Contraindications
Treatment is not recommended for the following categories of patients:
- children under 2 years old;
- people suffering from severe kidney and liver diseases;
- patients with individual intolerance to the components of the drug.
Avamis should not be used in parallel with Ritonavir , as this may enhance the effect of both drugs and cause a hormonal overdose.
The drug can be prescribed to pregnant women only if the benefit to the mother is expected to be greater than the possible risk to the child. Avamis is prescribed to breastfeeding women in minimal doses.
Indications for use
There are three main indications for the use of Avamis drops:
- purulent sinusitis;
- adenoids in children;
- allergic runny nose.
Experts strongly advise the independent use of a nasal spray only for allergic seasonal rhinitis.
In this case, it is advisable to start using it in advance, approximately 2 weeks before the arrival of the season. This strategy can help you survive a dangerous time without typical problems. In case of complications such as sinusitis or enlargement of the adenoids, it is best to discuss the use of Avamis with an ENT specialist. As a rule, in these cases, Avamis is combined with other medications and manipulations.
During a runny nose
Avamis nasal drops have proven themselves to be excellent both in the fight against allergies during flowering plants, and in relieving allergens that complicate life all year round: six animals, dust, etc. Interaction with nasal receptors makes it possible to avoid reactions to external irritants and eliminate classic manifestations in the form of profuse runny nose, sneezing and itching.
During a runny nose of bacterial etiology, the use of Avamis is ineffective without taking antibiotics.
During sinusitis
Otolaryngologists for sinusitis have found nasal drops as an independent medicine to be ineffective, which is why Avamis is most often included in a complex of drug therapy as an auxiliary medicine. The product effectively removes swelling, freeing the sinuses from pus, preparing the mucous membrane for the effects of other drugs.
During adenoids
A runny nose in children is often complicated by adenoiditis. As in the case of sinusitis, Avamis drops eliminate only the symptoms, however, without the simultaneous use of other medications, the drug is not able to cure the disease. The main effect of Avamis in this case is aimed at facilitating breathing through the nose when it is congested and generally improving the well-being of children.
Dosage
From 2 to 12 years
27.5 mcg (one spray) into the nasal passages 1 time per day. If the specified dose and recommendations of the attending physician are followed, Avamis quickly alleviates the patient’s condition and has no side effects.
Children over 12 years old and adults
55 mcg (two sprays) into the nasal passages once a day. Subsequently, when a positive effect is achieved, the dose can be halved to 1 spray into the nasal passages once a day.
For elderly patients, no special treatment adjustment is required.
An overdose of this drug is unlikely. Studies have been conducted in which the dosage was increased more than 20 times, but no adverse reactions were identified. If they occur, you should stop taking Avamis and consult a doctor. If necessary, overdose is treated symptomatically. There is no specific antidote to the drug.
Composition and release form
Composition of Avamys according to instructions for use:
The active substance is a synthetic hormone of the glucocorticosteroid (GCS) group, fluticasone furoate. Two sprays of the product contain 27.5 mcg of the hormone.
Additional substances:
- Distilled water,
- emulsifier,
- glucose,
- cellulose.
The consistency of the Avamis solution is a homogeneous white suspension, which is enclosed in a vial of bright orange glass. For ease of administration, the glass is placed in a plastic container with a window for visual observation of the remaining amount of the drug, a nozzle for spraying the suspension and a button for precise dosage. To protect the sprayer from clogging, the device is closed with a removable cover. The medicine is sold in cardboard packages of 30, 60 and 120 doses.
Avamis nasal spray cost
The production process of any hormonal drug is expensive due to the high cost of raw materials and complex processing technology. Therefore, the significant price of Avamis is justified by the specifics of its manufacture.
How much does Avamys spray cost? The cost varies depending on the number of doses in the vial. The maximum dosage of 120 doses in Russia costs from 550 to 750 rubles, depending on the region and the selling pharmacy. It is more profitable to buy a large package, especially if there is a small allergy sufferer in the family, when the drug should always be present in the first aid kit.
Instructions for use
The drug is intended for intranasal use. An important condition is continuous systematic use. Interruptions in treatment significantly reduce the effectiveness of treatment. Relief is usually observed 7-8 hours after application, then a lasting improvement develops within several days.
Before using Avamis for the first time, as well as if the drug has not been used for a long time (more than 1 month), you must shake the bottle by removing the cap and pressing the spray button all the way.
