Introduction
Neotison 200 Convicap is a steroid. It relieves the symptoms of allergic rhinitis such as runny nose, sneezing and sinus discomfort. It works by blocking the production of certain chemical messengers that cause inflammation (swelling) and allergies, thus relieving the discomfort and irritation in your nose.
You should always use it as advised by your doctor but to get the full benefit you should take it regularly. It may take a few days for the spray to take full effect. If you do not see an improvement in your symptoms after a week you should talk to your doctor.
The most common side effects of Neotison 200 Convicap include burning or itching in your nose. It can also cause nosebleed and headache in some patients. Talk to your doctor if you are worried about side effects or they do not go away. This medicine may lower the ability of your body to fight off infections, so try to stay away from someone having chickenpox, measles, or tuberculosis. In general, you should try to avoid situations which make your symptoms worse (things like pollen and dust mites), and it would be best to avoid smoking.
Before starting to use this medicine you should let your doctor know if you are pregnant or breastfeeding, discuss the risks and benefits with your healthcare team. If you use this medicine for a long time, your doctor may want to carry out certain medical tests during the duration of treatment to check your progress.
Uses of Neotison 200 Convicap
- Sneezing and runny nose due to allergies
Side effects of Neotison 200 Convicap
Common
- Nosebleeds
- Headache
- Nasal inflammation
How to use Neotison 200 Convicap
Use this medicine in the dose and duration as advised by your doctor. Check the label for directions before use. Insert the bottle tip into one nostril and close the other nostril. Direct the spray towards the sides of your nostril, away from the cartilage dividing the two sides of your nose. As you spray, breath gently and keep the head upright. Repeat the same process for the other nostrils.
How Neotison 200 Convicap works
Neotison 200 Convicap is a steroid which works by blocking the production of certain chemical messengers in the body that cause inflammation (redness and swelling) and allergies.
Indication
Indicated for maintenance treatment of, asthma, as prophylactic therapy
Administration
Inhaled Administration
For oral inhalation only
Rinse mouth with water and expectorate after each dose to prevent oral/esophageal candidiasis
Adult Dose
Inhalation
Asthma prophylaxis
Adult: As fluticasone furoate dry powd inhaler: 100-200 mcg once daily.
Starting dose is based on asthma severity
Recommended starting dose: 100 mcg/day
May increase to 200 mcg/day after 2 weeks if patient does not respond to 100 mcg/day
Not to exceed 200 mcg qDay
Hepatic impairment
Mild: No dosage adjustment required
Moderate-to-severe: Caution advised; monitor patients for corticosteroid-related adverse effects
Child Dose
Asthma
Indicated for once-daily maintenance treatment of asthma as prophylactic therapy in children aged >5 years
<5 years: Safety and efficacy not established
5-11 years: 50 mcg inhaled PO qDay
>12 years
1 inhalation PO qDay; not to exceed 1 inhalation every 24 hr
Starting dose is based on asthma severity
Recommended starting dose: 100 mcg/day
May increase to 200 mcg/day after 2 weeks if patient does not respond to 100 mcg/day
Not to exceed 200 mcg qDay
Renal Dose
Renal impairment (all severities): No dosage adjustment required
Contraindication
Status asthmaticus or other acute episodes of asthma
Hypersensitivity, including severe allergy to milk protein
Mode of Action
Fluticasone utilises a fluorocarbothioate ester linkage at the 17 carbon position. It has potent vasoconstrictive and anti-inflammatory activity, but weak hypothalamic-pituitary-adrenal (HPA) inhibitory effect when applied topically.
Precaution
Localized infections of the mouth and pharynx with Candida albicans reported with inhaled corticosteroids
Not indicated for use as rescue therapy for acute bronchospasm
Potential worsening of existing tuberculosis; fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex; more serious or even fatal course of chickenpox or measles in susceptible patients; use caution because of potential for worsening of these infections; if exposed to chickenpox, prophylaxis with varicella-zoster immune globulin or pooled IV immunoglobulin may be indicated; if a patient is exposed to measles, prophylaxis with pooled IM immunoglobulin (IG) may be indicated
Caution when withdrawing from systemic corticosteroids and transferring to inhaled corticosteroids; taper systemic corticosteroids gradually and monitor for symptoms of HPA axis suppression and adrenal insufficiency; prednisone reduction can be accomplished by reducing the daily prednisone dose by 2.5 mg on a weekly basis during therapy
Systemic absorption from inhaled corticosteroids is low, but hypercorticism and adrenal suppression may occur with very high dosages or at regular dosage in susceptible individuals; if changes occur, discontinue therapy slowly
Long-term use decreases bone mineral density; patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, postmenopausal status, tobacco use, advanced age, poor nutrition, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, oral corticosteroids) should be monitored and treated with established standards of care
May cause reduction in growth velocity when administered to children and adolescents
Glaucoma, increased intraocular pressure, and cataracts have been reported in patients following the long-term administration of inhaled corticosteroids
Epistaxis, nasal ulceration, Candida albicans infection, nasal septal perforation, impaired wound healing; monitor patients periodically for signs of adverse effects on nasal mucosa; avoid use in patients with recent nasal ulcers, nasal surgery, or nasal trauma
Lactation
No information is available on the presence of fluticasone furoate in human milk, the effects on the breastfed child, or the effects on milk production
Low concentrations of other inhaled corticosteroids have been detected in human milk
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for the drug and any potential adverse effects on the breastfed child from fluticasone furoate or from the underlying maternal condition
Side Effect
>10%
Nasopharyngitis (8-13%)
Headache (6-13%)
1-10%
Bronchitis (4-7%)
Sinusitis (4-7%)
Influenza (4-7%)
Pharyngitis (3-6%)
URT infection (2-6%)
Oropharyngeal pain (3-4%)
Toothache (3%)
Back pain (3%)
Viral gastroenteritis (3%)
Abdominal pain (3%)
Cough (3%)
Oropharyngeal candidiasis (3%)
Dysphonia (2-3%)
Oral candidiasis (<1-3%)
Procedural pain (<1-3%)
Rhinitis (<1-3%)
Throat irritation (<1-3%)
Pregnancy Category Note
Pregnancy
Insufficient data on use in pregnant women
Animal studies
No fetal structural abnormalities were observed in animal (ie, rats, rabbits) reproduction studies during organogenesis at doses 4 times (rat) and 1 times (rabbit) the maximum recommended human daily inhalation dose
Clinical considerations
In women with poorly or moderately controlled asthma, there is an increased risk of several perinatal adverse outcomes such as preeclampsia in the mother and prematurity, low birth weight, and small for gestational age in the neonate
Pregnant women with asthma should be closely monitored and medication adjusted as necessary to maintain optimal asthma control
Lactation
No information is available on the presence of fluticasone furoate in human milk, the effects on the breastfed child, or the effects on milk production
Low concentrations of other inhaled corticosteroids have been detected in human milk
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for the drug and any potential adverse effects on the breastfed child from fluticasone furoate or from the underlying maternal condition
Interaction
Increased plasma concentration w/ potent CYP3A4 inhibitors (e.g. ritonavir).