Sterinitis nasal spray 50mcg dose 140 doses
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Active ingredients
Mometasone
Release form
Spray
Composition
Active ingredient: Mometasone Concentration of active ingredient (mcg): 50 mcg
Pharmacological effect
GCS for local use. Mometasone has anti-inflammatory and anti-allergic effect. The local anti-inflammatory effect of the drug is manifested when it is used in doses that do not cause systemic effects. It slows down the release of inflammatory mediators. It 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 products of the metabolism of arachidonic acid - cyclic endoperoxides, prostaglandins. It warns the regional accumulation of neutrophils, which reduces inflammatory exudate and production of lymphokines, inhibits the migration of macrophages, leads to a decrease in the processes of infiltration and granulation. Reduces inflammation by reducing the formation of chemotaxis substance (effect 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 the mast cells). The nasal cavity was shown to have a high anti-inflammatory activity of the drug, both in the early and in the later stages of the allergic reaction. When compared with placebo, a decrease in the level of histamine and eosinophil activity, as well as a decrease (compared to baseline) in the number of eosinophils, neutrophils and proteins of epithelial cells were found.
Pharmacokinetics
With intranasal use, mometasone fuorate has a systemic bioavailability of less than 1% (with a detection method sensitivity of 0.25 pg / ml). A small amount of active substance that can get into the gastrointestinal tract with intranasal use is absorbed to a small extent and is actively biotransformed when it first passes through the liver.
Indications
For inhalation use: basic therapy of asthma of any severity; COPD. For intranasal use: treatment of seasonal and perennial allergic rhinitis in adults, adolescents and children from 2 years; acute sinusitis or exacerbation of chronic sinusitis in adults (includingold age) and adolescents from 12 years of age (as an auxiliary therapeutic agent for antibiotic treatment); acute rhinosinusitis with mild and moderately severe symptoms without signs of severe bacterial infection in patients aged 12 years and older; prevention of seasonal allergic rhinitis of moderate and severe course in adults and adolescents from the age of 12; nasal polyposis, accompanied by a violation of nasal breathing and smell in adults.
Contraindications
Hypersensitivity to mometasone. For inhalation use: children's age up to 12 years. For intranasal use: recent surgery or injury of the nose with damage to the nasal mucosa before healing of the wound (due to the inhibitory effect of GCS on healing processes); children and adolescents up to 18 years with nasal polyposis; children up to 12 years with acute sinusitis or exacerbation of chronic sinusitis; Children up to 2 years with seasonal and year-round allergic rhinitis.
Precautionary measures
Do not exceed the recommended dose. With caution, you should prescribe the drug for tuberculosis (active or latent) of the respiratory tract; fungal, bacterial or systemic viral infection (including Herpes simplex with eye damage); long-term therapy GCS; the presence of untreated local infection with involvement in the process of the nasal mucosa; pregnancy and breastfeeding.
Use during pregnancy and lactation
Special studies on the safety of mometasone during pregnancy and during breastfeeding have not been carried out. As with other nasal GCS, Desrinit should be prescribed during pregnancy and lactation only if the expected benefit to the mother outweighs the potential risk to the fetus and baby Newborns whose mothers used GCS during pregnancy should be carefully examined to identify possible adrenal hypofunction.
Dosage and administration
The dosage regimen is set individually, depending on the evidence, the age of the patient, the method of administration, the dosage form used.
Side effects
On the part of the respiratory system: during inhalation use for the treatment of bronchial asthma, bronchospasm may develop and the number of wheezing in the lungs may increase immediately after inhalation; intranasal nasal bleeding, pharyngitis, burning sensation in the nose, sneezing are possible; irritation of the nasal mucosa; very rarely with intranasal use - cases of perforation of the nasal septum. Systemic effects (especially when used in high doses and for a long time): during inhalation use - suppression of the function of the adrenal cortex, growth retardation in children and adolescents, bone demineralization, glaucoma, increase intraocular pressure (occurs in some cases with intranasal use), the development of cataracts. Allergic reactions: with post-marketing use in isolated cases - manifestations are higher Noah sensitivity, such as rash, itching, angioneurotic edema and anaphylactic reaction. It was reported about the worsening of the course of asthma, which can manifest itself as coughing, shortness of breath, wheezing and bronchospasm. Others: intranasal use may cause headache.
