Classes
DEA Class; Rx
Common Brand Names; Alvesco, Omnaris, Zetonna
- Corticosteroids, Inhalants
Description
Non-halogenated glucocorticoid; similar potency as beclomethasone and budesonide; low systemic absorption
Nasal spray used for seasonal/perennial allergic rhinitis in adults and children 12 years and older
Oral inhalation used for asthma in adults and children 12 years and older
Indications
Indicated for asthma maintenance treatment.
Contraindications
Documented hypersensitivity
Treatment of acute asthma or status asthmaticus
Adverse Effects
- Headache (11%)
- Nasopharyngitis (11%)
- Epistaxis (4.9%)
- Ear pain (2.2%)
- Facial edema (3%)
- Urticaria (3%)
- Oral candidiasis (3%)
- Back pain (3%)
- Extremety pain (3%)
- Conjunctivitis (3%)
- Upper respiratory infection (9%)
- Gastroenteritis (3%)
- Sinusitis (3%)
Warnings
Caution in active serious infections
Secondary infections may occur as a result of prolonged use of corticosteroids
Avoid exposure to chickenpox or measles
Not for acute asthma treatment
When switching from oral corticosteroids
Bronchospasm may occur following inhalation (treat with fast acting bronchodilator)
High doses may cause suppression of hypothalamic-pituitary-adrenal axis, which can result in adrenal crisis
Long-term use may result in: reduced BMD; glaucoma or cataracts; increased IOP
Development of Kaposi’s sarcoma associated with prolonged use of corticosteroids
Psychiatric disturbances reported with corticosteroid use
Pregnancy and Lactation
Pregnancy Category: C
Lactation: Not known if excreted in breast milk, use caution
Maximum Dosage
200 mcg intranasally (2 sprays in each nostril) daily (Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.
200 mcg intranasally (2 sprays in each nostril) daily(Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.
200 mcg intranasally (2 sprays in each nostril) daily (Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.
>= 12: 200 mcg intranasally (2 sprays in each nostril) daily (Omnaris); 74 mcg intranasally (1 spray in each nostril) daily (Zetonna); 640 mcg/day by oral inhalation.
6—11 years: 200 mcg intranasally (2 sprays in each nostril) daily (Omnaris). Safe and effective use has not been established for nasal aerosol (Zetonna) or oral inhalation; however, doses up to 160 mcg/day via oral inhalation have been used off-label for asthma.
4—5 years: Safety and efficacy have not been established; however, doses up to 160 mcg/day via oral inhalation have been used off-label for asthma.
< 4 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
