little contact as possible with household chemicals and dust.

After the inflammation disappears, it is usually not necessary to repeat the course of intranasal GCS.

Nasonex or Nasobek

Nasobek is a cheaper replacement than Nasonex; the drug contains beclomethasone. Because of this, it exhibits an immunosuppressive effect, helping to restore local immunity.

Another advantage of nasobek is the reduction of mucus production, good tolerance by patients and the possibility of using it in the treatment of vasomotor rhinitis.

The disadvantages of the drug include the age restriction, according to which Nasobek can be used by children over 6 years of age. It is also not used as a prophylactic.

Nasobek is contraindicated in the first trimester of pregnancy.

Overdose

An overdose of mometasone develops with prolonged use of the drug in high doses, as well as in the case of simultaneous use of several corticosteroids. As a result, the function of the hypothalamic-pituitary-adrenal system .

The systemic bioavailability of mometasone is extremely low, so it is unlikely that in case of an intentional/accidental overdose, it will be necessary to take any measures other than monitoring the patient and then continuing to use Nasonex at the recommended dose.

Nasonex or Polydexa

Polydexa is a combination drug containing dexamethasone, phenylephrine, polymyxin and neomycin. Thanks to this composition, the drug exhibits decongestant, vasoconstrictor effects, and is also active against pathogens of bacterial infections.

In view of this, Polydexa has a wider list of indications, as well as contraindications. The drug is not prescribed to children under 15 years of age, with intolerance to the components, a history of ischemic stroke and convulsions, severe arterial hypertension, coronary insufficiency, glaucoma, herpetic infection.

When using Nasonex and its analogues, you should remember:

These drugs cannot be combined with others containing glucocortisteroids, as the risk of overdose increases;
drug withdrawal is carried out gradually to avoid the development of “withdrawal syndrome”;
the sprayer should be washed under running water at least once a week;
with long-term use, the functioning of the adrenal glands should be monitored;
Such drugs are used strictly according to the scheme and regularly.

Nasonex analogues have a similar spectrum of action and an identical list of side effects. However, only the attending physician can choose the most effective one in each specific case. After all, self-medication can lead to hormonal imbalance.

special instructions

The bottle is calibrated. If the product is not used for more than 14 days, recalibration is required.

With long-term (several months) use of the spray, you should undergo periodic examinations by an otolaryngologist for possible changes in the nasal mucosa. If a local mycotic infection of the pharynx/nose develops, you should stop using Nasonex or undergo a course of special treatment.

Particularly careful medical supervision is required for patients who use Nasonex simultaneously with systemic corticosteroids, as well as patients to whom the drug was prescribed after discontinuation of corticosteroid therapy.

Withdrawal of systemic corticosteroids often leads to adrenal insufficiency, which may require appropriate measures. When switching from systemic corticosteroids to the use of a nasal spray, some patients may experience symptoms of corticosteroid withdrawal:

joint and/or muscle pain;
depression;
feeling tired.

A change in therapy may cause symptoms of previously developed allergic diseases (for example, eczema or allergic conjunctivitis ), which were previously masked by systemic glucocorticosteroid .

In patients receiving treatment with corticosteroids, immune reactivity is potentially reduced. For this reason, they should be warned about the increased risk of infection if they come into contact with an infectious patient (including people with measles or chickenpox ) , and about the need to consult a doctor if such contact occurs.

In placebo-controlled trials in children, when the drug was used at a dose of 100 mcg for a year, growth was delayed in children. Also, with prolonged use of Nasonex, there are no signs of suppression of the function of the hypothalamic-pituitary-adrenal system .

In cell culture, mometasone furoate showed tenfold greater activity compared to other steroids , including Betameson , Dexamethasone , beclomethasone dipropionate , in suppressing the synthesis/release of interleukins (IL) 1, 5 and 6, TNF-α, as well as IL-4, IL- 5 and Th2 cytokines from human CD4+ T cells.

By suppressing the production of IL-5, the drug exhibits six times greater activity than betamethasone and beclomethasone dipropionate.

Nazarel or Nasonex - which is better?

