Alvesco
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Alvesco is an inhaled glucocorticosteroid (GCS) for the treatment of bronchial asthma.
Release form and composition
Dosage form - metered dose aerosol for inhalation: transparent colorless solution (in aluminum cans with a dosing valve and a mouthpiece closed with a protective lid, 5 and 8 ml each (60 or 120 sprays, respectively), 1 can in a cardboard box).
Active substance: ciclesonide, its content in 1 dose (1 spray) - 40, 80 or 160 mcg.
Auxiliary components: ethanol and norflurane (HFA-134a).
Indications for use
Alvesco is a remedy for the treatment of bronchial asthma.
Contraindications
- Children under 6 years old;
- Individual hypersensitivity to the drug.
Carefully:
- Active or chronic form of pulmonary tuberculosis;
- Viral, fungal, or bacterial respiratory tract infections.
Method of administration and dosage
Alvesco is intended for oral inhalation. The drug should be used daily, treatment is long-term.
The initial dose is selected by the doctor depending on the severity of the disease. After achieving the required clinical effect, the dose is reduced to the minimum, which allows controlling the manifestations of the disease.
Adolescents over 12 years old and adults, including the elderly, with mild and moderate bronchial asthma are prescribed 160-640 mcg per day, the highest daily dose is divided into 2 applications. In severe cases of the disease, it is possible to increase the dose to 640 mcg 2 times a day every day.
Improvement of the condition is noted within 24 hours after inhalation of Alvesco. The maximum effect should be achieved after 2-3 months of therapy.
Children over 6 years of age are prescribed 80-160 mcg 1 time per day or 80 mcg 2 times a day.
An important condition for effective treatment is the continuous use of the drug, even in the absence of symptoms of bronchial asthma.
Alvesco can be used both independently and with a spacer. In the latter case, it is recommended to choose the AeroChamber Plus spacer.
In severe bronchial asthma in adults and adolescents who are constantly receiving oral corticosteroids (for example, prednisone), the dose of Alvesco is 640 mcg 2 times a day. The duration of treatment is 10 days, after which the daily dose is gradually reduced (no more than 2.5 mg every week) until the minimum effective is achieved.
In the stage of remission of the disease, it is possible to transfer patients from oral corticosteroids to Alvesco.
Instructions for using the inhaler:
- Remove the protective cap from the spray bottle, check the inside and outside of the mouthpiece and make sure it is dry and clean;
- Turn the inhaler upside down, place your index finger on the bottom of the can, your thumb under the mouthpiece;
- If the inhaler is new or has not been used for more than 1 week, perform the first 3 pressings of the valve in the air;
- Exhale as much as possible to the side (not into the inhaler);
- Place the mouthpiece in your mouth and close your lips around it;
- Start a slow and deep breath and press the top of the inhaler with your index finger. Make sure that the drug cannot pass through the space between the mouthpiece and the lips;
- Hold your breath, remove the mouthpiece from your mouth, remove your finger from the top of the inhaler. Breathing should be held for at least 10 seconds, if possible longer;
- Exhale slowly through your mouth (not through the mouthpiece);
- If you need to take another dose, you should wait 30 seconds, then repeat steps 4-8;
- Put on the protective cap on the can, close it tightly and fix it in place.
The can does not need to be shaken, because aerosol, dissolved.
For hygiene purposes:
- Clean the mouthpiece regularly with a dry cloth outside and inside;
- Wipe the surface with a small hole where the medicine comes out using a dry folded cloth;
- Do not use water or other liquids for cleaning.
