Pharmacological properties

Pharmacodynamics. oxymetazoline a hydrochloride — synthetic adrenomimetik which, stimulating α-adrenoceptors of vessels, has the expressed and long vasoconstrictive effect. the vasoconstrictive effect is shown by blood inflow reduction, decrease in hypostasis of a mucous membrane of a nasal cavity, adnexal bosoms and an Eustachian tube owing to what the nasal breath broken at flu, catarrhal and allergic diseases is restored. local vasoconstriction of a mucous membrane of a nose and adnexal bosoms occurs in 5–10 min. after medicine injection назол® advans in a nasal cavity, antiedematous action lasts up to 12 h

Pharmacokinetics. T _½ hydrochloride oxymetazoline — 5–8 h. It is removed generally in not changed view with urine and a stake.

Indication

Symptomatic treatment of the catarrhal diseases, flu and SARS which are followed by sharp rhinitis, antritis, other sinusitis (the frontal sinusitis, etmoidit).

Use

to Adults and children aged from 12 years — 2 injections in each nasal course, to children at the age of 6–12 years — 1 injection. the bottle should be held vertically. to repeat injection not earlier than in 12 h treatment duration — no more than 3 days. perhaps more prolonged use up to 7–10 days on 2 injections a day under control of the doctor.

Contraindication

Increased individual sensitivity to oxymetazoline, other adrenomimetika or any of medicine components, severe forms ag, the expressed atherosclerosis, sharp cardiovascular diseases or cardiac asthma, takhisistolichesky violations of a warm rhythm, stenocardia, a renal failure, the expressed prostatauxe, a pheochromocytoma, metabolic violations (hyperthyroidism, diabetes), atrophic rhinitis, the increased intraocular pressure, especially at closed-angle glaucoma, after transsphenoidal hypophysectomy or other surgical intervention with opening of a firm meninx, inflammation or injuries of skin around the nasal courses or a mucous membrane of a nose, simultaneous use of the medicines causing increase hell, simultaneous application with Mao's inhibitors and application during 2 weeks after the treatment termination by Mao's inhibitors.

Side effects

At frequent and prolonged use can arise burning sensations, prickings in a nose, rushes of blood to the person, sneezing, xeromycteria. seldom — after the effect of use of medicine ends — feeling of strong congestion of a nose (reactive hyperemia). prolonged continuous use of vasoconstrictive medicines can lead to a tachyphylaxis or development of medicamentous rhinitis. generally heavy side effects are not noted.

from a cardiovascular system: tachycardia, heartbeat, increase in the ABP, a heartache are very seldom possible.

from an organ of sight: the irritation, discomfort or reddening of eyes, the obscured sight can seldom be observed.

from a GIT: there can seldom be nausea.

from the immune system: in isolated cases reactions of hypersensitivity, including rash, an itch, a Quincke's edema are possible.

Disturbance respiratory, thoracic and from mediastinum: the discomfort or irritation in a nose, a mouth and a throat, dryness in a mouth, nasal bleeding are seldom possible.

from nervous system: concern, nervousness, uneasiness, insomnia, drowsiness, a tremor, hallucinations (especially at children), increased fatigue, a headache, dizziness.

from skin and hypodermic fabrics: rash.

from musculoskeletal and connective tissues: spasms (especially at children).

General violations: weakness.

Special instructions

At injection of medicine in a nasal cavity not to throw back the head and not to overturn a bottle. to use a bottle individually in order to avoid spread of an infection.

Maintaining puffiness of the nasal courses after 3 days of use of medicine can demonstrate the existence of a curvature of a nasal partition, purulent antritis, adenoides, allergic rhinitis, steady bacterial infection or other not diagnosed diseases demanding consultation of the doctor and specialized complex therapy.

Should consult with the doctor prior to use of medicine in the following cases: raised by the ABP, heart diseases, violations from a liver or kidneys, a porphyria.

Needs to avoid prolonged use and overdose. Prolonged use of antiedematous can lead to weakening of its action. Abuse of this means can cause a mucosal atrophy and a reactive hyperemia with medicamentous rhinitis and also injury of a mucous epithelium and inhibition of activity of an epithelium. Doses are higher recommended it is possible to apply only under observation of the doctor. It is not necessary to exceed the recommended doses.

Use during pregnancy and feeding by a breast. Oxymetazoline was not connected with an adverse course of pregnancy. It is necessary to apply with care at patients with hypertensia or signs of reduction of blood supply of a placenta. Frequent or prolonged use of high doses can lead to reduction of a placentary blood-groove. To women during pregnancy the use of medicine is possible only if, according to the doctor, the advantage of application for mother exceeds potential risk for the fruit/child. It is unknown whether oxymetazoline gets into breast milk. Due to the lack of data oxymetazoline should not be applied when breastfeeding.

Children. Not to apply at children under 6 years.

Ability to influence speed of response during the driving or work with mechanisms. After prolonged use of medicine in the doses exceeding recommended the general influence on a cardiovascular system is not excluded. In such cases the ability to steer the vehicle can decrease.

Interaction

At use of other medicines in an initiation of treatment medicine is recommended to see a doctor. it is necessary to use medicament together with other vasoconstrictors (at any way of introduction of the last) or with other nasal decongestants and also with tricyclic antidepressants, Maprotilinum after consultation with the doctor as increase hell is possible.

. Therefore it is not necessary to use medicament at the same time or during 2 weeks after the treatment termination by MAO inhibitors.

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Oksimetazolin can reduce efficiency of blockers of β-adrenoceptors, Methyldopums or other antihypertensive medicines.

At simultaneous application of sympathomimetics and protivoparkinsonichesky means perhaps additive toxic influence on a cardiovascular system.

Overdose

At topical administration usually side system reactions do not arise.

oxymetazoline overdose Symptoms different. Allocate stages of hyperreactivity and braking. Stimulation of central nervous system is clinically shown in the form of feeling of fear, excitement, hallucinations, spasms.

Symptoms of overdose of average or heavy degree: a miosis (narrowing of pupils), a mydriasis (expansion of pupils), nausea, vomiting, cyanosis, fever, the increased sweating, spasms, tachycardia, arrhythmia, cardiac arrest, increase in the ABP, a fluid lungs, short wind, physical discomfort.

in the form of drowsiness, decrease in body temperature, bradycardia, arterial hypotension, collapse, shock, respiratory frustration and an apnoea, loss of consciousness, a coma.

symptoms from central nervous system belong To clinical manifestations of overdose at children: spasms and the coma, hallucinations, bradycardia, an apnoea, hypertensia, passes into hypotension.

Emergency aid. In case of suspicion on overdose of oxymetazoline the urgent hospitalization in intensive care unit is necessary. Apply activated carbon and depletive. Gastric lavage is necessary. For the purpose of decrease in the raised ABP it is necessary to appoint blockers of α-adrenoceptors (phentolamine). It is not recommended to accept angiotonic means. If necessary anticonvulsant therapy is shown. In hard cases there can be a need of an intubation and IVL.

Storage conditions

At a temperature not above 30 °C.