Mometasone spray analogues

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Nasonex

Description current as of 11/11/2015

  • Latin name: Nasonex
  • ATX code: R01AD09
  • Active ingredient: Mometasone furoate
  • Manufacturer: Schering-Plough Central East AG, Belgium

Compound

One dose of spray contains 50 mcg of anhydrous mometasone furoate and auxiliary components: dispersed cellulose (sodium carboxymethylcellulose and MCC), glycerin, citric acid, polysorbate-80, sodium citrate dihydrate, benzalkonium chloride solution, purified water.

Table of contents:

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.

pharmachologic effect

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

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 activity and histamine levels, 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 runny nose, 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.

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 spray from the age of two. For the treatment of sinusitis in pediatrics, it is used in children over twelve years of age.

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 virus 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.

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:

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.

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. Total dose kg/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. Total dose kg/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, temper himself, 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.

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 may be inhibited.

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.

Interaction

Patients tolerate combination therapy with Loratadine well. Drug interactions with other drugs have not been studied.

Terms of sale

Storage conditions

The spray bottle should be stored at a temperature of 2-25°C. Freezing the drug is unacceptable.

Best before date

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:

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 therapy.

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.

What can replace Nasonex?

What analogues are cheaper than Nasonex?

The price of Nasonex analogues is from 128 rubles. The most inexpensive substitute for Nasonex is Desrinit nasal spray.

What is better Nasonex or Avamis?

Avamys is available in the 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, which 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%.

Among all existing corticosteroids for intranasal administration, 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 conducted 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 group was more pronounced (45%) compared with the mometasone group (36%) and the placebo group (11%).

Patients receiving fluticasone were less likely than patients receiving 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 spray 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 rubles for 120 doses).

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 hypofunction of the adrenal cortex.

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 for years 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.

Doctors' reviews of Nasonex allow us to conclude that endonasal corticosteroids do not completely cure polypous rhinosinusitis and allergic rhinitis, but are able to completely - and as quickly as possible - relieve the symptoms of allergic rhinitis and significantly delay the timing of relapse of nasal polyp growth.

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

How much does Nasonex cost?

Price in Ukraine

Price of Nazonex Sinus (60 doses) in large cities of Ukraine (Kharkov, Kyiv, Dnepropetrovsk, etc.) 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.

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Nasonex (Mometasone)

There are contraindications. Before starting use, consult your doctor.

Commercial names abroad (abroad) - Nasomet, Rinelon, Rinoval.

Other glucocorticosteroids (hormones) for the nasal cavity - Nasobek.

All medications for the treatment of the nasal cavity and sinuses are here.

All drugs used in ENT practice are here.

Mometasone preparations for external use are here.

You can ask a question or leave a review about the medicine (please, do not forget to indicate the name of the drug in the text of the message) here.

Preparations for topical use in ENT practice containing Mometasone (Mometasone, ATC code R01AD09):

Nasonex - instructions for use. The drug is a prescription, the information is intended only for healthcare professionals!

Clinical and pharmacological group

GCS for intranasal use (glucocorticosteroid for administration into the nasal cavity).

pharmachologic effect

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 (due to inhibition of the production of arachidonic acid metabolites and a decrease in 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 the early and late stages of the 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.

Pharmacokinetics

When administered intranasally, the systemic bioavailability of mometasone furoate is <1% (with a sensitivity of the detection method of 0.25 pg/ml).

Mometasone is very poorly absorbed from the gastrointestinal tract.

Metabolism and excretion

A small amount of the active substance that can enter the gastrointestinal tract after intranasal administration undergoes active metabolism during the “first pass” through the liver. Excreted in urine and bile.

Indications for use of the drug NAZONEX®

  • treatment of seasonal and year-round allergic rhinitis in adults, adolescents and children over 2 years of age;
  • acute sinusitis or exacerbation of chronic sinusitis in adults (including the elderly) and adolescents over 12 years of age - as an auxiliary therapeutic agent in treatment with antibiotics;
  • acute rhinosinusitis with mild to moderate symptoms without signs of severe bacterial infection in patients aged 12 years and older;
  • prevention of moderate and severe seasonal allergic rhinitis in adults and adolescents from 12 years of age (recommended 2-4 weeks before the expected start of the dusting season);
  • Nasal polyposis, accompanied by impaired nasal breathing and sense of smell in adults.