Nazarel has a lower cost compared to Nasonex. It has a similar principle of action, exhibits a decongestant, anti-inflammatory, antihistamine effect, which appears 3 hours after the first injection.

Nazarel also helps reduce itching in the nose, eliminates sneezing, rhinitis, nasal congestion, discomfort in the maxillary sinuses, and alleviates eye allergy symptoms.

The therapeutic effect lasts for 24 hours after a single use of the spray. In addition, fluticasone has virtually no systemic effects, without affecting the functioning of the hypothalamic-pituitary-adrenal systems.

However, like Flixonase, according to the instructions, Nazarel is used to treat children over 4 years of age. Therefore, only Nasonex is suitable for patients under this age.

What can replace Nasonex?

Analogs of Nasonex spray with the same active ingredient (synonyms): Desrinit , Rizonel , Asmanex Twistheiler .

Analogues of Nazonex with a similar mechanism of action (in spray form): Flutinex , Avamis , Flixonase , Beclonazal , Beclomethasone , Fluticasone , Tafen , Rinoklenil , Polydexa , Nasobek , Nazarel , Budoster , Aldecin .

Nasal drops with GCS: Benacap , Benarin .

What analogues are cheaper than Nasonex?

The price of Nasonex analogues is from 128 rubles. Desrinit nasal spray .

What is better Nasonex or Avamis?

Avamys form of an aqueous spray for intranasal administration. Its active substance is fluticasone furoate (the concentration of the substance in one dose is 27.% 5 mcg).

Fluticasone and mometasone are the most modern drugs that are characterized by a very high degree of affinity for GCS receptors and exceptional topical activity.

Both substances have extremely low absolute bioavailability. However, for mometasone this figure is slightly lower than for fluticasone - 0.1% versus 0.5%.

mometasone has the lowest bioavailability and the fastest development of the therapeutic effect.

In addition, its use is permitted from the age of two, while fluticasone furoate in pediatric practice is used only for the treatment of children over six years of age. Even with long-term use, mometasone does not have a negative effect on the growth of the child.

Nasonex or Flixonase - which is better?

Flixonase is an endonasal aqueous spray based on micronized fluticasone propionate . The concentration of the active substance in one dose is 50 mcg.

The drug has a rapid anti-inflammatory effect on the nasal mucosa, and its anti-allergic effect appears 2-4 hours after the first inhalation.

The effect (in particular, reduction of nasal congestion) persists for 24 hours after a single administration of Flixonase at a dose of 200 mcg.

When used in therapeutic doses, the drug does not have any pronounced systemic activity and almost does not inhibit the hypothalamic-pituitary-adrenal system .

Systematic reviews of the comparative effectiveness and safety of fluticasone propionate and mometasone furoate , carried out as part of the DERP project, showed that the differences in their effectiveness are very small. However, it should be borne in mind that fluticasone propionate is characterized by higher bioavailability than mometasone . This figure varies from 0.5 to 2%.

It is significant that Flixonase in pediatrics can only be used from the age of four.

Results from studies conducted by the FDA showed that the reduction in the severity of symptoms of allergic rhinitis as assessed by patients in the fluticasone was more pronounced (45%) compared with the mometasone (36%) and the placebo group (11%).

Patients treated with fluticasone were less likely than patients treated with mometasone and placebo to use additional medications (eg, nasal constrictors) for relief: rates of use were 42%, 47%, and 58%, respectively, for fluticasone , mometasone , and placebo.

Side effects when using fluticasone were also recorded less frequently (in particular, pharyngitis and gastrointestinal disorders),

What is better Nasonex or Nazarel?

The active substance of Nazarel is fluticasone propionate (50 mcg/dose), therefore, comparing the effectiveness of the drug with the effectiveness of Nasonex, we can say that, as in the case of Flixonase and Avamys , it is comparable.

The research results and subjective feelings of patients taking different endonasal corticosteroids confirm that both drugs are effective and safe. However, the advantage of Nazarel is its significantly lower cost (about 330-350 rubles for 120 doses).