Rules for using Avamis:
- clean the nasal passages well;
- tilt your head forward slightly and hold the bottle vertically;
- insert the spray into one nostril and press the other with your finger;
- while inhaling, press the spray button, trying to direct the stream away from the nasal septum;
- exhale through the mouth;
- spray the medicine into the other nostril in the same way;
- wipe the nozzle dry and close the lid;
- in case of accidental contact of the drug with the eyes, rinse them immediately with running water;
Shelf life: 2 months after opening.
The most common side effect is nosebleeds. It can occur with long-term use of Avamis (more than 1.5 months). In individual cases, an allergic reaction may develop.
Original instructions —
Composition and action
The main active ingredient of the drug is fluticasone fuorate. One dose (this is one injection) contains 27.5 mcg of the component. Fluticasone, entering the nasal cavity, has the following effects:
- decongestant;
- anti-inflammatory;
- antiallergic.
The synthetic hormone is distinguished by its affinity (that is, relatedness) to glucocorticosteroids (hormones produced by the adrenal glands that have anti-inflammatory, detoxification, anti-shock, anti-allergic and immunosuppressive effects).
The active substance of the drug penetrates the cell cytoplasm and binds firmly and permanently to the steroid receptors located in it, stimulating them. As a result, the production of substances that block the allergic reaction is activated. The mucous membrane ceases to perceive the environment as an enemy and suspends the fight against it.
For many parents, the adjective “hormonal” raises concerns: such drugs are usually associated with dangerous side effects and harm to the body. But Avamis works only in the mucous membrane of the nasal passages and affects exclusively local immunity. A minimal amount of its active component enters the blood plasma - this concentration (in most cases) is not capable of having a serious effect on health. But still, if a child additionally takes steroids in the form of injections or tablets, it is not recommended to be treated with Avamis: the total effect can cause an overdose.
In the first days of taking the drug, the effect may be weak.
You should not expect instant results from using Avamis spray (as when using vasoconstrictor drops). The drug has a cumulative effect: the first relief from treatment is felt after about 8 hours, and the maximum effect appears 2-3 days after the start of use.
The drug is completely broken down by the liver and is eliminated from the body in a short time.
Analogs
Unfortunately, there is no drug with a similar active ingredient.
The most identical drugs to Avamis are:
- Flixonase - their compositions are almost the same;
- Nasonex - contains another hormone.
You can also use as analogues:
- Flutinex;
- Nasobek;
- Nazophan;
- Metaspray;
- Tafen nasal;
- Reasonel.
All these drugs relieve swelling of the nasal mucosa, eliminate inflammation and symptoms of allergic rhinitis, quickly alleviating the person’s condition. The list of contraindications for their use is similar to Avamis.
Pharmacological properties
Fluticasone furoate is a synthetic glucocorticosteroid, code ATX (ATC) R01A D12. In combination with salmeterol, the drug belongs to the group of drugs included in the list of essential drugs. Developed for the symptomatic treatment of allergic and vasomotor rhinitis, relieving edema and other inflammatory diseases.
The principle of action of Avamis is based on the versatile effects of glucocorticoids on the human body. Fluticasone furoate is characterized by powerful anti-inflammatory and antiallergic activity. By inhibiting the synthesis of potent inflammatory mediators, the drug effectively relieves the symptoms of allergic rhinitis.
The mechanism of action of Avamis is distinguished by its clear affinity for GC receptors. The high pharmacodynamic activity of fluticasone furoate provides excellent therapeutic results in the lowest possible dose compared to other glucocorticoids.
Being a trifluorinated derivative, honey has low absorption when applied topically. Only 0.5% of the daily dose (from 2640 mcg) administered intranasally enters the systemic circulation. This low bioavailability rarely causes structural complications.
The low load of nasal spray on the body is due to its significant binding ability. Fluticasone furoate can bind to proteins contained in blood plasma by 99% or more. The volume of distribution of the drug is 608 l.
Avamys is metabolized primarily in the liver, through the formation of inactive metabolites of 17-carboxylic acid. Accordingly, excretion occurs through the intestines with feces. The half-life is 10-11 hours.
How long does it take for Avamys to start working? It takes several days to achieve results and relieve congestion. The appearance of the therapeutic effect depends on the chosen dose.
The drug acts most quickly 8 hours after the first use of the nasal aerosol, when using a concentration of 110 mcg. At a dosage of 55 mcg, improvement is observed after 24 hours.
