Nasalide
Nasalide - General Information
Nasalide (marketed as AeroBid, Nasalide, Nasarel) is a corticosteroid often prescribed as treatment for allergic rhinitis.
The principle mechanism of action of flunisolide is to activate glucocorticoid receptors. It also has anti-inflammatory action.
Pharmacology of Nasalide
Nasalide is a synthetic corticosteroid. It is administered either as an oral metered-dose inhaler for the treatment of asthma or as a nasal spray for treating allergic rhinitis. Corticosteroids are naturally occurring hormones that prevent or suppress inflammation and immune responses. When given as an intranasal spray, flunisolide reduces watery nasal discharge (rhinorrhea), nasal congestion, postnasal drip, sneezing, and itching oat the back of the throat that are common allergic symptoms.
Nasalide for patients
Since the relief from AEROBID Inhaler depends on its regular use and on proper inhalation technique, patients must be instructed to take inhalations at regular intervals. They should also be instructed in the correct method of use.
Patients whose systemic corticosteroids have been reduced or withdrawn should be instructed to carry a warning card indicating they may need supplemental systemic steroids during periods of stress or a severe asthmatic attack that is not responsive to bronchodilators.
Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles. Patients should also be advised that if they are exposed, medical advice should be sought without delay.
An illustrated leaflet of patient instructions for proper use accompanies each AEROBID Inhaler System.
CONTENTS UNDER PRESSURE
Do not puncture. Do not use or store near heat or open flame. Exposure to temperatures above 120°F (49°C) may cause container to explode. Never throw container into fire or incinerator. Keep out of reach of children.
DIRECTIONS FOR USE:
Before using your new AEROBID Inhaler System, it is important that you read over the following simple instructions and familiarize yourself with the inhaler and its metal cartridge. As your doctor has probably told you, the AEROBID Inhaler System must be used for a few days before it begins working, and then should be used regularly to help reduce the frequency and severity of your asthma attacks. It is not a bronchodilator and will not provide relief during an actual attack, but it can cut down the number of bad attacks if used regularly every day.
- Before the first use, place the AEROBID metal cartridge inside the plastic container as shown.
- Shake the inhaler system before each inhalation.
- Before each use, remove dustcap and inspect mouthpiece for foreign objects.
- Replace dustcap after each use.
- Breathe out as completely as possible.
- Hold the inhaler system upright and put plastic mouthpiece in your mouth as shown, being sure to dose your lips tightly around the mouthpiece.
- Breathe in slowly through your mouth. At the same time firmly press down on the metal cartridge with your index finger.
- Hold your. breath as long as you can.
- While holding your breath, stop pressing on the cartridge and remove mouthpiece from your mouth.
- If your doctor has prescribed two or more inhalations at each use, wait a minute to allow pressure to build up again in the metal canister, then repeat steps two through nine (2-9). Be sure to shake the inhaler system again before each inhalation.
- After the prescribed number of inhalations, rinse out your mouth thoroughly with water.
- Clean the inhaler system every few days. To do so, remove the metal cartridge, then rinse the plastic inhaler and cap with briskly running warm water. Dr. thoroughly. Replace the cartridge and cap.
NOTE: If your mouth becomes sore or develops a rash, be sure to mention this to your doctor, but do not stop using your inhaler system unless he tells you.
WARNING: The contents of the metal cartridge are under pressure. Do not puncture. Do not use or store near heat or open flame. Exposure to temperature above 120°F (49°C) may cause cartridge to explode. Never throw cartridge into fire or incinerator. Use by children should always be supervised by an adult.
Nasalide Interactions
No information provided.
Nasalide Contraindications
AEROBID (flunisolide) Inhaler is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Hypersensitivity to any of the ingredients of this preparation contraindicates its use.
Localized infections with Candida albicans or Aspergillus niger have occurred in the mouth and pharynx and occasionally in the larynx. Positive cultures for oral Candida may be present in up to 34% of patients. Although the frequency of clinically apparent infection is considerably lower, these infections may require treatment with appropriate antifungal therapy or discontinuance of treatment with AEROBID Inhaler. AEROBID Inhaler is not to be regarded as a bronchodilator and is not indicated for relief of bronchospasm.
Patients should be instructed to contact their physician immediately when episodes of asthma that are not responsive to bronchodilators occur during the course of treatment. During such episodes, patients may require therapy with systemic cortico-steroids. Theoretically, the use of inhaled corticosteroids with alternate day prednisone systemic treatment should be accompanied by more HPA suppression than a therapeutically equivalent regimen of either alone.
Transfer of patients from systemic steroid therapy to AEROBID Inhaler may unmask allergic conditions previously suppressed by the systemic steroid therapy, e.g. rhinitis, conjunctivitis, and eczema.
Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals. Chicken pox and measles, for example, can have a more serious or even fatal course in non-immune children or adults on cortico-steroids. In such children or adults who have not had these diseases, particular care should be taken to avoid exposure. How the dose, route and duration of corticosteroid administration affects the risk of developing a disseminated infection is not known. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not known. If exposed to chicken pox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated. If chicken pox develops, treatment with antiviral agents may be considered.
Additional information about Nasalide
Nasalide Indication: For the maintenance treatment of asthma as a prophylactic therapy.
Mechanism Of Action: Nasalide is a glucocorticoid receptor agonist. The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding. Nasalide binds to plasma transcortin, and it becomes active when it is not bound to transcortin.
Drug Interactions: Not Available
Food Interactions: Not Available
Generic Name: Flunisolide
Synonyms: Flunisolide [anhydrous]
Drug Category: Anti-Asthmatic Agents; Anti-inflammatory Agents
Drug Type: Small Molecule; Approved
Other Brand Names containing Flunisolide: Aerobid; Bronalide; Lunis; Nasalide; Nasarel; Rhinalar; Synaclyn; Syntaris;
Absorption: Absorbed rapidly
Toxicity (Overdose): Not Available
Protein Binding: Approximately 40% after oral inhalation
Biotransformation: Primarily hepatic, converted to the S beta-OH metabolite.
Half Life: 1.8 hours
Dosage Forms of Nasalide: Spray Nasal
Spray, metered Nasal
Chemical IUPAC Name: Not Available
Chemical Formula: C24H31FO6
Flunisolide on Wikipedia: https://en.wikipedia.org/wiki/Flunisolide
Organisms Affected: Humans and other mammals