Nasonex's analogues are cheaper

Sometimes it becomes necessary to choose cheaper Nasonex analogues, the effectiveness of which will not be lower than the original product. The price of a drug with a volume of 60 doses varies from 420 to 500 rubles, 120 doses - from 700 to 870 rubles.

Analogs exhibit similar effects, but may differ in composition. At the same time, they also effectively cope with manifestations of allergies, inflammation, and asthma attacks.

The only generic (with the same composition as Nasonex) is the Czech “Desirint” costing 350 rubles for 140 doses. Both medications are identical, but the list of side effects of the substitute is longer and may occur during administration: anxiety, hyperactivity, sleep disturbances, glaucoma, cataracts.

The list of drugs with similar effects and lower cost is as follows:

"Rinoclenil" (beclamethasone) - 200 doses 370 rubles;
"Flixonase" (fluticasone propionate) - 120 doses 780 rubles;
"Nazarel" (fluticasone propionate) - 120 doses 400 rubles;
"Avamys" (fluticasone furoate) - 120 doses 725 rubles;
“Nasobek” (beclamethasone) - 200 doses, 180 rubles;
"Tafen nasal" (budesonide) - 200 doses 420 rubles;
“Polydexa” (dexamethasone, phenylephrine, polymyxin, neomycin) - 295 rubles;
"Sinoflurin" (fluticasone propionate) - 120 doses 390 rub.

Only a doctor can select a similar substitute for Nasonex based on the previously collected anamnesis and the severity of symptoms. Self-medication in this case is dangerous due to side effects and can worsen the patient’s condition.

Nasonex during pregnancy

After administration of the drug into the nasal cavity in the maximum permissible therapeutic dose, its active substance is not detected in the blood even in the minimum concentration.

Thus, its potential reproductive toxicity (including effects on male/female fertility and effects on the developing organism) is negligible.

However, due to the fact that well-controlled studies of the effect of mometasone furoate on the body when used during pregnancy and lactation have not been conducted, the spray should be prescribed to pregnant women, mothers who are breastfeeding, and women of childbearing age only in those cases. cases where the expected effect of therapy justifies the potential risk to the fetus/newborn.

Newborn infants whose mothers received corticosteroids during pregnancy should be examined for possible adrenal hypofunction .

Desrinit or Nasonex

Desrinit is the only drug synonymous with Nasonex in terms of the active substance; it can be used intranasally and for inhalation, which is an undeniable advantage.

The active substance does not exhibit systemic effects because it has low bioavailability. Also, during treatment there is no effect of the drug on the state of the immune system.

The medicine is prescribed to relieve allergic rhinitis, diseases that are accompanied by inflammatory lesions of the nasopharynx, and reduces the risk of developing complications after infectious diseases.

According to the instructions, the indications for use of Nasonex and Desrinit are similar.

Reviews of Nasonex

Reviews of Nasonex Sinus/Nasonex are mostly good. More than 80% of patients who used the drug noted a very rapid improvement in their condition, calling the drug an indispensable assistant in the fight against seasonal and year-round allergic rhinitis .

Moreover, some patients who have been on vasoconstrictor drugs claim that it was Nasonex spray that helped them get rid of this addiction.

However, there are also those for whom the drug did not suit or did not give the expected result, which may be due to the body’s individual reaction to the prescribed treatment.

A separate group of reviews are reviews of Nasonex for children. For children, the spray is most often prescribed for adenoids , if the proliferation of lymphoid tissue is a consequence of allergies . Despite the fact that the drug is hormonal, mothers believe that it is better to undergo treatment with it than to send the child for surgery.

If we talk about the effectiveness of Nasonex for adenoids , then positive dynamics become noticeable quite quickly, but only if the treatment regimen is chosen correctly.

The big advantage of the drug is that its active substance is absorbed in negligibly small quantities and does not have systemic activity. Thanks to this, Nasonex, unlike most analogues, can be used from the age of two.

It should be noted that there are, although extremely rare, reviews in which mothers who used Nasonex to treat their child complain that after the end of the course of treatment, all the old drugs that were prescribed to the child before do not work and do not even provide temporary relief.