Obtaining results and eliminating the symptoms of allergic rhinitis, including eye manifestations, is possible with regular use of the drug
Since Avamys does not begin to act immediately when there is nasal congestion, it is important to continue spraying it as prescribed by the doctor.
Is Avamys addictive? In rare cases, individual long-term use of the drug or exceeding the specified dosage provokes resistance to the active substance. Over a course of 3-6 months of using nasal drops, addiction does not affect the body.
Reviews
Marina, 27 years old
I suffered for a long time with an allergy, as it turned out, to a domestic cat. There were constant headaches, runny nose, shortness of breath. On the advice of a doctor, I bought Avamis. At first I didn’t notice any effect, I thought I wasted my money. But on day 4 (lo and behold!) I started breathing! Herself! I didn’t know what happiness it was to breathe through my nose. I used the spray for more than a month and felt good. But 2.5 weeks after stopping the drug, the symptoms began to return. I don’t want to use the medicine all the time, and I don’t know if it’s possible. You will probably have to part with your pet. Although it’s a shame, health is more important.
Alexander, 35 years old
I tried many nasal drops and sprays for allergic rhinitis, but nothing really helped. There were only minor and short-lived improvements. I work as a manager in a household appliances store and constantly walking around with a handkerchief, sniffling and sneezing was very embarrassing. A relative recommended Avamis. I no longer hoped for a serious result, but it really helped. Now I only buy it and finally feel like a normal person.
Natalya, 40 years old
I spent a long time running around with my 7-year-old son to doctors and getting treatment for his runny nose until they found out that the child had an allergy. The biggest problem was nasal congestion, my son did not sleep well at night, there were periods when it was impossible to lie down at all, he slept sitting up. The doctor prescribed Avamis. Already on the first night the child slept much better. Now we are saved only by them.
Victoria, 32 years old
I have had chronic rhinitis and naphthyzine addiction for 15 years now. Initially, no allergies were detected; all tests were negative. Even when I started to choke, no allergens were found. But the doctor still prescribed Avamis for me. After three days I felt relief. Naphthyzin was no longer needed. I used it for a month and a half or two. After the withdrawal it got worse again. Now I use it occasionally, as a preventive measure, because I can’t live without it.
Pharmacodynamics
Fluticasone furoate is a synthetic trifluorinated glucocorticosteroid with very high affinity for glucocorticosteroid receptors. It is characterized by a pronounced anti-inflammatory effect.
Pharmacokinetics
The active component of Avamys is only partially absorbed, participating in primary metabolic processes in the liver and intestines, which causes insignificant systemic exposure. Intranasal administration of a dose of 110 mcg once a day does not reveal measurable plasma concentrations of the substance (concentration less than 10 pg/ml). The absolute bioavailability of fluticasone furoate administered intranasally at a dosage of 880 mcg 3 times a day (daily dose is 2640 mcg) is 0.5%.
The binding of fluticasone furoate to plasma proteins is 99%. After reaching equilibrium concentration, the volume of distribution of the substance is approximately 608 l.
Fluticasone furoate is eliminated from the systemic circulation at a high rate (total plasma clearance is 58.7 l/hour), predominantly metabolized in the liver with the participation of the CYP3A4 isoenzyme of the cytochrome P450 system with the formation of a 17p-carboxyl metabolite that does not have pharmacological activity (GW694301X).
In vivo studies have demonstrated that fluticasone furoate is not degraded to fluticasone.
When administered intravenously and orally, fluticasone furoate and its metabolites are eliminated from the body mainly through the intestines by excretion in the bile. When administered intravenously, the half-life of the drug is 15.1 hours. Approximately 2% and 1% of the substance are excreted through the kidneys when administered intravenously and orally, respectively.
The pharmacokinetics of Avamis in elderly patients has been studied only in small statistical samples. In this category of patients, cases of detection of fluticasone furoate in concentrations that allow quantitative determination are observed no more often than in young patients.
In children, the plasma content of fluticasone furoate when administered intranasally at a dose of 110 mcg once a day is usually so low that it cannot be quantified (less than 10 pg/ml). Concentrations of the substance that can be quantified were detected in less than 16% of children in whom Avamys was administered intranasally at a dosage of 110 mcg once a day, and in less than 7% of children taking the drug at a dose of 55 mcg once a day. There are no data confirming that in children under 6 years of age, cases of detection of fluticasone furoate in concentrations available for quantitative determination are more common.
