Desrinit - instructions for use, analogues, difference from Nasonex, composition

Release forms, description and composition

Desrinit is a nasal spray, which is available in special bottles with a dispenser of 60 or 140 doses. The active ingredient of the spray is mometasone furoate, a topical glucocorticosteroid.

Nasal glucocorticosteroids have low bioavailability and rapid metabolic inactivation, so systemic adverse effects are rare. Topical glucocorticosteroids are characterized by a late onset of action and slow development of effect. The action of Desrinit begins after 12 hours.

pharmachologic effect

Anti-inflammatory effect is achieved through:

suppression of the activity of the enzyme Phospholipase A2, which leads to disruption of the formation of arachidonic acid, a precursor of prostaglandins and leukotrienes;
stabilization of cell membranes.

The antiallergic effect is achieved by reducing allergy mediators (histamine, heparin, leukotrienes, prostaglandins), which are formed as a result of:

degranulation of mast cells, basophils and eosinophils;
activation of other immune cells (lymphocytes).

The immunosuppressive effect is achieved as a result of:

inhibition of T and B lymphocytes;
reducing the release of antibodies and cytokines;
suppression of macrophage activity.

The antiproliferative effect is manifested in:

suppression of the formation of collagen and mucopolysaccharides;
deterioration of the ability of cells to move.

Desrinit spray 50 µg/dose bottle 18 g 140 doses

A country

Czech Republic
Country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.

Active substance

Mometasone

Compound

Active substance: mometasone furoate monohydrate (in terms of mometasone furoate) 0.052 mg (0.050 mg).

pharmachologic effect

Pharmacodynamics: Mometasone is a synthetic glucocorticosteroid (GCS) for topical 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. It 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 allergic 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 mast cells). In studies with provocative tests with the application of antigens to the mucous membrane in the nasal cavity, high anti-inflammatory activity of the drug was demonstrated, both in the early and late stages of an allergic reaction. When compared with placebo, a decrease in the level of histamine and eosinophil activity was found, as well as a decrease (compared to the baseline) in the number of eosinophils, neutrophils and epithelial cell proteins. Pharmacokinetics: When administered intranasally, the systemic bioavailability of mometasone fuorate is Indications for use: Seasonal and year-round allergic rhinitis in adults, adolescents and children from 2 years of age; acute sinusitis or exacerbation of chronic sinusitis in adults (including the elderly) and adolescents from 12 years of age - as an auxiliary therapeutic agent in antibiotic treatment; acute rhinosinusitis with mild and moderate symptoms without signs of severe bacterial infection in patients aged 12 years or more; preventive treatment of moderate and severe seasonal allergic rhinitis in adults and adolescents from 12 years of age (recommended two to four weeks before the expected start of the dusting season); nasal polyposis, accompanied by impaired nasal breathing and sense of smell , in adults (from 18 years old).

Mode of application

Intranasally. Inhalation of the suspension contained in the bottle is carried out using a special dispensing nozzle on the bottle. Before using the nasal spray for the first time, it is necessary to “calibrate” it. Do not pierce the nasal applicator. To carry out “calibration”, you must press the dosing nozzle 10 times until until splashes appear, indicating that the drug is ready for use. Tilt your head and squirt the medication into each nostril as directed by your healthcare professional. If the medication has not been used for 14 days or more, press the dispensing nozzle 2 times until a spray appears. Tilt your head and squirt the medication into each nostril as directed by your healthcare professional. Cleaning the Dispensing Nozzle It is important to clean the dispensing nozzle regularly to prevent it from working properly. Remove the cap that protects the nozzle from dust, then carefully remove the spray tip. Rinse the spray tip and dust cap thoroughly in warm water and rinse under the tap. Do not attempt to open the nasal applicator with a needle or other sharp object as this will damage the applicator and may result in you taking the wrong dose. .Dry the cap and knee pad in a warm place. After this, attach the spray tip to the bottle and screw the dust cap back onto the bottle. When using the nasal spray for the first time after cleaning, it is necessary to recalibrate by pressing the dispensing nozzle 2 times. Before each use, shake the bottle vigorously. Treatment of seasonal and year-round allergic rhinitis. Adults (including the elderly) 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 once a day (total daily dose - 200 mcg). Upon achieving a therapeutic effect for maintenance therapy, it is possible to reduce the dose by 1 inhalation into each nostril 1 time per day (total daily dose - 100 mcg). 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 up to 4 inhalations into each nostril 1 time per day (total daily dose - 400 mcg). After the symptoms of the disease have reduced, 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 2-11 years old: Recommended therapeutic dose - 1 inhalation (50 mcg) into each nostril 1 time per day (total daily dose - 100 mcg). To use the drug in young children, adult assistance is required. Adjuvant treatment of acute sinusitis or exacerbation of chronic sinusitis. Adults (including older people) and teenagers 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 - 400 mcg). If a reduction in the symptoms of the disease cannot be achieved by using the drug at the recommended therapeutic dose, the daily dose of the drug can be increased up to 4 inhalations into each nostril 2 times a day (total daily dose - 800 mcg). After the symptoms of the disease have reduced, 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 nasal passage 2 times a day (total daily dose 400 mcg). If symptoms worsen during treatment, consultation with a specialist is necessary. Treatment of nasal polyposis. Adults (including the elderly) from 18 years of age The recommended therapeutic dose is 2 injections (50 mcg each) into each nostril 2 times a day (total daily dose - 400 mcg After reducing the symptoms of the disease, it is recommended to reduce the dose to 2 inhalations (50 mcg each) into each nostril once a day (total daily dose - 200 mcg).