Reviews from doctors about Nasonex allow us to conclude that endonasal corticosteroids do not completely cure polypous rhinosinusitis and allergic rhinitis , but are capable of completely - and as quickly as possible - stopping the symptoms of allergic rhinitis and significantly delaying the relapse of nasal polyp .

Drugs in this group are the only drugs whose clinical effectiveness in chronic polypous rhinosinusitis is confirmed by evidence-based medicine.

Nasonex or Flixonase

Flixonase is not the cheapest analogue of Nasonex. However, these drugs contain similar active ingredients, so the indications and contraindications for use are the same.

However, the original is approved for use from 2 years of age, and flixonase - only from 4 years of age.

Flixonase, unlike Nasonex, helps eliminate lacrimation, swelling, redness and itching of the eyelids. Thanks to this, the drug can be used without antihistamines, as monotherapy.

How much does Nasonex cost?

Price in Ukraine

The price of Nazonex Sinus (60 doses) in large cities of Ukraine (Kharkov, Kyiv, Dnepropetrovsk, etc.) is 245 UAH. You can buy Nasonex (drops, 140 doses) for an average of 485 UAH.

Nasonex price in Russian pharmacies

The price of Nasonex Sinus spray in St. Petersburg and Moscow is from 440 rubles, the cost of a bottle containing 120 doses of the drug is from 780 rubles.

Additionally

The manufacturer does not produce Nasonex nasal drops. The only dosage form of the drug is a metered-dose nasal spray.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine
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ZdravCity

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Nasonex nasal spray dosed 50 µg/dose 140 doses No. 1

Name

Nasonex spray called dosage 50 mcgd in bottle 140 doses in pack No. 1

Description

White or almost white opaque suspension.

Main active ingredient

Mometasone

Release form

nasal spray

Dosage

140doses

Pharmacological properties

Pharmacodynamics

Mechanism of action of Mometasone furoate? a glucocorticosteroid for local use, which has a local anti-inflammatory effect, manifested in doses at which systemic effects do not occur. It is likely that the main mechanism of antiallergic and anti-inflammatory action of mometasone furoate is associated with its ability to inhibit the release of mediators of allergic reactions. Mometasone furoate significantly reduces the release of leukotrienes from the leukocytes of patients suffering from allergic diseases. Mometasone furoate demonstrated high activity in cell culture in inhibiting the synthesis/release of IL-1, IL-5, IL-6 and TNF?. It is also a potent inhibitor of leukotriene production. In addition, it is also a potent inhibitor of the production of Th2 cytokines, IL-4 and IL-5 from human CD4* T cells. In studies with provocative tests with the application of antigens to the nasal mucosa, the anti-inflammatory activity of NASONEX nasal spray was revealed in both the early and late stages of an allergic reaction. This was confirmed by a decrease (compared with placebo) in histamine levels and eosinophil activity, as well as a decrease (compared with baseline) in the number of eosinophils, neutrophils and epithelial cell adhesion proteins. In 28% of patients with seasonal allergic rhinitis, NASONEX nasal spray demonstrated a clinically significant onset of action within 12 hours of the first dose. On average (50%), relief occurred within 35.9 hours. Children In a placebo-controlled clinical trial in which children (n=49/group) received 100 mcg per day of NASONEX nasal spray for one year, growth rate was delayed was not observed. There are limited data on the safety and effectiveness of NASONEX nasal spray in children aged 3 to 5 years, and an appropriate dosage range cannot be established. In a study of 48 children aged 3 to 5 years treated with intranasal mometasone furoate 50, 100, or 200 mcg/day for 14 days, there was no significant difference when compared with placebo in the mean change in plasma cortisol in response. for a stimulation test with tetracosactrin.

Pharmacokinetics

The bioavailability of mometasone furoate when administered as an aqueous nasal spray is

Indications for use

Treatment of seasonal or year-round allergic rhinitis in adults and children over 2 years of age.
Preventive treatment of moderate and severe allergic rhinitis in adults and children over 12 years of age (recommended to start 2-4 weeks before the expected start of the dust season).
Treatment of symptoms of acute rhinosinusitis without signs of severe bacterial infection in adults and children over 12 years of age.
Treatment of nasal polyps and associated symptoms, including nasal congestion and loss of smell, in patients over 18 years of age.