Dosage regimen

The drug is used intranasally (in the nose).

Treatment of seasonal or year-round allergic rhinitis:

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

The recommended preventive and therapeutic dose of the drug is 2 inhalations (50 mcg each) into each nostril 1 time per day (total daily dose mkg). Upon achieving a therapeutic effect for maintenance therapy, it is possible to reduce the dose to 1 inhalation in each nostril 1 time per day (total daily dose kg).

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 once a day (total daily dose). 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

The recommended therapeutic dose is 1 inhalation (50 mcg) into each nostril 1 time per day (total daily dose kg).

To use the drug in young children, adult assistance is required.

Adjuvant treatment of acute sinusitis or exacerbation of chronic sinusitis:

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

The recommended therapeutic dose is 2 inhalations (50 mcg each) into each nostril 2 times a day (total daily dose kg).

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). After the symptoms of the disease decrease, a dose reduction is recommended.

Treatment of acute rhinosinusitis without signs of severe bacterial infection:

The recommended dose for adults and adolescents is 2 inhalations of 50 mcg in each nostril (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 of age, the recommended therapeutic dose is 2 inhalations (50 mcg each) into each nostril 2 times a day (total daily dose).

After the symptoms of the disease have reduced, it is recommended to reduce the dose to 2 inhalations (50 mcg each) into each nostril 1 time per day (total daily dose kg).

Rules for using 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, a stereotyped delivery of the drug is established, in which each press of the dosing device releases approximately 100 mg of a suspension containing mometasone furoate (as monohydrate) in an amount equivalent to 50 μg of mometasone furoate anhydrous. 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.

Side effect

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 use of the drug NAZONEX®

  • recent surgery or trauma to the nose with damage to the mucous membrane of the nasal cavity - before the wound heals (due to the inhibitory effect of GCS on the healing processes);
  • children's age (for seasonal and year-round allergic rhinitis - up to 2 years, for acute sinusitis or exacerbation of chronic sinusitis - up to 12 years, for polyposis - up to 18 years) - due to the lack of relevant data;
  • hypersensitivity to the components of the drug.

The drug should be used with caution in case of tuberculosis infection (active or latent) of the respiratory tract, untreated fungal, bacterial, systemic viral infection or infection caused by Herpes simplex with eye damage (as an exception, the drug can be prescribed for these infections as directed by a doctor), the presence of untreated local infection involving the nasal mucosa.

Use of the drug NASONEX® during pregnancy and breastfeeding

There have been no special, well-controlled studies of the safety of Nasonex® during pregnancy.

Like other corticosteroids for intranasal use, Nasonex® should be prescribed during pregnancy and breastfeeding only if the expected benefit from its use justifies the potential risk to the fetus or infant.

Infants whose mothers received corticosteroids during pregnancy should be carefully examined to identify possible adrenal hypofunction.

Use for liver dysfunction

A small amount of the active substance, which can enter the gastrointestinal tract during intranasal use, is absorbed to a small extent and is actively biotransformed during the “first pass” through the liver.

special instructions

When using the drug for a 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 special treatment. 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.

With long-term use of the drug, no signs of suppression of the function of the hypothalamic-pituitary-adrenal system were observed.

Patients who switch to treatment with Nasonex® nasal spray after long-term therapy with systemic GCS require special attention. Withdrawal of systemic corticosteroids in such patients can lead to adrenal insufficiency, the subsequent recovery of which may take up to several months. If symptoms of adrenal insufficiency appear, you should resume taking systemic corticosteroids and take other necessary measures.

During the transition from treatment with systemic corticosteroids to treatment with Nasonex® nasal spray, some patients may experience withdrawal symptoms of systemic corticosteroids (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. A change in therapy may also reveal previously developed allergic diseases, such as allergic conjunctivitis and eczema, which were previously masked by systemic corticosteroid therapy.

Patients who have undergone GCS therapy have a potentially reduced immune reactivity and should be warned about the increased risk of infection when contacting patients with infectious diseases (including chickenpox, measles), as well as the need to consult a doctor if such contact occurs.

If signs of a severe bacterial infection appear (for example, fever, persistent and sharp pain on one side of the face or toothache, swelling in the orbital or periorbital area), immediate consultation with a doctor is required.

