Nasonex for children: instructions for use

Nasonex is called one of the most effective local hormone medications. It is often prescribed for adults with various forms of rhinitis, especially if the disease has an allergic nature. But is such a drug approved for treating children, how does it affect the children's body and how can it be dangerous for babies?

Nasonex is produced in only one form, which is a spray for use in the nose. It is dosed and sold in two quantities:

• Bottle weighing 10 g, containing 60 doses. One box contains one such polyethylene bottle equipped with a dispensing device.
• A bottle weighing 18 grams, inside which there are 120 doses of medicine. In one pack there can be 1, 2 or 3 such plastic bottles having a dosing device.

Nasonex action provides a substance called mometasone furoate. This compound is represented by monohydrate and is micronized. From each dose of the drug, the patient receives it in an amount of 50 μg. Additionally, the suspension contains dispersed cellulose, benzalkonium chloride, citric acid and glycerol, as well as purified water, sodium citrate and polysorbate 80. Such substances are needed to preserve the drug in liquid form and prevent its damage.

Mometasone is a glucocorticoid hormone, so it has anti-allergic and anti-inflammatory effects. When using the spray in doses that are recommended in the annotation, its active substance acts only locally and no systemic effects occur (it is absorbed in amounts less than 1%). The use of Nasonex leads to:

• inhibition of the process of release of substances which are inflammatory mediators;
• increased lipomodulin production, as a result, arachidonic acid metabolism is inhibited, which also affects the activity of inflammation and allergic reaction;

• preventing the accumulation of neutrophilic leukocytes at the site of inflammation, whereby the exudate is reduced, the movement of macrophages is inhibited, and granulation and infiltration are reduced.

Due to these effects, Nasonex not only eliminates the inflammatory process, but also inhibits allergic reactions (especially of the immediate type). Due to the glycerin in the composition, the suspension does not provoke drying, but, on the contrary, moisturizes the nasal cavity, which contributes to the regeneration of the epithelium.

The therapeutic effect of the drug in most patients begins to appear 12 hours after the first use of the spray. A lasting effect of therapy develops by the 5-7th day of the use of the medicine. However, even with prolonged use, addiction to mometasone does not develop.

Nasonex prescribed:

• With year-round allergic rhinitis.
• With the seasonal form of allergic rhinitis.
• In acute sinusitis (with antibiotics or antiviral drugs, if inflammation provoked ARVI).
• In the chronic course of sinusitis during the exacerbation of the disease (in combination with other medications).

• With moderate and mild course of acute rhinosinusitis.
• To prevent severe or moderate seasonal runny nose caused by plant pollen allergens.
• In the presence of polyps in the nose (the drug is prescribed only for adults).

The drug is contraindicated in children under 2 years of age, and from the age of two it is prescribed only for the treatment of rhinitis. For prophylactic purposes, as well as for inflammation of the sinuses, Nasonex is recommended to be used in children only from the age of 12, and for nasal polyposis, the drug is not indicated until 18 years.

Spray can not be used in children with hypersensitivity to any of the components of the suspension. Also, the drug is harmful for patients who have recently undergone surgery in the nasopharynx or injured nasal mucosa. In such situations, the medication is not prescribed until complete healing.

Patients with tuberculous lesion of the respiratory system, an active bacterial or fungal infection require the attention of the doctor when using Nazonex. In addition, the tool must be injected carefully and with serious viral infections, including infection with the herpes simplex virus. The question of the use of drugs in children with local changes in the mucous membrane of the nasopharynx is solved individually.

The use of Nasonex in children sometimes provokes the appearance of:

• headache;
• nosebleeds;
• sneezing;
• irritation of the mucous membrane.

In adolescents, the spray can occasionally cause a burning sensation in the nose, ulceration of the mucous membrane or pharyngitis. In rare cases, the drug provokes bronchospasm, anaphylaxis or another allergic reaction, and also violates the sense of smell and taste. Extremely rare side effects during treatment with Nasonex are called an increase in intraocular pressure and perforation of the nasal septum.

Theoretically, a very long use of the drug can cause side effects such as growth retardation, fungal infection of the nasopharynx, Cushing's syndrome, glaucoma, sleep disturbance, aggressive behavior, and other problems. However, studies have shown that even long-term treatment with a spray does not provoke systemic effects, because the drug is absorbed in very small quantities.