Directions for use and doses

Treatment of seasonal or year-round allergic rhinitis: for adults (including the elderly) and adolescents over the age of 12 years, the recommended preventive and therapeutic dose of the drug is 2 injections (50 mcg each) into each nostril 1 time per 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 nostril once a day (total daily dose 100 mcg). If relief of the symptoms of the disease cannot be achieved by using the drug at the recommended therapeutic dose, the daily dose can be increased to the maximum: 4 injections into each nostril once a day (total daily dose - 400 mcg). After the symptoms of the disease have subsided, a dose reduction is recommended. In some patients with seasonal allergic rhinitis, this drug demonstrated a clinically significant onset of action within 12 hours after the first dose. However, the full benefit of treatment cannot be achieved in the first 48 hours, so the patient must continue regular use to achieve the full therapeutic effect. Treatment with NASONEX nasal spray can be started a few days before the start of the dust season in patients with a history of moderate or severe seasonal allergic rhinitis. For children aged 2-11 years, the recommended therapeutic dose is 1 injection (50 mcg each) into each nostril once a day (total daily dose 100 mcg). Acute rhinosinusitis. For adults (including the elderly) and children aged 12 years and older, the recommended therapeutic dose is 2 injections (50 mcg) into each nostril 2 times a day (total daily dose: 400 mcg). Nasal polyps. For patients over the age of 18 years (including the elderly), the recommended dose is 2 sprays (50 mcg each) in each nostril once a day (total daily dose: 200 mcg). If after 5-6 weeks of treatment there is no improvement in the symptoms of the disease, the dose can be increased to two injections into each nasal passage 2 times a day (total daily dose - 400 mcg). The dose should be gradually reduced to a lower dose that provides effective control of symptoms. If after 5-6 weeks of treatment there is no improvement in the symptoms of the disease, the patient's condition should be re-evaluated and alternative treatment methods should be considered. Preparing the nasal spray for use NASONEX nasal spray has a dust cap that protects the sprayer and keeps it clean. Remember to take it off before using the spray and put it back on after use. Before the first use, you must first “calibrate” the spray by pressing the dispensing device 10 times until the spray begins to spray: 1. Gently shake the bottle. 2. Place your index and middle fingers on either side of the spray bottle and your thumb under the bottle. Do not puncture the nasal applicator. 3. Point the sprayer away from you, then press your fingers down 10 times until the spray begins to spray. If the nasal spray has not been used for 14 days or more, a recalibration is required by pressing the dispenser 2 times until the spray dispenses. How to use the nasal spray 1. Shake the bottle gently and remove the dust cap 2. Gently clean your nose. 3. Close one nostril and place the sprayer in the other nostril. Tilt your head slightly forward, holding the bottle upright. 4. Begin to inhale gently or slowly through your nose and at the same time squirt the spray into your nostril by pressing the dispensing device once. 5. Exhale through your mouth. Repeat step 4 to spray a second time into the same nostril, if applicable. 6. Remove the nebulizer from that nostril and exhale through your mouth. 7. Repeat steps 3-6 for the second nostril. Wipe the sprayer thoroughly with a clean handkerchief or napkin after using the spray, and put on the dust cap. Cleaning the nasal spray

It is important to clean your nasal spray atomizer regularly, otherwise it will not work properly.
Remove the dust cap and carefully remove the sprayer.
Wash the sprayer and dust cap with warm water and then rinse under running water.
Do not attempt to clean the dosing device with a needle or other sharp object as this may damage the device and cause the medication to be dosed incorrectly.
Dry the sprayer and dust cap in a warm place.
Place the spray bottle on the spray bottle and put on the dust cap.
Re-calibrate by pressing the dispenser 2 times before use after cleaning.

If you use more NASONEX than you should Tell your doctor if you accidentally use more than you were told. Using steroids for a long time or in large quantities can sometimes affect some of your hormones. In children, it can affect growth and development. If you forget to use NASONEX If you forget to use the nasal spray at the right time, use it as soon as you remember, and then continue as before. Do not take a double dose to make up for a forgotten dose.