When administered intranasally to healthy volunteers, the active component of Avamis was not detected in the urine. No more than 1% of metabolites are excreted through the kidneys, so it is believed that renal dysfunction does not affect the pharmacokinetics of the drug.
Studies conducted in patients with moderate liver dysfunction who received a single inhalation dose of 400 mcg of fluticasone furoate showed an increase in the area under the concentration-time pharmacokinetic curve by 172% and an increase in the maximum concentration of the substance in the body by 42% compared with healthy volunteers . It is assumed that the probable exposure of the active substance of Avamys at a dose of 110 mcg when administered intranasally will not cause cortisol suppression and will not lead to clinically significant adverse effects. Therefore, dose adjustment is not required in patients with mild to moderate liver dysfunction (class A and B on the Child-Pugh scale).
There are no data available for patients with severe liver dysfunction (Child-Pugh class C)
Caution must be exercised when determining the dose for this category of patients, since they are more at risk of systemic adverse reactions caused by the administration of glucocorticosteroids
Avamis or sinoflurin
The effect of the drug sinoflurin largely coincides with the effect provided by its structural analogues - flixonase and nazarel. The indications, adverse reactions, and contraindications also coincide.
When choosing a specific drug, you need to consider the following parameters: all drugs have the same composition, but their manufacturers are different. Therefore, you should choose the company that inspires maximum confidence. The cost of medications also differs. To make the final choice, you should consult a doctor.
The price in pharmacies for a spray (120 doses) is 400 rubles.
How to treat allergic rhinitis
The active component of Nasobek spray is the glucocorticoid hormone - beclomethasone dipropionate, which is completely different from the active ingredient of Avamis. This drug has an antihistamine effect and provides an immunosuppressive effect. The product can be used for any form of allergic rhinitis and helps to cope with the vasomotor form of the runny nose.
This substance has additional contraindications that Avamis does not have. These include the first trimester of pregnancy, age less than 6 years, fungal diseases. Also, the drug nasobek should not be used for tuberculous lesions of the respiratory system or hemorrhagic diathesis. Relative limitations include glaucoma, amoebiasis and heart attack. It is worth considering that Avamis does not have such restrictions.
During therapy, there is a risk of developing candidiasis of the respiratory system, myalgia, and developmental delays in children. The drug also creates problems with bone mineralization. Similar consequences usually occur when using an excessive dosage. Nasobek is usually used 2-4 times a day, which creates certain difficulties for patients. In addition, the drug may cause drowsiness.
Nasobek is much cheaper than Avamis and costs around 200 rubles per spray.
When is the remedy prescribed?
Most often, doctors recommend a nasal spray for rhinitis of allergic etiology, seasonal or chronic.
It is noteworthy that this medication can be taken by both adults and young patients. This information is confirmed by the instructions for Avamis and reviews. Children tolerate injection of the solution well. Doctors recommend the use of the spray for children aged two years and older.
In addition, the drug is actively prescribed to older people and patients with impaired liver and kidney function. According to various studies, the concentration of the drug in such vital organs is not so significant as to harm them.
How should this drug be used to achieve the desired therapeutic effect?
Other instructions
Since, according to research, fuluticasone furoate can provoke growth retardation in children, with long-term use of the drug it is necessary to carefully monitor this indicator through medical examinations. In any case, the dosage of the medication for children should be minimal.
As mentioned above, this remedy can cause visual impairment. If a person has a history of similar pathologies (glaucoma, intraocular pressure, cataracts), then the use of the spray should be carried out under the careful supervision of an ophthalmologist.
The use of fuluticasone furoate intranasally does not affect the ability to drive equipment and cars.
Basic rules of use for children
The Avamis bottle is equipped with a button for spraying and an indicator window that allows you to control the amount of the drug. With a volume of 30 or 60 doses, the initial level can be seen immediately, in packages of 120 doses - after several uses. To find out how much medicine is left, you need to look at the window, placing the bottle opposite the light source.
Before the first use, the drug must be prepared for use, this will allow the spray to be dosed correctly. Leaving the cap closed, shake the bottle thoroughly for 8-10 seconds
Avamis is a suspension, so it is important that the liquid base is mixed with the thick sediment before spraying. When shaking, you can feel that the drug has become more liquid
Then the cap must be removed and the tip turned away from you. Holding the bottle vertically in your palm, press the button with your thumb several times in a row until spraying occurs. After these manipulations, Avamis is ready for use.
