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Momat Rino Advance: instructions for use and reviews

Instruction:

Clinical and pharmacological group

Release form, composition and packaging

Cream for external use 0.1% white.

Excipients: white soft paraffin, white beeswax, propylene glycol monostearate.

5 g - aluminum tubes (1) - packs of cardboard.

pharmachologic effect

Preparation for external use.

Mometasone is a synthetic GCS with anti-inflammatory, antipruritic and anti-exudative action. GCS induce the release of lipocortin proteins that inhibit phospholipase A2, which control the biosynthesis of inflammatory mediators (prostaglandins, leukotrienes) by inhibiting the release of their common precursor, arachidonic acid.

Pharmacokinetics

Suction

Absorption of ointment and cream Momat is negligible. 8 hours after a single application of the drug to intact skin (without an occlusive dressing), about 0.7% (ointment) and 0.4% (cream) of the active substance are found in the systemic circulation.

Metabolism

Mometasone is extensively metabolized in the liver.

breeding

It is excreted mainly by the kidneys and in small amounts with bile. T1 / 2 of mometasone from Momat ointment is approximately 5.8 hours.

Dosage

Outwardly. A thin layer of ointment or cream Momat is applied to the affected areas of the skin 1 time / day. The duration of the course of treatment is determined by its effectiveness, tolerability of the drug, as well as the presence and severity of side effects.

Overdose

Symptoms: depression of the function of the hypothalamic-pituitary-adrenal system, including secondary adrenal insufficiency.

Treatment: symptomatic, if necessary, carry out a correction of the electrolyte balance, drug withdrawal (with long-term therapy - gradual withdrawal).

drug interaction

Studies of drug interactions of the ointment and cream Momat with other drugs have not been conducted.

Use during pregnancy and lactation

The safety of using mometasone furoate during pregnancy and lactation (breastfeeding) has not been established.

GCS penetrate the placental barrier. Long-term treatment and the use of high doses during pregnancy should be avoided due to the threat of negative effects on fetal development.

GCS are excreted in breast milk. In the case when the use of corticosteroids in large doses and / or for a long time is expected, breastfeeding should be stopped.

Side effects

From the endocrine system: when using external forms of corticosteroids for a long time and / or for treatment on large areas of the skin, or using occlusive dressings, especially in children and adolescents - adrenal insufficiency, Cushing's syndrome.

Dermatological reactions: rarely - skin irritation, dry skin, burning sensation, folliculitis, hypertrichosis, acne, hypopigmentation, perioral dermatitis, skin maceration, secondary infection, signs of skin atrophy, striae, prickly heat; less than 1% of cases - the formation of papules, pustules.

Allergic reactions: rarely - itching, allergic contact dermatitis.

Terms and conditions of storage

The drug should be stored out of the reach of children, dry, dark place at a temperature not exceeding 25 ° C; do not freeze. Shelf life - 2 years.

Indications

For cream

- inflammation and itching in dermatoses amenable to glucocorticosteroid therapy.

- inflammation and itching in dermatoses (psoriasis, atopic dermatitis, seborrheic dermatitis), amenable to glucocorticosteroid therapy, in adults and children over 2 years old.

Contraindications

- rosacea;

- perioral dermatitis;

- bacterial, viral (Herpes simplex, chickenpox, Herpes zoster) or fungal infections of the skin;

- tuberculosis, syphilis;

- post-vaccination reactions;

- children's age up to 2 years (for ointment);

- pregnancy (use on large areas of the skin, long-term treatment);

- lactation period (use in high doses and / or for a long time);

- hypersensitivity to corticosteroids or to the components of the drug.

With caution, the drug should be applied to intertriginous skin and facial skin, used with occlusive dressings, on large areas of the skin and / or for a long period of time (especially in children).

special instructions

When applying the drug to large areas of the skin for a long time, especially when using occlusive dressings, it is possible to develop signs of suppression of the function of the hypothalamic-pituitary-adrenal system and the development of Cushing's syndrome.

Avoid getting Momat ointment and cream on the mucous membrane of the eye.

Propylene glycol, which is part of Momat, can cause irritation at the site of application. In such cases, stop using the drug and prescribe appropriate treatment.

It should be borne in mind that corticosteroids can change the manifestations of some skin diseases, making it difficult to make a diagnosis. In addition, the use of corticosteroids can cause delayed wound healing.

With long-term therapy with corticosteroids, a sudden cessation of therapy can lead to the development of rebound syndrome, which manifests itself in the form of dermatitis with intense reddening of the skin and a burning sensation. Therefore, after a long course of treatment, the drug should be discontinued gradually, for example, switching to an intermittent treatment regimen before completely stopping it.