Use during pregnancy and lactation

Pregnancy There is no or limited information regarding the use of mometasone furoate in pregnant women. Animal studies have shown reproductive toxicity. Like other intranasal corticosteroids, NASONEX nasal spray is used in pregnant women only if the expected benefit justifies the potential risk to the mother, fetus or infant. Infants whose mothers used corticosteroids during pregnancy should be carefully monitored for possible adrenal hypofunction. Lactation It is not known whether mometasone furoate is excreted into human breast milk. As with other intranasal corticosteroids, a decision should be made regarding discontinuation of breastfeeding or discontinuation/abstinence of NASONEX nasal spray therapy, taking into account the benefits of breastfeeding for the child and the benefits of treatment for the woman.

Precautionary measures

Immunosuppression NASONEX Nasal Spray should be used with caution or not at all in patients with active or latent tuberculosis infection of the respiratory tract, as well as untreated fungal, bacterial or systemic viral infection. Patients using corticosteroids may potentially have reduced immune responsiveness and should be warned of the increased risk of infection if exposed to patients with certain infectious diseases (eg, chickenpox, measles), and the need to consult a physician if such exposure occurs. Local nasal effects In a study of patients with perennial rhinitis, there were no signs of nasal mucosal atrophy after 12 months of treatment with NASONEX nasal spray; In addition, mometasone furoate contributed to the normalization of the histological picture of the nasal mucosa. However, patients using NASONEX nasal spray for several months or longer should be periodically examined for possible changes in the nasal mucosa. If a local fungal infection of the nose or throat develops, it may be necessary to discontinue treatment with NASONEX nasal spray or undergo special treatment. Irritation of the nasal and pharyngeal mucosa that persists for a long time may also be an indication to discontinue treatment with NASONEX nasal spray. The use of NASONEX is not recommended in case of perforation of the nasal septum. In clinical studies, nosebleeds were observed with a higher frequency than with placebo. Nosebleeds stopped on their own and were moderate. NASONEX nasal spray contains benzalkonium chloride, which may cause irritation to the nasal mucosa. Systemic effects of corticosteroids Systemic effects may occur with the use of nasal corticosteroids, especially when given in high doses and for long-term use. These effects are less likely to occur than with oral corticosteroids and may vary between patients and between different corticosteroid agents. Potential systemic effects may include Cushing's syndrome, Cushingoid symptoms, adrenal suppression, growth retardation in children and adolescents, cataracts, glaucoma, and, less commonly, psychiatric or behavioral disorders including psychomotor agitation, hyperactivity, sleep disturbances, anxiety, depression, or aggression (especially in children). Cases of increased intraocular pressure have been reported following the use of intranasal corticosteroids. When using systemic and local corticosteroids (including intranasal, inhaled and intraocular administration), visual disturbances may occur. If symptoms such as blurred vision or other visual disturbances occur, the patient should be evaluated by an ophthalmologist to evaluate possible causes of the visual disturbance, which may include cataracts, glaucoma, or rare diseases such as central serous chorioretinopathy, which has been reported following the use of corticosteroids systemic and local action. Patients switching to treatment with NASONEX nasal spray after long-term treatment with systemic corticosteroids should be closely monitored. Discontinuation of systemic corticosteroids in such patients may lead to insufficiency of adrenal cortex function for several months until the function of the hypothalamic-pituitary-adrenal axis is restored. If these patients exhibit signs and symptoms of adrenal insufficiency or withdrawal symptoms (eg, joint and/or muscle pain, fatigue, and initial depression), despite relief of nasal symptoms, systemic corticosteroids should be reinstituted, other therapies, and appropriate measures have been taken. This change in therapy may also reveal pre-existing allergic diseases, such as allergic conjunctivitis and eczema, that developed earlier and were masked by systemic corticosteroid therapy. Treatment with doses higher than recommended may result in clinically significant suppression of adrenal function. If there is evidence that doses higher than recommended are being used, then the use of additional systemic corticosteroid should be considered during periods of stress or elective surgery. Nasal polyps The safety and effectiveness of NASONEX nasal spray in the treatment of unilateral polyps, polyps associated with cystic fibrosis, or polyps that completely obstruct the nasal passage have not been studied. For unilateral polyps with an unusual or irregular shape, especially those that are ulcerated or bleeding, a more in-depth examination is required. Effect on growth in children It is recommended that growth be closely monitored in children receiving long-term treatment with nasal corticosteroids. If growth slows down, treatment should be reconsidered with a view to reducing the dose of nasal corticosteroid, if possible, to the lowest dose that effectively controls symptoms of the disease. In addition, consideration should be given to referring the patient to a pediatrician. Non-nasal symptoms Although nasal symptoms will be controlled in most patients with NASONEX nasal spray, concomitant use of appropriate adjunctive treatment may provide additional relief of other symptoms, particularly ocular symptoms. Children. When conducting placebo-controlled clinical studies in children using NAZONEX at a daily dose of 100 mcg for a year, no growth retardation was observed in children. However, the long-term effects of intranasal/inhaled steroids have not been fully studied. The physician should carefully monitor the growth and development of children receiving long-term treatment with glucocorticosteroids. 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 perennial allergic rhinitis in children under 2 years of age have not been studied. The use of high doses or long-term treatment with glucocorticosteroids may lead to systemic side effects, including growth retardation in children. The long-term effect of intranasal/inhaled steroids in children has not been fully studied. The physician should carefully monitor the growth and development of children receiving long-term treatment with glucocorticosteroids. In a study of 49 children who received 100 mg of NAZONEX daily for 1 year, no reduction in growth rate was observed.