Before using the spray, it is necessary to clear the child's nose of dust and mucus. To do this, you can use saline solutions (Marimer, Aqua Maris, Physiomer, Aqualor, etc.).
Injection of Avamys should be carried out in a vertical position. Tilt your head slightly forward and insert the sprayer into the nasal passage, pointing it at the outer wall (not at the septum). Ask the child to inhale lightly and at this time press the bottle button once. Remove the tip and let the child exhale (preferably through the mouth). If the dosage is 55 mcg in each nostril, then repeat the injection into the same nostril, then move on to the next one.
After the administration of the drug is completed, the sprayer and the cap from the inside must be dried with a napkin. Do not allow water to enter. To avoid problems with spraying, the bottle should always be closed immediately after use. The cap prevents the tip from becoming dusty and protects against accidental spraying.
AVAMIS: SIDE EFFECTS
Determination of the frequency of adverse reactions: very often (≥ 1/10); often (≥ 1/100,
From the respiratory system: very often - nosebleeds; often - ulceration of the nasal mucosa. In adults and adolescents, cases of nosebleeds were observed more often with long-term use (more than 6 weeks) than with a short course (up to 6 weeks). In studies in children with treatment durations of up to 12 weeks, the incidence of epistaxis was similar between fluticasone furoate and placebo.
Allergic reactions: rash, urticaria, Quincke's edema, anaphylaxis.
Avamys or Flutinex
Flutinex is produced in the form of a nasal spray, which is produced in the form of a suspension. The active ingredient of this drug is a corticosteroid hormone - fluticasone propionate. This remedy perfectly helps with allergic rhinitis. It can be used from 4 years of age. At the same time, Avamys can also be used for 2-year-old children.
According to the instructions, flutinex provides a pronounced therapeutic effect already on the 3-4th day of use. This product is well tolerated and does not cause any side effects. The main thing is to strictly adhere to the dosage prescribed by your doctor.
Avamis is considered a very effective drug that successfully copes with rhinitis of allergic origin. However, this tool cannot always be used. In some situations, there is a need to select cheaper analogues
In order not to make a mistake with your choice, it is very important to follow all medical recommendations
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A runny nose of an allergic nature is a common disease in otorhinolaryngology. Avamis is a modern English remedy that effectively fights sinusitis and allergic rhinitis. The release form of the drug is nasal spray. The medicine can be prescribed for children over 2 years of age.
The composition of the medicine includes the active ingredient fluticasone furoate. This is a synthetic glucocorticosteroid that also has an anti-inflammatory function. According to the instructions, the drug can be prescribed during pregnancy only in cases where the risk to the health of the mother exceeds the danger to the fetus. It is not recommended to use the spray during breastfeeding.
The consistency of the medicine inside the bottle is a thick suspension. This necessitates careful maintenance of the sprayer. It should not become clogged and should be washed regularly.
Another disadvantage of the medicine is the high price - from 520 rubles. Cheap analogues of the drug Avamis can be found in the list of Russian-made or imported drugs.
About the drug
The medication belongs to the group of corticosteroid drugs. The main component is the artificially created hormone fluticasone furoate, which is effective in the treatment of adenoids of varying degrees. It is widely used in the practice of otolaryngologists in children, in cases where previous drug therapy has not given the desired result and the next step in treatment is surgical removal of the tonsils.
The drug consists of:
- micronized fluticasone furoate - 27.5 mcg;
- auxiliary components in the form of dextrose - 2700 mcg;
- dispersible cellulose - 820 mcg;
- polysorbate - 80 mcg;
- benzalkonium chloride - 17 mcg;
- disodium edetate - 9 mcg;
- purified water - 60 µl.
Available in the form of a nasal spray in a plastic case with a special dispenser located on the side. The dispenser is designed to deliver one therapeutic dose by pressing it. Available in quantities of 30, 60, 120 doses. Application is individual, depends on the degree of development of the adenoids, and is strictly prescribed by the attending physician.
The product eliminates hyperemia of the mucous membrane, reduces pain, and relieves difficulty breathing. Avamys only acts locally, because... enters the circulatory system in minimal quantities and does not have a negative effect on the child’s hormonal levels, and therefore the natural production of hormones is not disrupted.
The drug is not completely absorbed, undergoes initial metabolism in the liver and intestines, binds to blood plasma proteins almost 100%, and is eliminated from the circulatory system by metabolism within a short time. It is excreted through the intestines and bile, partly by the kidneys.