After using Nasonex® for 12 months, there were no signs of atrophy of the nasal mucosa. When studying biopsy samples of the nasal mucosa, it was revealed that mometasone furoate tended to contribute to the normalization of the histological picture.

Use in pediatrics

In placebo-controlled clinical studies in children, when Nasonex® was used at a dose of 100 mcg per day for a year, no growth retardation was observed.

Overdose

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.

The drug has low systemic bioavailability (< 1%, with a sensitivity of the detection method of 0.25 pg/ml), so it is unlikely that in case of accidental or intentional overdose, any special measures will be required other than observation and possible subsequent resumption of the drug at the recommended dose.

Drug interactions

The simultaneous use of Nasonex® with loratadine did not lead to changes in the concentration of loratadine or its main metabolite in the blood plasma. In these studies, mometasone furoate was not detected in plasma (with a sensitivity of the detection method of 50 pg/ml). Combination therapy with loratadine was well tolerated by patients.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature of 2° to 25°C; do not freeze. Shelf life: 2 years.

Source: http://xn—-7sbabkdpwufdsp9apq.xn--p1ai/nasonex

Active substance 'Mometasone'

Service quality assessment: (4.92); completed orders: (92%)

Pharmacy 'Nova Vita'. Active substance 'mometasone'.

Service quality assessment: (4.85); completed orders: (83%).

Pharmacy 'Neo-pharm'. Active substance 'mometasone'.

Service quality assessment: (4.83); completed orders: (88%).

Pharmacy 'Nova Vita'. Active substance 'mometasone'.

Service quality assessment: (4.85); completed orders: (79%)

Pharmacy 'Beauty Laboratory'. Active substance 'mometasone'.

Service quality assessment: (4.8); completed orders: (82%)

Pharmacy 'Koptevskaya'. Active substance 'mometasone'.

Service quality assessment: (4.82); completed orders: (74%)

Pharmacy 'Farmer-M'. Active substance 'mometasone'.

Mometasone - mechanisms of action, effects and areas of application:

Today in pharmacies

We wish you good health!

Synonymous and analog replacement. Selection of analogues, generics, synonyms.

Replacement of the active ingredient 'mometasone'.

Search for 'mometasone' in Moscow pharmacies.

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Source: http://amt-apteka.ru/sinonim/mometazon.html

Nasonex - analogues

Despite the fact that side effects when using the drug Nasonex occur relatively rarely, in some cases they are possible.

When should Nasonex be replaced?

The most common undesirable manifestations are:

  • nosebleeds;
  • pharyngitis;
  • increased intraocular pressure;
  • malfunction of the adrenal glands.

There are contraindications to the use of Nasonex related to:

  • with the patient's childhood;
  • tuberculosis of the respiratory system;
  • hypersensitivity to the components of the drug.

In addition, it is prohibited to use the drug after a nasal injury or surgery on the nasopharynx.

In all of these cases, it is necessary to replace Nasonex with analogue drugs. Let's look at what medications similar to Nasonex spray are recommended for use by experts.

Analogues of the drug Nasonex

The list of drugs analogous to the active substance of Nasonex spray is quite impressive. Among the structural analogues it should be noted:

The active ingredients contained in these medicinal analogues of Nasonex have a similar effect, so the decision on the use of a particular drug is usually made by the attending physician. Sometimes the cost of the drug is decisive in choosing a medicine. Currently, Nasonex costs approximately 6 USD. Let's consider the comparative characteristics and cost of ointments and nasal drops that are analogues of Nasonex.

Avamys spray, produced in the UK, is perhaps the most famous of Nasonex analogues. The drug also has anti-inflammatory and antiallergic effects. Avamis can replace Nasonex if increased reactivity is observed when using the latter. For many, price is significant when choosing one of the sprays, and they prefer Avamis for this reason. Its cost is approximately 20% lower.

The active substance in Nazarel spray is fluticasone propionate. Experts emphasize that the effectiveness of Nazarel and Nasonex is approximately the same. But Nazarel costs around 5 USD, so we can say that its price is about % lower.

The Israeli drug Dezrinit is a spray intended for intranasal and inhalation use for allergic manifestations and inflammatory processes in the nasopharynx. The indications for use of Dezrinit and Nasonex are similar, but in addition, Dezrinit is used in the form of inhalations in the treatment of bronchial asthma and COPD (chronic obstructive pulmonary disease). The cost of the drug Desrinit is comparable to the price of Nasonex, and ranges from 5 to 6 USD.

