Drug reference
Rhinorrhoea associated with allergic and non-allergic rhinitis ▶BY INTRANASAL ADMINISTRATION ▶Child 12–17 years: 2 sprays 2–3 times a day, dose to be sprayed into each nostril ▶Adult: 2 sprays 2–3 times a day, dose to be sprayed into each nostril DOSE EQUIVALENCE AND CONVERSION ▶1 metered spray of nasal spray = 21 micrograms.
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Avoid spraying near eyes. bladder outflow obstruction. cystic fibrosis. prostatic hyperplasia (in adults). susceptibility to angle-closure glaucoma Avoid after nasal surgery (until healing has occurred). avoid in pulmonary tuberculosis. avoid in the presence of untreated nasal infections. patients transferred from systemic corticosteroids may experience exacerbation of some symptoms CAUTIONS, FURTHER INFORMATION ▶Systemic absorption Systemic absorption may follow nasal administration particularly if high doses are used or if treatment is prolonged; therefore also consider the cautions and side-effects of systemic corticosteroids. The risk of systemic effects may be greater with nasal drops than with nasal sprays; drops are administered incorrectly more often than sprays.
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Contra-indicated in patients with hypersensitivity to atropine or its derivatives.
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→Appendix 1: ipratropium
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▶Common or very common Epistaxis. gastrointestinal motility disorder. headache. nasal complaints. throat complaints ▶Uncommon Corneal oedema. eye disorders. eye pain. nausea. respiratory disorders. stomatitis. vision disorders ▶Rare or very rare Palpitations ▶Common or very common Altered smell sensation. epistaxis. headache. nasal complaints. taste altered. throat irritation ▶Rare or very rare Glaucoma. nasal septum perforation (more common following nasal surgery). vision blurred SIDE-EFFECTS, FURTHER INFORMATION Systemic absorption may follow nasal administration particularly if high doses are used or if treatment is prolonged. Therefore also consider the side-effects of systemic corticosteroids.
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Manufacturer advises only use if potential benefit outweighs the risk.
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No information available—manufacturer advises only use if potential benefit outweighs risk.
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MHRA/CHM ADVICE: CORTICOSTEROIDS: RARE RISK OF CENTRAL SEROUS CHORIORETINOPATHY WITH LOCAL AS WELL AS SYSTEMIC ADMINISTRATION (AUGUST 2017) Central serous chorioretinopathy is a retinal disorder that has been linked to the systemic use of corticosteroids. Recently, it has also been reported after local administration of corticosteroids via inhaled and intranasal, epidural, intra-articular, topical dermal, and periocular routes. The MHRA recommends that patients should be advised to report any blurred vision or other visual disturbances with corticosteroid treatment given by any route; consider referral to an ophthalmologist for evaluation of possible causes if a patient presents with vision problems.
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▶In children The height of children receiving prolonged treatment with nasal corticosteroids should be monitored; if growth is slowed, referral to a paediatrician should be considered. eiiii F above
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There can be variation in the licensing of different medicines containing the same drug. Spray EXCIPIENTS: May contain Benzalkonium chloride, disodium edetate ▶Rinatec (Sanofi) Ipratropium bromide 21 microgram per 1 dose Rinatec 21micrograms/dose nasal spray | 180 dose P £6.54 DT = £6.54 CORTICOSTEROIDS Corticosteroids (intranasal) f
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Patients or carers should be counselled on appropriate administration technique and warned against accidental contact with the eye (due to risk Ear, nose and oropharynx of ocular complications). Driving and skilled tasks Manufacturer advises patients and carers should be counselled on the effects on driving and performance of skilled tasks—increased risk of dizziness and vision disorders.
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2 sprays 2–3 times a day, dose to be
First-line fragment. Read the complete Indications and Dose section above.
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2 sprays 2–3 times a day, dose to be sprayed into
First-line fragment. Read the complete Indications and Dose section above.
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