Intal
Intal: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Intal
ATX code: R03BC01
Active ingredient: cromoglicic acid
Producer: Aventis Pharma (Great Britain)
Description and photo updated: 2019-27-08
Intal - antiallergic drug, stabilizer of mast cell membranes.
Release form and composition
Dosage forms:
- Powder capsules for inhalation: size No. 2, gelatinous, consisting of a hard transparent colorless body and a transparent yellow cap, with the inscription "SODIUM CROMOGLYCATE 20 mg", inside capsules - white or almost white powder of a homogeneous structure (10 pcs. In blisters or in a sachet, in a cardboard box 1 blister or 3 sachets);
- Dosed aerosol for inhalation: after evaporation, a white powder remains at the spray site (112 doses in aluminum aerosol cans, 1 can in a cardboard box).
Each pack also contains instructions for using Intal.
The active substance is sodium cromoglycate:
- 1 capsule - 20 mg;
- 1 aerosol dose - 5 mg.
Auxiliary components:
- Capsules: shell composition - 100% gelatin;
- Spray: macrogol (polyethylene glycol) 600, povidone K30, hydrofluoroalkane (HFA-227).
Pharmacological properties
Pharmacodynamics
The active ingredient of Intal is sodium cromoglycate - antiallergic, anti-inflammatory and anti-asthmatic agent. Has a membrane stabilizing effect, with systematic use reduces the symptoms of allergic inflammation in the respiratory system.
The drug inhibits both early and late stages of an allergic reaction due to the fact that it has the ability to prevent the degranulation of mast cells and the release of inflammatory mediators from them, such as prostaglandins, leukotrienes, bradykinin, histamine and a slowly reacting substance. These properties of Intal prevent bronchospasm caused by an allergen or any provoking factor (physical stress, stress, cold air).
Intal is not used to relieve acute attacks of bronchial asthma, since it does not eliminate the developed bronchospasm. The most effective for the prevention of immediate allergic reactions in patients of relatively young age, if they have not yet developed irreversible chronic changes in the lungs.
The therapeutic effect of the drug develops slowly. The frequency of bronchial asthma attacks decreases after about 4-6 weeks of regular treatment. Preventive therapy should be prolonged. With prolonged use, Intal reduces the frequency of attacks of bronchial asthma and facilitates their course, reduces the need for other anti-asthma drugs (glucocorticosteroids, bronchodilators).
After the abolition of Intal, it is possible to resume attacks of bronchial asthma.
Pharmacokinetics
After inhalation, sodium cromoglycate reaches its maximum concentration within about 15 minutes. Poorly absorbed from the gastrointestinal tract. Systemic absorption is about 5-15% of the dose received. From the mucous membranes of the respiratory tract, absorption occurs quickly, but it can decrease if the amount of secretion increases.
The drug is quickly excreted from the systemic circulation, therefore, subsequent doses do not cumulate (subject to the recommended dosage regimen).
Binds reversibly to plasma proteins (approximately 65%).
Sodium cromoglycate is not biotransformed. It is excreted from the body unchanged with bile and urine in approximately equal amounts. The rest of the drug is excreted from the lungs with the flow of exhaled air or settles on the walls of the oropharynx, then swallowed (without significant absorption, absorbed no more than 2%) and excreted through the digestive tract.
The half-life on average is about 80 minutes (46–99 minutes).
Indications for use
The use of capsules and Intal aerosol is indicated for the prophylactic treatment of bronchial asthma, including exercise asthma.
Contraindications
- I trimester of pregnancy;
- Hypersensitivity to drug components.
Prescribing in the II and III trimesters of pregnancy and during breastfeeding is possible only if the intended benefits of treatment for the mother outweigh the possible harm to the fetus or child.
Do not use Intal capsules when treating children under the age of 2 years.
The capsules are prescribed with caution in patients with hepatic and / or renal insufficiency.
It is contraindicated to use aerosol for children under 5 years of age.
It is recommended to use the aerosol with caution in case of impaired renal and / or liver function.
Intal, instructions for use: method and dosage
- Powder capsules for inhalation: intended only for inhalation use with the Spinkhaler inhaler, capsules cannot be taken inside. Preventive therapy involves the regular use of capsules by adults and children from 2 years of age. The dosage regimen for adults and children is the same: 1 capsule 4 times a day every 3-6 hours. With an increased content of antigen in the environment or a severe form of allergy, the frequency of administration can be increased up to 6-8 times a day (120-160 mg sodium cromoglycate per day). For the prevention of asthma attacks from the upcoming physical activity, you can first carry out an additional inhalation. The transition to a maintenance minimum dose capable of controlling the symptoms of bronchial asthma is possible only after a stable therapeutic effect has been achieved;
- Dosed aerosol for inhalation: for children over 5 years old, adults and elderly patients - 2 inhalations 4 times a day. After achieving a therapeutic effect that ensures optimal control of the disease, it is possible to switch to a maintenance dose - 1 inhalation 4 times a day. It is allowed to increase the dose of the drug up to 2 inhalations 6-8 times a day with an increased concentration of allergens or in case of severe attacks. It is not recommended to suddenly discontinue the use of the drug after stabilization of the condition, the cancellation is carried out within a week, gradually. If the dose is reduced, symptoms of the disease may recur. An additional dose of Intal can be taken to prevent asthma immediately before exercise or anticipated contact with allergens. With simultaneous treatment with bronchodilators,inhalations must be carried out after taking them. Patients receiving corticosteroids, while using Intal, can significantly reduce the dose or completely cancel their intake. The use of the spray by children is recommended only under adult supervision. The effectiveness of treatment depends on the correct use of the inhaler. Before using the inhaler for the first time, shake it and press the metering valve several times. Each time you use the inhaler, after removing the dust cap, make sure the inner and outer surfaces of the tip are clean and shake the contents of the inhaler several times. After exhaling fully, holding the inhaler in an upright position, place the tip between the teeth (do not bite) and clasp it tightly with your lips. When inhaling air through the mouth, pressing all the way on the base of the cartridge,spray a dose of the drug, calmly continuing to take a deep breath. With a held breath, pull the tip out of your mouth and not breathe for a while (as far as you can). A second dose can then be administered (if required). Close the handpiece with a dust cap after use.