Side effects
- From the digestive system: infrequently (> 1/1000, 1/10 000, <1/1000) - dyspepsia, abdominal pain;
- From the side of the cardiovascular system: rarely - increased blood pressure, as well as increased heart rate (with the simultaneous use of drugs that can have side effects on the heart rate, for example, theophylline or salbutamol);
- From the respiratory system: infrequently - cough after inhalation, dysphonia, paradoxical bronchospasm;
- Infectious and parasitic diseases: infrequently - fungal infections of the oral cavity;
- From the nervous system: infrequently - headache;
- On the part of the skin: infrequently - skin rash, eczema;
- Allergic reactions: rarely - angioedema, hypersensitivity reactions;
- Local reactions: infrequently - dryness of the mucous membrane of the mouth and pharynx, a feeling of perspiration and irritation in the throat;
- Systemic side effects: when using the drug in high doses for a long time - Cushing's syndrome and Cushing-like symptoms such as decreased bone density, glaucoma, cataracts, growth retardation in children and adolescents, adrenal suppression.
Paradoxical bronchospasm is possible immediately after inhalation. It is an acute nonspecific reaction to any inhalation drugs and can be associated with the active substance, auxiliary components or cooling due to the evaporation of the propellant when using metered-dose inhalers. In most cases, bronchospasm is an adverse reaction that goes away on its own and does not require discontinuation of treatment.
special instructions
According to the doctor's prescription, Alvesco can be used during pregnancy and lactation if the expected effect outweighs the potential risks. Newborns whose mothers received GCS during pregnancy should be under close medical supervision to exclude adrenal hypofunction.
Alvesco is not intended for the treatment of status asthmaticus and other acute attacks of bronchial asthma, the relief of which requires intensive therapeutic measures.
The dose of the drug should be reduced in patients who need oral corticosteroids.
Paradoxical bronchospasm and other symptoms of bronchoconstriction, which develop immediately after inhalation, are stopped with fast-acting bronchodilators. After that, the doctor must examine the patient and decide whether to continue Alvesco therapy. This is possible only if the expected effect significantly outweighs the risks. In this case, it is necessary to take into account the relationship between the severity of bronchial asthma and the patient's general predisposition to acute bronchial reactions.
Antibiotics should be given if an infection develops.
In patients transferred from oral corticosteroids to Alvesco, the function of the adrenal cortex may decrease for a long time, and there is also a risk of side effects of oral corticosteroids for some time after their cancellation. In this case, it is recommended to monitor the reserve function of the adrenal cortex. In this case, one should take into account the likelihood of residual deterioration in the function of the adrenal cortex in a critical situation (surgical or therapeutic) and in other individual cases caused by a stressful situation. As a result, it is necessary to begin the appropriate treatment of GCS.
In case of serious exacerbations and in case of insufficient function of the adrenal cortex, it is necessary to increase the dose of Alvesco, if necessary, prescribe oral corticosteroids.
In patients receiving systemic corticosteroids (prednisolone or its equivalent) at a high dose or for a long time, adrenal function may be suppressed, therefore, it should be regularly monitored and the dose of systemic corticosteroids should be gradually reduced. After about 1 week, you can gradually eliminate this drug by reducing the dose by 1 mg daily. When taking a daily maintenance dose of more than 10 mg, special care must be taken to bear in mind that it may be appropriate to reduce the dose more significantly during weekly intervals.
There are cases when, after discontinuation of the drug, patients did not feel well, despite the preservation or even improvement of respiratory function. Such patients should be evaluated for adrenocortical insufficiency.
When transferring patients from systemic corticosteroids to Alvesco, there is a possibility of developing allergic reactions (for example, allergic rhinitis, eczema), which were previously suppressed by a systemic drug. In these cases, symptomatic therapy with antihistamines is indicated, including for local and external use, containing GCS.
Since the effect of inhaled GCS on children with prolonged use has not been fully established, during treatment, one should constantly monitor the development of the growth of children. If it slows down, it is necessary to revise the therapy and reduce the dose of the drug to the minimum effective one, which allows you to control the symptoms of bronchial asthma.
There is no information on the effect of Alvesco on the speed of reactions and the ability to concentrate.
Drug interactions
It is not recommended to use simultaneously with Alvesco inhibitors of CYP3A4, including potential ones.
Analogs
There is no information about Alvesco analogues.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 25 ° C. Do not open the cylinder and do not expose it to heat above 50 ºС.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