Interaction with other drugs

Clinical interaction studies with loratadine have been conducted. No interaction was observed. Mometasone furoate is metabolized via CYP3A4. Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir, drugs containing cobicistat) may increase plasma concentrations of corticosteroids and potentially increase the risk of systemic corticosteroid adverse reactions. The benefits of concomitant use of corticosteroids and the potential risk of systemic corticosteroid reactions should be considered, and the patient should be monitored for the occurrence of the above adverse reactions.

Contraindications

Hypersensitivity to the active substance, mometasone furoate, or any excipient. NASONEX nasal spray should not be used in the presence of an untreated localized infection involving the nasal mucosa, such as herpes simplex. Because corticosteroids slow wound healing, intranasal corticosteroids should not be administered to patients who have recently undergone surgery or nasal trauma until the wounds have completely healed.

Compound

1 dose of spray contains mometasone furoate monohydrate in an amount equivalent to 50 mcg of mometasone furoate (anhydrous); excipients: dispersed cellulose, glycerin, sodium citrate dihydrate, citric acid, polysorbate-80, benzalkonium chloride, purified water.

Overdose

Symptoms Inhalation or oral administration of excessive doses of corticosteroids can lead to inhibition of the function of the hypothalamic-pituitary-adrenal axis. Treatment Due to the fact that the systemic bioavailability of NASONEX nasal spray is

Side effect

Summary of Safety Profile Nosebleeds were generally self-limiting, mild, and occurred slightly more frequently than with placebo (5%) but less frequently than with other intranasal corticosteroids used as active controls in allergic rhinitis clinical trials. (in some of them, the incidence of nosebleeds was up to 15%). The incidence of all other adverse reactions was comparable to that observed with placebo. In patients treated for nasal polyps, the overall incidence of adverse reactions was similar to that observed in patients with allergic rhinitis. Systemic effects may occur with nasal corticosteroids, especially at high doses and with long-term use. List of Adverse Reactions Table 1 summarizes the treatment-related adverse reactions (≥1%) reported in clinical trials in patients with allergic rhinitis or nasal polyps and in post-marketing reports, regardless of indication. Adverse reactions are presented according to the MedDRA major organ system class. Within each organ system class, adverse reactions are categorized based on frequency. Frequency categories were as follows: very often (? 1/10); often (? 1/100 and

Storage conditions

Store at a temperature not exceeding 25 °C, out of the reach of children. Do not freeze.