Azelastine + Fluticasone Propionate Nasal prep

Indications

Azelastine + Fluticasone Propionate Nasal prep is used for: Seasonal Allergic Rhinitis

Adult Dose

Nasal Spray Seasonal allergic rhinitis The recommended dosage is 1 spray each nostril twice daily.

Child Dose

Nasal Spray Seasonal Allergic Rhinitis <6 years: Safety and efficacy not established >6 years: 1 each nostril twice daily.

Renal Dose

Administration

Shake bottle gently prior to each use Prime the bottle before initial use by releasing 6 sprays or more until a fine mist sprays Reprime the bottle if unused for >14 days by spraying once or more until fine mist appears

Contra Indications

There is no known contraindication.

Precautions

Avoid spraying directly into eyes; if drug is sprayed into eyes, flush with water for a minimum of 10 minutes May cause somnolence; avoid operating heavy machinery or engaging in tasks that require mental alertness and coordination Do not use with history of recent nasal ulcers, nasal surgery, or any nasal trauma May cause glaucoma or cataracts As corticosteroids may cause immunosuppression, patients should notify healthcare providers if they experience any symptoms of tuberculosis, viral, bacterial, fungal or parasitic infections or ocular herpes simplex Due to the potential reduction in growth velocity in children, patients must be monitored routinely Lactation: Unknown whether distributed in breast milk, exercise caution

Pregnancy-Lactation

Interactions

Additive effects with CNS depressants and ethanol. Increased plasma concentration w/ potent CYP3A4 inhibitors (e.g. ritonavir).

Adverse Effects

Side effects of Azelastine + Fluticasone Propionate Nasal prep : 1-10% Dysgeusia (4%),Headache (2%),Epistaxis (2%) Frequency Not Defined Somnolence,Nasal effects (eg, nasal ulceration, nasal septal perforation),Impaired wound healing,Candida albicans infection,Glaucoma,Cataracts,Immunosuppression,Hypothalamic-pituitary-adrenal (HPA) axis suppression

Mechanism of Action

Azelastine: Phthalazinones derivative; elicits histamine H1-receptor antagonist activity; major metabolite (desmethylazelastine) also exhibits histamine H1-receptor antagonist activity Fluticasone: Corticosteroid possessing anti-inflammatory activity; exact mechanism of action unknown, but shown to exhibit anti-inflammatory effect on multiple cells (eg, neutrophils, eosinophils, macrophages, mast cells, lymphocytes) and mediators (eg, histamine, leukotrienes, cytokines and eicosanoids)