Flixonase nasal spray is also a British-made pharmaceutical product. An aerosol drug is used for the prevention and treatment of seasonal and year-round allergic rhinitis. The cost of Flixonase is almost twice as high as that of Nasonex (approximately 10 USD).

Uniderm is a drug in which the active substance is mometasone, as in Nasonex. The product is available only in the form of a cream, therefore it is not suitable for use in the treatment of respiratory organs, but is used exclusively for skin allergic diseases.

Gistan N is a 0.1% cream made in India, used for allergy symptoms. When compared by price, a tube of Gistan N costs much less than Nasonex aerosol. Now the price of the drug Gistan N is less than 2 USD.

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Source: http://womanadvice.ru/nazoneks-analogi

Substitutes for Nasonex nasal spray for children and adults - list of drugs with descriptions, composition and prices

In case of allergic rhinitis, it is appropriate for a child to use Nasonex nasal spray according to the instructions - analogues are also highly effective and help solve the health problem that has arisen. Before making a choice, you need to consult with your doctor, especially when it comes to a child’s body. Nasonex and analogues are especially popular in ENT practice, as they eliminate a runny nose and internal discomfort in the shortest possible time. All that remains is to choose the most effective medicine in a given direction.

What is Nasonex

This representative of the group of glucocorticosteroids is necessary for intranasal use. The active ingredient is mometasone furoate. In the body it demonstrates anti-inflammatory, immunostimulating, antibacterial, antiallergic properties, and provides a local effect directly on the pathological site. The active component in small concentrations is absorbed into the systemic circulation, disintegrates in the liver, and is excreted by the kidneys. The drug has non-toxic pharmacological properties, so the list of side effects is not extensive.

The medication is prescribed for allergic rhinitis, sold in pharmacies, and sold without a prescription. Nasonex is produced in the form of a water-based nasal spray, intended for external use. Recommended for other allergic diseases that are accompanied by a severe runny nose, sore throat, and rhinitis. With long-term use of hormonal drugs, doctors prescribe alternating medications, avoiding the “addictive effect.” In this way, you can suppress inflammatory processes, speed up the removal of infection and ensure recovery.

Instructions for use

If symptoms of allergic rhinitis suddenly arise, the first step is to determine the etiology of the pathological process in a laboratory and eliminate the provoking factor. Then the patient is prescribed conservative treatment, which includes Nasonex nasal drops or its analogues for a full course. For intranasal use, daily doses of a typical medication are presented in detail below:

  • children 2-12 years old - 2 injections into each nostril once a day (preferably at the same time) for 5-7 days;
  • patients over 12 years of age and adults - 2 injections into each nostril twice a day - preferably in the morning and evening;
  • for chronic sinusitis, Nasonex is prescribed in combination with antibiotics in a volume of 2-4 injections into each nostril twice a day for a week;
  • if the symptoms of the disease characterize a severe pathological process in the body, it is recommended to take Nasonex in a high dose - 4 injections into each nostril a week;
  • Before using the medicine, the bottle must be shaken well, a control injection into the air must be performed, and after use, the medicine must be stored in the refrigerator, in a dark place;
  • the period of use of Nasonex spray is about 5-7 days, after which you need to take a break and individually adjust the daily dosage according to indications;
  • there is a drug interaction, and this fact must be taken into account when choosing a complex treatment regimen for rhinitis or another disease with symptoms of a runny nose.

Analogs

If the medicine is not suitable, or turns out to be ineffective in relation to the focus of the pathology, doctors prescribe an analogue of Nasonex Desrinit or another medicine as part of GCS therapy. For example, such a replacement is necessary when nosebleeds occur, in chronic diseases of the adrenal glands, or in the complete absence of an antiallergic effect. Before ordering one of Nasonex's analogues, if you have an allergic disease, it is recommended to consult with your doctor.

