Summary of medicine characteristics - RHINOLAST ALLERGY 0.1% W/V NASAL SPRAY
1 NAME OF THE MEDICINAL PRODUCT
Rhinolast Allergy 0.1% w/v Nasal Spray
2 QUALITATIVE AND QUANTITATIVE COMPOSITION
Azelastine Hydrochloride 0.1% w/v
For full list of excipients, see section 6.1
3 PHARMACEUTICAL FORM
Nasal spray
Clear, to almost colourless solution
4 CLINICAL PARTICULARS
4.1 Therapeutic indications
For the treatment of both seasonal allergic rhinitis (e.g. hay fever) and perennial allergic rhinitis in patients aged 6 years and over.
4.2 Posology and method of administration
Route of application is topical – nasal mucosa.
Adults
One application (0.14 ml) in each nostril twice daily (0.56 mg of azelastine hydrochloride).
Children
For children aged 6 years and older, one application (0.14 ml) in each nostril twice daily (0.56 mg of azelastine hydrochloride).
Duration
Rhinolast Allergy 0.1 % w/v Nasal Spray should not be used continuously for longer than 4 weeks without a consultation with a doctor.
4.3 Contraindications
Proven allergy against azelastine hydrochloride
4.4 Special warnings and precautions for use
Not to be used to relieve the symptoms of Upper Respiratory Tract Infection.
4.5 Interaction with other medicinal products and other forms of interaction
No specific interactions have been studied.
4.6 Fertility, Pregnancy and lactation
At high oral doses in animals, 500 times the proposed oral human daily dose, foetal death, growth retardation and an increased incidence of skeletal abnormalities occurred during reproduction toxicity testing. Due to the nasal route of administration and the low dose administered, minimal systemic exposure can be expected. However as with all medicines caution should be exercised with use during pregnancy and lactation.
4.7 Effects on ability to drive and use machines
None
4.8 Undesirable effects
The following frequencies of undesirable effects were reported:
Commonly (1 – 10 %), a substance-specific bitter taste may be experienced after administration (often due to incorrect method of application, namely tilting the head too far backwards during administration) which, in rare cases, may lead to nausea.
Uncommonly (0.1 – 1 %), a mild, transient irritation of the inflamed nasal mucosa may occur with symptoms such as stinging, itching, sneezing and epistaxis.
In very rare cases (< 0.01 %), hypersensitivity reactions (such as rash, pruritus, urticaria) were reported.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
4.9 Overdose
4.9 OverdoseThe results of animal studies show that toxic doses can produce CNS symptoms, e.g. excitation, tremor, convulsions. Should these occur in humans symptomatic and supportive treatment should be instigated as there is no specific antidote. Gastric lavage is recommended if the overdose is recent.
With the nasal route of administration overdosage reactions are not anticipated.
5.1
Azelastine, a phthalazinone derivative of novel structure, is classified as a potent long acting anti-allergic compound with particularly strong H1 antagonist properties.
Data from animal studies show that where high levels of azelastine are achieved both inhibition and release of chemical mediators (e.g. leukotriene, histamine, serotonin) involved in allergic reaction occurs.
5.2 Pharmacokinetic properties
After repeated nasal application (0.14mg) into each nostril twice daily, the plasma levels of azelastine were about 0.26ng/ml. The levels of the active metabolite desmethylazelastine were detected at or below the lower limit of quantification (0.12ng/ml).
After repeated oral administration, the mean Cmax steady state plasma levels were determined giving 3.9ng/ml for azelastine and 1.86ng/ml for desmethylazelastine after 2.2mg b.i.d. azelastine which represents the therapeutic oral dose for the treatment of allergic rhinitis.
Following oral administration azelastine is rapidly absorbed showing an absolute bioavailability of 81%. Food has no influence on absorption. The volume of distribution is high indicating distribution predominantly to the peripheral tissues. The level of protein binding is low, (80–95% a level too low to give concern over drug displacement reactions).
Plasma elimination half lives after a single dose of azelastine are approximately 20 hours for azelastine and about 45 hours for N desmethylazelastine (a therapeutically active metabolite). Excretion occurs mainly via the faeces. The sustained excretion of small amounts of the dose in the faeces suggests that some enterohepatic circulation may take place.
5.3 Preclinical safety data
5.3 Preclinical safety dataNothing relevant
6.1
Hypromellose
Disodium edetate
Citric acid anhydrous
Disodium phosphate dodecahydrate
Sodium chloride
Purified water
6.2 Incompatibilities
None
6.3 Shelf life
Three years unopened, discard six months after opening
6.4 Special precautions for storage
Do not refrigerate
6.5 Nature and contents of container
Either a 10ml polyethylene bottle with polypropylene and polyethylene seals (containing 5ml solution), or a brown glass bottle with attached Valois pump containing 5ml Rhinolast Allergy 0.1% w/v Nasal Spray solution (36 doses).
6.6 Special precautions for disposal
6.6 Special precautions for disposalRemove the protective cap. Before first using, squeeze down the collar several times until an even spray emerges. The Rhinolast Allergy 0.1% w/v Nasal Spray 5ml spray is now ready to use.