flunisolide


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flunisolide

 [floo-nis´o-līd]
a steroid antiinflammatory agent administered as an aerosol spray for treatment of bronchial asthma and seasonal or perennial allergic rhinitis when conventional treatment is unsatisfactory.

flunisolide

APO-Flunisolide (CA), Nasarel, PMS-Flunisolide (CA), Ratio-Flunisolide (CA), Rhinalar Nasal Mist (CA)

Pharmacologic class: Intranasal steroid

Therapeutic class: Respiratory inhalant

Pregnancy risk category C

Action

Unknown. Thought to diminish capillary permeability and suppress migration of polymorphonuclear leukocytes, decreasing inflammation.

Availability

Spray solution: 25 ml (each actuation delivers approximately 25 mcg)

Indications and dosages

Relief of seasonal or perennial rhinitis

Adults: Two sprays in each nostril b.i.d.; may increase to two sprays in each nostril t.i.d. Maximum daily dose is eight sprays in each nostril. For maintenance, after desired clinical effect occurs, reduce dosage to smallest amount needed to control symptoms.

Children ages 6 to 14: One spray in each nostril t.i.d. or two sprays in each nostril b.i.d.; maximum daily dose is four sprays in each nostril. For maintenance, after desired clinical effect occurs, reduce dosage to smallest amount needed to control symptoms.

Contraindications

• Hypersensitivity to drug or its components

• Untreated local infections of nasal mucosa

Precautions

Use cautiously in:

• localized Candida albicans infection; tuberculosis; untreated fungal, bacterial, or systemic viral infections; ocular herpes simplex

• patients receiving immunosuppressive therapy.

Administration

• Don't increase dosage or discontinue drug abruptly.

Adverse reactions

CNS: headache, light-headedness, nervousness, dizziness

EENT: cataracts; glaucoma; blurred vision; conjunctivitis; increased intraocular pressure; lacrimation; dry, irritated eyes; tinnitus; otitis; otitis media; rhinorrhea; rhinitis; nasal irritation, burning, and dryness; nasal stuffiness and pain; sneezing; nasal ulcer; epistaxis; localized Candida albicans nasal infections; nasal mucosa ulcerations; nasal septum perforation; throat discomfort, soreness, and dryness; mild nasopharyngeal irritation; pharyngitis; dry mucous membranes; nasal and sinus congestion; sinusitis; hoarseness, voice changes

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, dry mouth

Metabolic: hyperadrenocorticism

Musculoskeletal: myalgia, arthralgia, aseptic necrosis of femoral head

Respiratory: wheezing, dyspnea, increased cough, bronchitis, bronchospasm, asthma symptoms

Skin: rash, pruritus, urticaria, contact dermatitis, alopecia, herpes simplex infection

Other: altered taste and smell, facial edema, fever, flulike symptoms, aches and pains, infections, angioedema, anaphylaxis

Interactions

Drug-diagnostic tests. Aspartate aminotransferase: increased level

Patient monitoring

Monitor patient closely for serious adverse reactions, including anaphylaxis, angioedema, hyperadrenocorticism, and serious infections.

Patient teaching

Teach patient to recognize and immediately report serious adverse reactions.

• Teach patient proper use of drug. Caution him not to use more than prescribed amount; doing so may cause serious side effects.

• Tell patient maximum drug effects may not occur for several weeks.

• Tell patient to avoid people with measles, chickenpox, and other transmissible infections.

• Caution patient to withhold dose and contact prescriber if infection occurs.

• Instruct female patient to tell prescriber if she becomes pregnant.

• Tell female patient not to breastfeed without consulting prescriber.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

flunisolide

(flo͞o-nĭs′ə-līd′)
n.
A corticosteroid, C24H31FO6, administered by inhalation to treat asthma and nasally to treat allergies.

flunisolide

Aerobid® An inhalant corticosteroid used to manage asthma

flunisolide

A CORTICOSTEROID drug used in the form of a spray to treat hay fever. A brand name is Syntaris.
References in periodicals archive ?
These trials tested different doses of all drugs except triamcinolone and flunisolide. Only three trials followed 728 children for a year or more, with one of these trials testing three different dosing regimens.
Capasso et al., "Intranasal flunisolide treatment in children with adenoidal hypertrophy," International Journal of Immunopathology and Pharmacology, vol.
Aerobid (flunisolide) will be removed from market June 30, 2011.
Only a few inhaled corticosteroid (ICS) products have the requisite median particle diameter (less than 2 mcm) needed to reach the alveolar tissue in the distal tracheobronchial tree, including beclomethasone dipropionate HFA (QVAR), flunisolide HFA (Aerospan), and ciclesonide (Sepracor).
Spahn Treatment Trends for Severe Asthma Current rate Historical rate Albuterol * (puffs/week) 34 72 Leukotriene-modifying agent 77% 0% Fluticasone/salmeterol * 66% 0% Budesonide 16% 2% Fluticasone * 16% l% Omalizumah 9% 0% Tiotropium 8% 0% Theophyline 8% n/a Mometasone * 3% 0% Beclomethasone HFA * 5% 0% Flunisolide * 0% 55% Triamcinolone * 0% 33% Beclomethasone CFC * 0% 15% * Statistically significant difference.
For example, with asthma, the primary treatment is an inhaled steroid such as flunisolide (Aerobid), but with COPD, the patient is usually placed on a bronchodilator, such as albuterol (Proventil), first.
The seven MDI drugs include: flunisolide (Forest's Aerobid), triamcinolone (Kos' Azmacort), metaproterenol (Boehringer Ingelheim's Alupent), pirbuterol (3M's Maxair), cromolyn (King's Intal), nedocromil (King's Tilade) and the combination of albuterol and ipratropium (Boehringer's Combivent).
Beclomethasone, budesonide, triamcinolone, and flunisolide are the inhaled corticosteroids most commonly used for asthma control.
(fluticasone), Nasacort (triamcinolone), Nasalide (flunisolide), Nasonex (mometasone), Rhinocort (budesonide), Vancenase DS or Vancenase Pockethaler (beclomethasone) Inhaled.
Beclomethasone dipropionate, betamethasone, budesonide, dexamethasone, fludrocortisone, flunisolide, fluorometholone, megestrol acetate, methylprednisolone, prednisolone, prednisone, triamcinolone, and triamcinolone acetonide were purchased from Sigma.
Drug Dosage Cost/Day fluticasone 88-264 $1.64 (Flovent) [micro]/day (176 [micro]g/day) (*) beclomethasone up to 504 Beclovent: $1.84; (Beclovent, [micro]g/day Vanceril: $1.76 Vanceril) (336 [micro]g/day) (*) beclomethasone 80-160 $1.04 (Qvar) [micro]g/day (160 [micro]g) (*) budesonide 200-400 $1.24 (Pulmicort) [micro]g/day (400 [micro]g) (*) flunisolide 500-1,000 $2.68 (Aerobid) [micro]g/day (1 mg) (*) fluticasone and 100 pg $2.88 (**) salmeterol fluticasone (Advair) b.i.d., 50 [micro]g salmeterol b.i.d.
She was controlled on theophylline, inhaled serevent, flunisolide, nedocromil, oral antihistamines, and regular peak flow monitoring.