Instructions for use. A child aged 2 to 11 years old is prescribed one inhalation, first in one nostril, and then in the second. The drug should be used once a day, as the total dose of the drug per day for patients younger than 12 years is 100 µg mometasone. To properly spray the suspension to young children, the help of adults is needed:

• Before first use press the dispensing nozzle several times until splashes appear. The same actions are needed if the spray has not been used for more than 14 days.
• Slightly bent the child’s head to the side, The tip of the nozzle is inserted into the nostril and press the dispenser device once. Further, medication is also administered in the second nasal passage.

• Before each use of nasonex The bottle should be shaken so that the suspension in the nose is homogeneous.
• If the medicine is used for a long time, The dosing nozzle must be periodically cleaned by washing its tip and protective cap in warm water. When these items are dry, they are carefully attached back to the bottle.

For adolescents 12 years and older, for allergic rhinitis, both for treatment and prophylaxis, 200 μg of mometasone is prescribed per day, which corresponds to two inhalations of Nasonex in each nasal passage. The spray is used in this dosage once, and when the therapeutic effect is achieved, the dose can be reduced to 1 inhalation in each nasal passage once a day (only 100 μg of active compound). In the case when the use of 2 inhalations does not relieve nasal congestion, itching and other symptoms, it is possible to increase the daily dosage to 400 μg of mometasone, that is, to four inhalations of the drug in each nasal passage.

With sinusitis and rhinus in a child over 12 years old, the drug is prescribed in a single dose of 100 micrograms per each nostril (two inhalations at once) twice a day. In total, for the treatment of such diseases, the patient receives 400 micrograms per day, but if not effective, this dosage may increase to 800 micrograms (four inhalations in each nostril twice a day).

Exceeding the dose of spray one or several times often does not affect the health of the patient and requires only observation, since the mometasone system bioavailability is very low. However, prolonged excess dosage of Nasonex or a combination of such agents with other glucocorticoids can cause adrenal suppression.

Studies have shown the safety of the simultaneous use of Nasonex and drugs loratadine. The manufacturer does not mention the incompatibility of the spray with other means.

Acquisition of Nasonex in a pharmacy is possible only if you have a prescription from an ENT specialist, pediatrician, or other specialist. The average price of a 60-dose bottle is 440-450 rubles, And for a bottle weighing 18 grams you need to pay from 700 to 800 rubles.

Keep the spray at home is recommended at a temperature +2 - +25 degrees, preventing freezing or overheating of the suspension. The expiration date of Nasonex is 2 years and marked on the box. After its completion, the medication should be discarded.

About the treatment of children Nasoneksom found a lot of positive feedback from both doctors and parents. Pediatricians and ENT doctors (including Dr. Komarovsky) call this spray effective and safe. Moms also confirm that the drug is effective for allergies and alleviates the condition of the child with a cold. Although the cost of the medication is called rather high, but doctors say that Nasonex works better than its peers and is more studied, so it is preferable for treating young patients.

To replace Nasonex with a cold in children, the doctor may prescribe another remedy based on mometasone, for example, Nozephrine or Scattering. Such medications are also represented by a dosed nasal spray and contain 50 µg of mometasone furoate in a single dose. These drugs have the same indications, age limits and possible side effects as with Nasonex. However, their cost is much lower, so these sprays are chosen when looking for an inexpensive equivalent.

In addition to drugs containing mometasone, other local glucocorticoid drugs can be used in the treatment of rhinitis, for example:

• Avamys. The effect of such a spray is provided by fluticasone furoate. The drug is prescribed to children over 2 years with allergic rhinitis.
• Fliksonaze. The composition of such a nasal spray also contains fluticasone, but in the form of propionate. The drug is used in the treatment of protracted rhinitis, triggered by allergens, prescribing it from 4 years of age.
• Nasarel. This metered spray is another fluticasone propionate preparation and, like Fliksonaze, is used in young patients over four years old.

• Dexamethasone. Such eye drops ENT doctors can prescribe in the form of drops in the nose, often combining them with other medicines (antibiotics, antiseptics, vasoconstrictor, etc.), creating "complex drops." The use of Dexamethasone in the nose is considered an emergency and is not recommended without a doctor's prescription.
• Polydex with phenylephrine. This combined agent, including dexamethasone, two antibacterial substances and an adrenergic mimic, is prescribed to children from 2.5 years. It is used for rhinopharyngitis, rhinitis, sinusitis and other sinusitis, if the cause of such diseases are bacteria.Separately produced drug Polydexused in otitis.
• Nasobek. Beclomethasone is the main ingredient of this spray. The medication is prescribed for children with rhinitis caused by allergies from 6 years of age.

Dr. Komarovsky will tell you about how to treat children’s rhinitis in the video below.