Cheaper analogue of Nasonex

If it is decided to urgently replace Nasonex, the price of the analogue is also of great importance for the patient. I would like to get an effective medical drug of a budget option that will act effectively and without side effects. Among the local glucocorticosteroids, the following medications are cheap; instructions for use are included in each package:

Nasonex analogue for children

This medication is prescribed in pediatrics for the treatment of adenoids. The use of a nasal spray is appropriate in childhood; the main thing is to choose an effective and hypoallergenic composition. In case of an allergic disease, it is recommended to first study the components of the drug in order to ultimately achieve the desired clinical effect without complications and health problems. It is also important to take into account the patient’s age and the cost of the supposed favorites. In case of exacerbation, effective analogues appropriate for children are presented below:

Review of effective analogues

If after long-term therapy Nasonex does not help, the doctor recommends an analogue. The list of medications of this pharmacological group is extensive; buying a medicine in an online store from a catalog will be much more profitable. Since Nasonex is a hormonal drug, in practice there are cases of a gradual weakening of the therapeutic effect upon repeated administration. The body, living on medicinal substances, adapts and develops the so-called “acquired immunity to chemistry.” This is where the urgent need for analogues arises.

Mometasone spray

A typical medication has an antiallergic effect in the body, relieves itching and inflammation. The active component is mometasone furoate, which has a concentration of 50 mcg per 100 ml of the drug. The use of intranasal inhalations enhances the therapeutic effect if antibiotics are additionally used. By regularly treating the lining of the nasal passages, nasal breathing becomes easier and allergy symptoms disappear. The use of nasal spray is allowed only on the recommendation of the attending physician.

Desrinitis

The Israeli medicine Dezrinit is an excellent remedy for acute and chronic runny nose. This pharmacological prescription is appropriate for obstructive pulmonary disease and bronchial asthma. The active component is mometasone furoate monohydrate, which has anti-inflammatory, antiallergic and antipruritic properties. It is recommended for use by adults and children, especially with seasonal allergic reactions of the body. When choosing Nasonex or Desrinit spray, it is advisable to give preference to the second medication with a gentle effect in the body

Avamis

This English analogue of Nasonex is used to treat allergic rhinitis and is approved in childhood and pregnancy. Reviews of the therapy completed with his participation have only positive content. If Nasonex was prescribed, but the medication was not suitable for a particular clinical picture, this is an inexpensive replacement with identical pharmacological properties. There are almost no side effects during treatment, and you can finally get rid of the unpleasant signs of allergic rhinitis.

Flixonase or Nasonex - which is better?

Both drugs have a pronounced anti-inflammatory effect and contain synthetic components in their chemical composition. The choice must be made in favor of the favorite. Voicing a list of analogues, the specialist recommends Flixonase spray. It is much more effective, but the price is much higher. Among systemic glucocorticosteroids, this is the best representative, thanks to which systemic measures are carried out that can stabilize the patient’s general condition in the shortest possible time.

Nasobek or Nasonex - which is better?

I examine the nasal mucosa; the otolaryngologist can detect polyps. Using Nasonex spray is not always effective, so doctors prescribe a more effective analogue - Nasobek. This is a nasal spray, which is indicated for treating the nasopharyngeal cavity twice a day for 7-10 days. Longer treatment is not recommended, since the therapeutic effect will weaken, and an analogue from the pharmacological group of GCS will again be required. In addition, in this way you can completely get rid of the systemic effects of allergies and provide reliable prevention of seasonal rhinitis.

Nasonex or Nazarel - which is better?

For rhinitis of various etiologies, it is better to use special sprays to treat the mucous membranes of the nasal passages than nasal drops. This is explained by the extensive area of ​​irrigation of the affected surface. Nasonex and Nazarel operate on the same principle and are complete analogues. However, the cost of Nazarel is 20% lower. This medicine can be safely prescribed even to a child, but at the same time do not violate the daily dose and do not delay the duration of the treatment course.

Many young parents know how much Nasonex costs, and consider this price too high. Therefore, they are looking for a more affordable alternative with a high therapeutic effect for their child. Such a replacement can be introduced only with the permission of the local pediatrician, otherwise complications may include not only local and allergic reactions, but also nosebleeds, dry mucous membranes, etc. In the online store, prices are more affordable, delivery is fast, and regular customers also get discounts. So the choice is up to the buyer.

The final prices of Nasonex spray and its full analogues in real pharmacies in Moscow are presented in detail below, however, the medications themselves for external use should not become a means of superficial self-medication for a clinical patient. A consultation with an otolaryngologist will not be superfluous. So:

Name of the medicine

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The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

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