Interaction

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, and the presence of mometasone in the plasma was not detected even at minimal concentrations. In these studies, mometasone fuorate was not detected in blood plasma (with a sensitivity of the detection method of 50 pg/ml).

Side effect

From the immune system: rarely - hypersensitivity reactions, including bronchospasm, shortness of breath; very rarely - anaphylaxis, angioedema. From the central nervous system: often - headache (in adults and children). Children experienced growth retardation, psychomotor hyperactivity, sleep disturbance, anxiety, depression, aggressive behavior. From the respiratory system, chest and mediastinal organs: often in adults - nosebleeds, burning in the nasal cavity, ulceration of the nasal mucosa, a feeling of irritation nasal mucosa, pharyngitis, upper respiratory tract infections; very rarely - perforation of the nasal septum. Nosebleeds, as a rule, stopped on their own and were not severe; they occurred at a rate slightly higher than with placebo (5%), but equal to or less than with other intranasal corticosteroids studied that were used as active controls (in some of them the incidence of nosebleeds was up to 15%) . The incidence of other side effects was comparable to that observed with placebo; often in children - nosebleeds, a feeling of irritation of the nasal mucosa, sneezing. The incidence of all of these adverse events in children was comparable to the frequency of placebo. From the gastrointestinal tract: rarely - a feeling of irritation of the pharyngeal mucosa; very rarely - taste disturbance. Others: rarely - disturbance of smell, taste disturbance, glaucoma, increased intraocular pressure, cataracts. With long-term use of nasal corticosteroids in high doses, systemic side effects may develop, such as: Cushing's syndrome, characteristic signs of Cushingoid, suppression of function adrenal glands, including the development of glaucoma, cataracts, growth retardation in children and adolescents. Children. Disorders of the respiratory system, chest and mediastinal organs: nosebleeds (6%), irritation of the nasal mucosa (2%), sneezing (2 %). Nervous system disorders: headache (3%). The incidence of these adverse events in children was comparable to the incidence when using placebo.

Contraindications

Hypersensitivity to mometasone or any of the components of the drug; children's age (for seasonal and year-round allergic rhinitis - up to 2 years; for acute sinusitis or exacerbations of chronic sinusitis - up to 12 years; for nasal polyposis - up to 18 years); recent surgery or trauma to the nose - before the wound heals (due to the inhibitory effect of GCS on the healing process).