Pediatric use

Due to the fact that in children the ratio of surface area and body weight is greater than in adults, children are at greater risk of suppression of the function of the hypothalamic-pituitary-adrenal system and the development of Cushing's syndrome with external use of corticosteroids. Long-term treatment of children with corticosteroids can lead to impaired growth and development. Children should receive the minimum dose of the drug, sufficient to reduce the effect.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Registration numbers

Momat is a topical hormonal drug.

It is used to relieve inflammation as monotherapy for severe allergies. It is also indicated when used during the infectious course of the pathology, but when used in conjunction with an antibiotic of a local or systemic type.

Mamat Rino also has anti-inflammatory properties, which allows you to use a spray or drops during the off-season to relieve the symptoms of colds.

Clinical and pharmacological group

Momat Rino is a glucocorticosteroid (GCS) for topical use.

Terms of dispensing from pharmacies

Released by prescription.

Prices

How much does Momat rino cost? The average price in pharmacies is at the level of 350 rubles.

Release form and composition

Dosage form Momata Rino - dosed nasal spray: a suspension of thick consistency, translucent or opaque, almost white or white (60 and 120 doses in polyethylene bottles with a dosing device, 1 bottle in a cardboard box).

One dose of nasal suspension contains:

• Active ingredients: 0.14 mg azelastine (as hydrochloride), 0.5 mcg mometasone (as furoate)
• Additional components: MCC, cellulose gum, d-glucose, E433 (polysorbate-80), benzalkonium chloride, trilon b, neotame, citric acid monohydrate, E331, water.

Pharmacological effect

The drug has antipruritic, anti-inflammatory, glucocorticoid action. Shows anti-exudative effect. The composition induces the release of proteins that are responsible for the inhibition of phospholipase. That is, the agent acts directly on the structure of inflammatory mediators, inhibiting the release of their precursor, arachidonic acid.

A small part enters the systemic circulation if not used over large areas or under an occlusive dressing. Mometasone is metabolized in the liver and excreted in the bile. The half-life is about 6 hours.

Indications for use

1. Seasonal and year-round in children from 2 years and adults;
2. Nasal polyposis, accompanied by a violation of smell and nasal breathing, in adults;
3. Acute rhinosinusitis with mild to moderate symptoms in children over 12 years of age and adults (provided there are no signs of severe bacterial infection);
4. Acute and exacerbation of chronic sinusitis in children from 12 years of age and adults (including the elderly) - as an aid in antibiotic therapy;
5. Prevention of seasonal allergic rhinitis of moderate and severe course in children from 12 years old and adults (2-4 weeks before the expected start of the dusting season).

Contraindications

Contraindications are conditions such as:

• Rosacea;
• Pregnancy
• Post-vaccination period, accompanied by appropriate reactions;
• Lactation;
• Hypersensitivity;
• tuberculosis or syphilis;
• Infectious damage to tissues;
• perioral dermatitis;
• Age less than 2 years (for ointment).

It is used with caution when applied under occlusive dressings, as well as on large areas of the skin.

Use during pregnancy and lactation

Contraindicated. Detailed studies on the use of the drug in pregnant women have not been conducted, but since azelastine hydrochloride can have a toxic effect on the embryos of laboratory animals, the use of the drug during pregnancy and lactation is prohibited.

Dosage and method of application

The instructions for use indicate that Momat Rino spray is used intranasally. Inhalation is carried out using the dosing nozzle provided in the kit.

Before using the spray for the first time, it is necessary to calibrate it - press the dosing nozzle 10 times until splashes appear. This indicates the readiness of the drug for use. If the product is not used for 14 or more days in a row, before use, make 2 test pressures in the air until splashes appear.

For inhalation, you need to tilt your head and inject the spray into each nasal passage as recommended by your doctor.

The dosing nozzle must be cleaned regularly. This is essential for its proper operation. To do this, remove the protective cap, and then the spray tip and rinse them thoroughly in warm water, rinse under the tap and dry in a warm place, after which the tip must be attached to the bottle and closed with a protective cap.

Do not pierce the nasal applicator or try to open it with sharp objects (eg needles), otherwise this will lead to damage and possibly incorrect further dosing of the drug.

After cleaning, before the first use, it is necessary to calibrate - press the dosing nozzle into the air 2 times.

Shake the vial vigorously before each use of Momat Rino.