Overdose
The drug has a low (less than 1%) systemic bioavailability, so it is unlikely that overdose will require taking any special measures other than observation and subsequent administration at the recommended dose. With prolonged use of GCS in high doses or with simultaneous use of several GCS, hypothalamic depression may occur. pituitary-adrenal system.
Interaction with other drugs
The simultaneous use of mometasone with loratadine did not lead to a change in the concentration of loratadine or its main metabolite in the blood plasma, while the presence of mometasone was not determined even at the minimum concentration in the plasma. Studies of the drug interaction of mometasone with other drugs were not carried out.
special instructions
When using mometasone for 12 months, no signs of atrophy of the nasal mucosa were noted. In the study of biopsy specimens of the nasal mucosa, it was revealed that mometasone showed a tendency to normalize the histological picture.When using the drug for a long time (as with any long-term treatment), a periodic examination of the nasal mucosa by an otorhinolaryngologist is necessary. When a local fungal infection of the nose or pharynx develops, it is recommended to stop the treatment with the drug and begin specific therapy. shell of the nasal cavity and pharynx is an indication for drug withdrawal. With long-term use of the drug, signs of suppression of the function of the hypothalamus pofizarno-adrenal system is not nablyudalos.Patsienty who switch to mometasone therapy after prolonged treatment with systemic corticosteroids, require special attention. Canceling GCS of a systemic action in these patients may lead to a lack of adrenal function, which may require taking appropriate measures. During the transition from treatment of GCS of a systemic action to mometasone, some patients may experience symptoms of GCS withdrawal for systemic use (for example, joint pain and / or muscles, feeling tired, depressed), despite the reduction in the severity of symptoms associated with lesions of the nasal mucosa, such patients must be specifically convincing in order to aznosti continuation of treatment Dezrinit. The transition from systemic corticosteroids to local corticosteroids can also reveal pre-existing, masked therapy with corticosteroids of systemic action, allergic diseases such as allergic conjunctivitis and eczema. completely cover the nasal cavity. Unilateral polyps of irregular shape or bleeding should be further examined. Patients undergoing GCS therapy have reduced immune reactivity, therefore they should be warned about the increased risk of infection when they come into contact with patients with certain infectious diseases (for example, chicken pox, measles), and also medical consultation, if such contact has occurred. With prolonged use of nasal GCS in high doses may develop systemic side effects.The likelihood of these effects is much less than with the use of systemic corticosteroids, and may vary in individual patients, as well as between different corticosteroids. Potential systemic effects include Cushing's syndrome, characteristic signs of cushingoid, suppression of adrenal function, growth retardation in children and adolescents, cataracts, glaucoma, and, rarely, a number of psychological or behavioral effects, including psychomotor hyperactivity, sleep disturbance, anxiety, depression, or aggression (especially in children). It is recommended to regularly monitor the growth of children receiving long-term therapy with mometasone. When growth is slowed down, ongoing therapy should be reviewed in order to reduce the dose of mometasone to the minimum effective one, allowing to control the symptoms of the disease. In addition, the patient should be referred for consultation to the pediatrician. The treatment of GCS in doses exceeding the recommended ones can lead to clinically significant inhibition of adrenal function. If it is known that GCS is used in high doses, it is necessary to consider the possibility of additional use of systemic GCS during periods of stress or planned surgical intervention. Impact on the ability to drive motor vehicles and control mechanisms Investigations to study the effect on the ability to drive vehicles and mechanisms have not been carried out.