Overdose

With long-term use of GCS in high doses, as well as with the simultaneous use of several GCS, inhibition of the function of the hypothalamic-pituitary-adrenal system is possible. Due to the low systemic bioavailability of the drug (Special instructions With caution. 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 may be prescribed for the listed infections as directed by a doctor), the presence of an untreated local infection involving the mucous membrane of the nasal cavity. Use during pregnancy and during breastfeeding. Special studies on the safety of the use of mometasone during pregnancy and during breastfeeding have not been conducted. As with using other nasal corticosteroids, Desrinit should be prescribed during pregnancy and breastfeeding only if the expected benefit from its use outweighs the potential risk to the fetus and newborn.Newborns whose mothers used corticosteroids during pregnancy should be carefully examined to identify possible adrenal hypofunction. As with any treatment, patients using the drug for several months or longer should be periodically examined by a doctor for possible changes in the nasal mucosa. It is necessary to monitor patients receiving intranasal corticosteroids for a long time. Possible development of growth retardation in children. If growth retardation is detected in children, it is necessary to reduce the dose of intranasal corticosteroids to the lowest that allows for effective control of symptoms. In addition, the patient should be referred for consultation to a pediatrician. If a local fungal infection of the nose or pharynx develops, it may be necessary to discontinue therapy with Dezrinit and undergo special treatment. Irritation of the mucous membrane of the nose and pharynx that persists for a long time can also serve as a basis for stopping treatment with Dezrinit. During placebo-controlled clinical studies in children, when the drug Dezrinit was used in a daily dose of 100 mcg for a year, growth retardation was not observed in children. With long-term treatment with the drug Dezrinit, there were no signs of suppression of the function of the hypothalamic-pituitary-adrenal system. Patients who switching to treatment with Desrinit after long-term therapy with systemic glucocorticosteroids, 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 signs of adrenal insufficiency appear, you should resume taking systemic glucocorticosteroids and take other necessary measures. When using intranasal corticosteroids, systemic side effects may develop, especially with long-term use in high doses. The likelihood of developing these effects is significantly less than with the use of oral corticosteroids. Systemic side effects may vary both in individual patients and depending on the glucocorticosteroid drug used. Potential systemic effects include Cushing's syndrome, characteristic Cushingoid signs, adrenal suppression, growth retardation in children and adolescents, cataracts, glaucoma, and less commonly a number of psychological or behavioral effects including psychomotor hyperactivity, sleep disturbance, anxiety, depression, or aggression (especially in children). During the transition from treatment with systemic corticosteroids to treatment with Desrinit, some patients may experience initial symptoms of systemic corticosteroid withdrawal (for example, joint and/or muscle pain, fatigue and 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 Dezrinit. Switching from systemic to topical glucocorticosteroids may also reveal pre-existing allergic diseases such as allergic conjunctivitis and eczema that were masked by systemic glucocorticosteroid therapy. Patients treated with glucocorticosteroids have a potentially reduced immune responsiveness and should be warned of their increased risk of infection in case of contact with patients with certain infectious diseases (for example, chicken pox, measles), as well as the need for medical advice 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 dental pain, swelling in the orbital or periorbital area) immediate medical consultation is required. When using the drug Desrinit for 12 months, there were no signs of atrophy of the nasal mucosa. In addition, momegasone furoate tended to promote normalization of the histological picture when examining biopsies of the nasal mucosa. The effectiveness and safety of mometasone has not been studied in the treatment of unilateral polyps, polyps associated with cystic fibrosis, and polyps that completely cover the nasal cavity. If unilateral polyps of an unusual or irregular shape are detected, especially those that are ulcerated or bleeding, it is necessary to conduct an additional medical examination. Effect on the ability to drive vehicles and machines. No studies have been conducted to study the effect on the ability to drive vehicles and machines.

Indications for use

Desrinitis is indicated for non-infectious inflammations of the nasopharynx:

allergic rhinitis;
prevention of seasonal allergic rhinitis;
nasal polyps.

Indications for use

Adenoids in children and adults, allowed from 2 years of age
Allergic rhinitis, prevention and treatment
Chronic sinusitis in children and adults, can also be used in old age
Polyposis of the nasal passages
Indicated for the treatment of children suffering from bronchial asthma, improving the course of the disease

More useful information in the review What is polyposis and how is it related to adenoids?

Contraindications

Desrinitis is contraindicated for:

hypersensitivity to the drug;
recent injuries or operations of the nose.

The drug is not recommended for patients with tuberculosis, with foci of chronic infection, especially in the presence of infectious inflammation in the nasopharynx.

With prolonged use of the drug, medical supervision is required. The appearance of signs of a fungal infection of the nasopharynx requires immediate discontinuation of the drug.

How to take the drug correctly?

According to the instructions, before you start using the drug, you need to “calibrate” it by pressing the dispenser ten times until drops appear.

The spray must be shaken before each new use.

The dispenser needs to be cleaned periodically. To do this, the cap, along with the spray tip, is washed in warm water and then dried.

From the table you can find out in what doses Desrinit should be used.

Seasonal or year-round allergic rhinitis		Acute sinusitis or rhinosinusitis	Nasal polyps
Adults	Children	Adults and children over 12 years old	Patients over 18 years of age
2 inhalations 1 r/s	1 inhalation 1 r/s	2 inhalations 2 r/s	2 inhalations 2 r/s

It is most advisable to take Desrinitis for adenoiditis of an allergic nature. Allergic adenoiditis in children usually occurs after allergic rhinitis. For infectious inflammation of the adenoids, the drug is used as an additional remedy, according to indications.

Features of reception in children

Children should take Dezrinit carefully, observing all age restrictions. With long-term therapy, children experience growth and development delays as a manifestation of the systemic undesirable effect of glucocorticosteroids.

How to use the medicine Desrinit for adenoids?

After opening the bottle, make 10 injections into the air. This is necessary to fill the aerosol system and each subsequent injection was with the same amount of active substance, namely 50 mcg of mometasone. Next, you should rinse the nasal cavity with a slightly salted solution to cleanse it and improve absorption of the drug. Shake the bottle well before injecting. This calibration must also be done after the dispenser has not been used for more than 14 days.

Don’t forget to rinse the cap and tip of the aerosol in warm boiled water to remove any dirt.

The average daily dosage is two injections into each nasal passage. However, the dosage should be adjusted by the doctor depending on the condition of the small patient.

The effect occurs 12 hours from the moment of first use.

For the treatment of adenoids in children, a course is usually prescribed for 30-90 days with a break of 1-2 months, then the course may need to be repeated.