Side effects

The incidence of side effects is defined as follows: very often (> 1/10); often (<1/10, >1/100); infrequently (<1/100, >1/1000); rarely (<1/1000, >1/10,000); very rarely (<1/10 000).

1. From the nervous system: often - headache, dysgeusia (unpleasant taste) as a result of improper use, namely, with excessive tilting of the head back during the introduction; very rarely - dizziness (may be caused by the disease itself).
2. From the digestive system: rarely - a feeling of irritation of the mucous membrane of the pharynx, nausea.
3. From the respiratory system: often - nosebleeds, discomfort in the nasal cavity (burning sensation, itching), ulceration of the nasal mucosa, sneezing, pharyngitis, sinusitis, upper respiratory tract infections.
4. From the immune system: very rarely - hypersensitivity, anaphylactoid reactions, urticaria.
5. On the part of the skin and subcutaneous tissues: very rarely - rash, itching.
6. Other: very rarely - fatigue, drowsiness, weakness (may be caused by the disease itself).
7. With prolonged use of corticosteroids in high doses, systemic side effects may develop, incl. glaucoma and cataracts.

Overdose

Cases of overdose have not been identified to date (with intranasal use). When azelastine is taken orally, it is possible to develop disorders of the central nervous system - lethargy, confusion, drowsiness, decreased pressure, tachycardia.

Treatment is symptomatic. Long-term use of corticosteroids in high doses and in combination with systemic treatment with them can lead to inhibition of the pituitary gland, hypothalamus, and adrenal glands.

special instructions

As with any long-term treatment, patients using Momat Rhino Advance nasal spray for several months or longer should be periodically examined by a doctor for possible changes in the nasal mucosa, perforation of the nasal septum (very rarely) and the possible development of systemic side effects. If a local fungal infection of the nose or pharynx develops, it may be necessary to stop therapy with Momat Rino Advance nasal spray and conduct special treatment. In case of development of persistent irritation of the nasopharynx, it is necessary to decide on the termination of therapy.

During the transition from treatment with systemic corticosteroids to treatment with Momat Rhino Advance nasal spray, some patients may experience initial symptoms of withdrawal of systemic corticosteroids (for example, joint and / or muscle pain, fatigue and depression), despite a decrease in the severity of symptoms associated with damage to the nasal mucosa; such patients need to be specifically convinced of the advisability of continuing treatment with Momat Rhino Advance nasal spray. Switching from systemic to topical corticosteroids may also reveal pre-existing, but masked by systemic corticosteroid therapy, allergic diseases such as allergic conjunctivitis and eczema.

Patients who switch to treatment with Momat Rino Advance nasal spray after long-term therapy with systemic glucocorticosteroids (GCS) require special attention. Cancellation of systemic corticosteroids in such patients can lead to insufficient adrenal function, the subsequent recovery of which may take up to several months. If signs of adrenal insufficiency appear, systemic corticosteroids should be resumed and other necessary measures should be taken.

Patients treated with corticosteroids have potentially reduced immune reactivity and should be warned about their increased risk of infection if they come into contact with patients with certain infectious diseases (for example, chicken pox, measles), as well as the need for medical advice if such contact occurs. .

When using intranasal steroids at doses higher than recommended, or at recommended doses in sensitive patients, systemic effects of corticosteroids and suppression of adrenal function may develop. If such changes occur, the use of Momat Rhino Advance nasal spray should be gradually discontinued, in accordance with the procedures adopted for stopping oral corticosteroids.

GCS for nasal and inhalation use can cause the development of glaucoma and / or cataracts. Therefore, patients with visual changes should be closely monitored, as well as patients who have previously had elevated intraocular pressure, glaucoma and/or cataracts.

If there are signs of a severe bacterial infection (for example, fever, persistent and sharp pain on one side of the face or toothache, swelling in the orbital or periorbital region), immediate medical consultation is required.

drug interaction

Mometasone furoate:

• Combination therapy with loratadine was well tolerated by patients. At the same time, there was no effect of the drug on the concentration of loratadine or its main metabolite in the blood plasma. In these studies, mometasone furoate was not detected in plasma (with a sensitivity of the method of determination of 50 pg / ml).

Azelastine:

• With intranasal use of azelastine, there were no clinically significant interactions with other drugs.

Analogues

There are currently no absolute analogues of Momat Rino Advance on sale. There are products that contain the same active ingredient as the described medication. These are the trade names:

• "Desrinitis".
• "Nasonex".