Side effects
The use of Intala capsules can cause side effects:
- From the respiratory system: irritation of the upper respiratory tract in the form of hoarseness and cough; extremely rare - pulmonary infiltrates with an increase in the content of eosinophils in the blood;
- Allergic reactions: bronchospasm, angioedema, laryngeal edema, skin rash; rarely - anaphylaxis;
- From the digestive tract: nausea, dry mouth;
- From the urinary system: urinary retention, impaired renal function;
- From the nervous system: headache, dizziness.
Aerosol can cause unpleasant taste sensations, dry mouth, mucosal irritation, short-term bronchospasm, hoarseness and cough.
In case of recurrent bronchospasm, inhalation of a bronchodilator is preliminarily done, and the cough is soothed by taking water after inhalation.
With the unexpected development of bronchospasm immediately after inhalation of the aerosol, it is recommended to cancel the use of Intal and prescribe another treatment.
The occurrence of these undesirable effects can be reduced by using an aerosol with a spacer.
Rare adverse events can be: headache and dizziness, anaphylaxis, urinary disorders (painful, rapid or difficult), nausea, skin rash.
Against the background of aerosol cancellation, there is a risk of exacerbation of bronchial asthma, eosinophilic infiltration of the lung, in very rare cases - the development of eosinophilic pneumonia.
Overdose
Cromoglycic acid has low toxicity, so overdose and the development of toxic reactions are unlikely. In the event of a significant excess of the recommended dose, only medical supervision is required.
special instructions
Intal capsules and aerosol are not intended to relieve attacks of bronchospasm.
Bronchodilators of concomitant therapy should be taken before inhalation of Intal.
Usually it is possible to reduce and sometimes completely cancel the maintenance dose of glucocorticosteroids while using Intal. The process of reducing the dose of glucocorticosteroids should take place under the close supervision of the attending physician, within a week it should not exceed 10%. With a decrease in the dose of glucocorticosteroids, Intal should be continued until a new dosage of glucocorticosteroids is prescribed.
The need to increase the dose of glucocorticosteroids may occur with infection, exacerbation of asthma, or an increase in the antigen content in the environment.
Patients on whom preventive therapy with Intal has a positive effect is recommended not to interrupt the use of the drug.
Cancellation of the drug is made within 1 week, a gradual dose reduction may contribute to the resumption of asthma symptoms.
Patients with renal and / or hepatic impairment should use capsules under constant medical supervision.
Application during pregnancy and lactation
Intal is prohibited for use in the first trimester of pregnancy.
In the II-III trimesters and during lactation, the administration of the drug is possible if the expected benefit to the woman outweighs the potential risks to the fetus / child.
Pediatric use
Intal capsules are contraindicated in children under 2 years of age, aerosol - up to 5 years.
With impaired renal function
Intal should be used with caution in patients with impaired renal function. Treatment should be carried out under the supervision of a physician. A dose reduction may be required.
For violations of liver function
Intal should be used with caution in patients with impaired liver function. Treatment should be carried out under the supervision of a physician. A dose reduction may be required.
Use in the elderly
Elderly patients do not need to adjust the dose of Intal.
Drug interactions
The combined use of sodium cromoglycate with glucocorticosteroids and bronchodilators is shown.
The simultaneous use of beta-adrenostimulants, antihistamines, glucocorticosteroids, theophylline enhances the effect of sodium cromoglycate.
When combined with cromoglicic acid and glucocorticosteroids Intal allows you to reduce their dose, and sometimes completely cancel.
Analogs
Analogs of Intal are: Nalkrom, Vividrin, Kromohexal, Kromoglin, Kromosol, Lekrolin, Taleum.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 30 ° C, do not freeze.
Do not keep the aerosol can in the refrigerator.
Shelf life: capsules - 5 years, aerosol - 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Intal
On forums and specialized medical sites, there are various reviews about Intal. Some patients describe it as an effective remedy for the treatment of bronchial asthma, which is well tolerated and does not cause adverse reactions. Others complain about the lack of effect or the development of undesirable phenomena. Many people note that the drug is effective, but the symptoms of the disease quickly return after its withdrawal, so the treatment must be constant.
There are messages in which users compare capsules and aerosols, noting the high efficacy and excellent tolerance of the capsules, and they very much regret that Intal is no longer sold in this dosage form.
Among the disadvantages, the bitter taste of the drug and the relatively high cost are noted.
Price for Intal in pharmacies
The approximate price of Intal in the form of a metered aerosol 5 mg / dose is 595-710 rubles. per bottle containing 112 doses. The cost of the capsules is currently unknown, since the drug is not available commercially in this dosage form.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