Analogue (instruction for "Momat Rino Advance" is similar to the rules for using this tool) "Allergodil" is known for its good therapeutic effect in case of an allergic reaction. Its main difference is a different active ingredient. This medicine is based on azelastine.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Store in a place protected from light, out of the reach of children, at a temperature of 15-25 °C.

Shelf life - 2 years.

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The instruction contains up-to-date information on the composition of Momat Rino Advance spray, indications and dosage, side effects and contraindications, as well as other details for the correct use of the drug.

Form, composition, packaging

The drug in the form of a dosed nasal spray is a white suspension.

The complex of active substances consists of azelastine hydrochloride and mometasone furoate. It is supplemented with microcrystalline cellulose, purified water, sodium carmellose, sodium citrate, dextrose, citric acid monohydrate, polysorbate 80, neotame, benzalkonium chloride, disodium edetate.

The drug is sold in HDPE bottles, one in a cardboard box. Each vial is equipped with a nose adapter and dosing device.

Terms and conditions of storage

Spray nasal is afraid of freezing. It can be stored for two years in the dark at 15-25 degrees indoors. Children should not be allowed to take the drug.

Pharmacology

The preparation of the combined composition is used in the practice of ENT for the purpose of anti-inflammatory and anti-allergic effect. Applied locally. Its pharmacological properties are due to the influence of the active substances that make up the drug.

Azelastine, which provides a long-lasting effect against an allergic reaction. It is a selective H 1 -receptor blocker of histamine capable of providing membrane-stabilizing, anti-allergic and antihistamine effects. Its function is to reduce exudation and capillary permeability. Azelastine prevents the release of substances with biological activity from the mast cell, which leads to the development of bronchospasm and other types of allergic (early / late) reactions and inflammation.

Mometasone is a synthetic local GCS, which contributes to the provision of an antihistamine effect with a clear anti-inflammatory effect. The range of its capabilities includes: inhibition of the release of inflammatory mediators, a decrease in the production of inflammatory exudate by preventing accumulations of marginal neutrophils, a decrease in granulation and infiltration processes. The substance of an active nature helps to reduce inflammation, influencing the reactions of the "late" type of allergy and the inhibition of reactions of the "immediate" type.

Pharmacokinetics

The bioavailability of the drug after intranasal use is not more than 40 percent. The maximum concentration in the blood plasma reaches a maximum of three hours. It binds to blood proteins almost completely (90%).

The process of metabolism is carried out in the liver with the participation of the cytochrome P450 system. During biotransformation, desmethylazelastine is formed as an active metabolite.

Excretion through the kidneys. The half-life of metabolites: inactive - twenty hours, active (desmethylazelastine) - at least 45 hours.

Fuorat Mometasone has a systemic bioavailability of not more than one percent. The suspension form of the drug, entering the digestive tract after intranasal use, is practically not absorbed and undergoes primary metabolism quite actively even before excretion through bile or urine.

Indications for use Momat Rino Advance

The drug is recommended for use in the treatment of adult patients with allergic rhinitis: seasonal, year-round and others.

Contraindications

The medicated spray should not be given to patients who

• recently underwent surgery in the nasal cavity or injured the nose, damaging the mucosa until the damage passes into the healing stage;
• are under the age of eighteen;
• suffer from hypersensitivity to the components of the drug.

The drug requires careful use in the presence of infections in the respiratory tract:

• tuberculosis;
• fungal;
• herpetic (with damage to the eye).

The use of the drug is carried out intranasally using a dosing nozzle.

It is prescribed one dose twice a day in the morning and evening hours in each nasal passage. Duration of admission - 14 days.

Instructions for use of the dispenser bottle

• Take off the protective cap.
• The first use of the spray should be preceded by "calibration" for which press the dosing device at least ten times. If the vial has not been used for more than a week, double-clicking is enough to re-“calibrate” until splashes from the dispenser appear.
• On the sides of the adapter, place the middle and index fingers, and place the thumb on the bottom of the bottle and inhale with the nose.
• The nasal adapter is not pierced.
• Avoid pointing adapter towards eyes when spraying.
• Before spraying, the nostrils should be cleaned.
• While holding the vial in a vertical position, insert the tip of the adapter into the nasal passage with the other, clamping it with your free hand. Make a sharp single press.
• Exhale with your mouth.
• Do the same for the other nasal passage.
• Wipe the adapter with a napkin and replace the cap for protection.

Cleaning the nasal adapter

• Remove the cap.
• Remove the adapter by gently pulling it up.
• Without using foreign objects, rinse the adapter in cold running water.
• Air dry.
• Rinse and dry the cap.
• Return the nasal adapter to its place, making sure to place the vial stem in the center of the adapter.
• Carry out calibration pressures until a stable fine dispersion is released.
• Replace cap for protection.

Application by various categories of patients

During pregnancy

During pregnancy, the use of Momat Rino Advance is not recommended, since the drug has not been studied for this category of patients.

When used in animals, one of the active components of the drug, azelastine hydrochloride, caused toxicity in the fetus during intrauterine development.

For kids

Children spray is not prescribed until the age of majority.

Side effects

When using the medicinal spray Momat Rino Advance, the following side effects were observed:

• Nervous system: Patients complained of frequent headaches, less often of the development of dizziness. A sensation of an unpleasant taste in the mouth was also noted, which is explained by the incorrect use of the spray, when the patient tilts his head back too much when injecting.
• Digestive system: In rare cases, nausea, irritation of the pharynx (mucosa) were recorded.
• Respiratory system : Quite often, the treatment was accompanied by bleeding from the nose and discomfort in the area of ​​\u200b\u200bspray. Ulceration of the nasal mucosa was noted, as well as the development of infections of the upper respiratory tract, sinusitis, and pharyngitis. It is not uncommon for patients to suffer from repeated sneezing.
• Immunity: In rare cases, the development of urticaria, hypersensitivity reactions or anaphylactoid reactions has been noted.
• Integuments of the skin / subcutaneous tissue: There have been occasional complaints of skin rash accompanied by itching.
• Miscellaneous : Rare manifestations of drowsiness, fatigue or weakness, which may also be due to the disease itself.

Long-term use, especially in high doses, can lead to the development of systemic side effects. Cataract/glaucoma is no exception.

Overdose

Cases of overdose with a spray when used correctly have not been recorded. However, when the patient uses the drug with violations and the contents of the vial get inside, a negative effect of azelastine, one of the active components of the drug, may develop. This is fraught for the patient with the development of drowsiness, hypotension, tachycardia and confusion. In this situation, treatment is carried out focusing on the symptoms.

Drug Interactions

Used strictly intranasally, Momat Rino Advance spray does not enter into drug interactions with other medicines, which would entail clinical significance.

Additional instructions

If there is a need for long-term therapy with this spray, the patient should undergo periodic examination to detect changes in the condition of the nasal mucosa, as well as possible perforation of the nasal septum, fungal infections in the pharynx / nose area, or other systemic side effects. Which, in turn, will require the abolition of drug therapy with a spray and a further special course of treatment for the identified pathological conditions.

At the beginning of use in the treatment of Momat Rino Advance spray, after stopping the use of systemic corticosteroids, the patient may complain of symptoms characteristic of the abolition of the latter in the form of joint / muscle pain, depression and increased fatigue, and allergic reactions (eczema, conjunctivitis) are not excluded, which, upon acceptance of systemic GCS, could be masked. However, it is not worth stopping spray treatment against the background of these complaints, since this therapy is one of the most effective options, and such symptoms will soon disappear by themselves.

If you allow overestimation of dosages in the treatment of nasal spray Momat Rino Advance in a patient, in addition to side effects of a systemic nature, signs of suppression of the functionality of the adrenal glands may appear. In this situation, it is necessary to gradually cancel the spray.

It is necessary to warn the patient that he should not come into contact with people suffering from infections (measles / chickenpox) during the period of treatment with GCS preparations, since when taking glucocorticosteroids, the patient has a potential risk of reduced immune reactivity.

It is possible that when taking the medicine, the manifestation of a bacterial infection of a pronounced nature (fever, toothache or swelling and pain on either side of the face), in this situation, it is necessary to urgently visit a doctor.

Nasal corticosteroids, as well as those intended for inhalation, can develop cataracts or glaucoma in those patients who suffer from visual impairment. Therefore, such patients need especially careful monitoring when prescribing Momat Rhino Advance spray therapy.

Sometimes, when treating with a spray, it is necessary to postpone the performance of work that is associated with the management of mechanisms and vehicles, since the consequences that cause the disease that is treated with this medicine in the form of increased fatigue and weakness, dizziness can reduce the patient's ability to work.

Analogues of the drug Momat Rino Advance

The drug does not have complete analogues. However, if necessary, you can use any anti-allergic nasal sprays, as well as: drugs Nasonex, Desirinat, which are produced on the basis of the active substance mometasone, or Allergodil, since it contains azelastine.

Spray price

According to online stores, the average cost of Momat Rino Advance spray ranges from 550 to 590 rubles per bottle.

Momat Rino: instructions for use and reviews