Nazohist
Nazohist Uses, Dosage, Side Effects, Food Interaction and all others data.
Nazohist, a phthalazinone derivative, exhibits histamine H1 receptor antagonist activity in isolated tissues, animal models and humans. It is administered as a racemic mixture with no difference in pharmacologic activity noted between the enantiomers in invitro studies. The major metabolite, desmethylazelastine, also possesses H1-receptor antagonist activity.
Nazohist antagonizes the actions of histamine, resulting in the relief of histamine-mediated allergy symptoms. Onset of action occurs within 15 minutes with intranasal formulations and as quickly as 3 minutes with ophthalmic solutions. Intranasal formulations have a relatively long-duration of action, with peak effects observed 4-6 hours after the initial dose and efficacy maintained over the entirety of the standard 12 hour dosing interval.
Trade Name | Nazohist |
Availability | Prescription only |
Generic | Azelastine |
Azelastine Other Names | Azelastina, Azelastine, Azélastine, Azelastinum |
Related Drugs | prednisone, cetirizine ophthalmic, dexamethasone ophthalmic, prednisolone ophthalmic, doxylamine, Deltasone |
Type | Nasal Spray |
Formula | C22H24ClN3O |
Weight | Average: 381.898 Monoisotopic: 381.160790112 |
Protein binding | In-vitro studies in human plasma indicate that the plasma protein binding of azelastine and desmethylazelastine are approximately 88% and 97%, respectively. |
Groups | Approved |
Therapeutic Class | Nasal Anti-histamine preparations |
Manufacturer | Leeford Healthcare Ltd |
Available Country | India |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Nazohist nasal spray is used for the treatment of the symptoms of seasonal allergic rhinitis such as rhinorrhea, sneezing, and nasal pruritus in adults and children 5 years and older, and for the treatment of the symptoms of vasomotor rhinitis, such as rhinorrhea, nasal congestion and postnasal drip in adults and children 12 years and older.
Nazohist is also used to associated treatment for these conditions: Allergic Eye Disease, Allergic Rhinitis (AR), Atopy Keratoconjunctivitis, Blepharitis allergic, Conjunctivitis allergic, Pollen Allergy, Seasonal Allergic Conjunctivitis, Seasonal Allergic Rhinitis, Vasomotor Rhinitis
How Nazohist works
Nazohist is primarily a selective antagonist of histamine H1-receptors, with a lesser affinity for H2-receptors, used for the symptomatic treatment of allergies. Histamine H1-receptors are G-protein-coupled receptors with 7 transmembrane spanning domains that are found on nerve endings, smooth muscle cells, and glandular cells. Following allergen exposure in sensitized individuals, IgE-receptor cross-linking on mast cells results in the release of histamine, which binds to H1-receptors and contributes to typical allergic symptoms such as itching, sneezing, and congestion.
Though its primary mode of action is thought to be via H1-receptor antagonism, azelastine (like other second-generation antihistamines) appears to affect other mediators of allergic symptomatology. Nazohist has mast cell-stabilizing properties that prevent the release of interleukin-6, tryptase, histamine, and TNF-alpha from mast cells, and has been shown to reduce mediators of mast cell degranulation such as leukotrienes in the nasal lavage of patients with rhinitis, as well as inhibiting their production and release from eosinophils (potentially via inhibition of phospholipase A2 and leukotriene C4 synthase). Additionally, patients using oral azelastine were observed to have significantly reduced concentrations of substance P and bradykinin in nasal secretions, both of which may play a role in nasal itching and sneezing in patients with allergic rhinitis.
Dosage
Nazohist dosage
Adult and children 12 years and older: 2 sprays in each nostril twice daily.
Children 5-11 years of age: 1 spray in each nostril twice daily.
Initial pump priming requires seven sprays of the pump. If used regularly as recommended, no further priming is required. If not used more than 24 hours, the pump will require 2 sprays, or if not used for more than seven days, the pump will require 7 sprays.
Side Effects
Headache, dizziness, sneezing, nosebleed, nausea, stinging or itching in nose, dry mouth, sore throat, bitter taste etc.
Toxicity
Overdosage of intranasal or ophthalmic azelastine is unlikely to result in clinically significant adverse effects aside from increased drowsiness. If overdose does occur, employ general supportive measures. Oral ingestion of antihistamines, including non-oral formulations of azelastine, can cause serious adverse effects in children - for this reason, these products should be kept out of the reach of children. The oral LD50 in rats is 580 mg/kg.
Precaution
In clinical trials, the occurrence of somnolence has been reported in some patients taking Nazohist nasal spray; due caution should therefore be exercised when driving a car or operating potentially dangerous machinery. Concurrent use of this nasal spray with alcohol or other CNS depressants should be avoided because additional reductions in alertness and additional impairment of CNS performance may occur.
Interaction
It is especially important to check before combining Nazohist nasal spray with Alcohol, CNS depressants, Cimetidine & Ketoconazole.
Food Interaction
- Avoid alcohol. Ingesting alcohol may cause additive CNS depressant effects.
Volume of Distribution
After intravenous and oral administration, the steady-state volume of distribution is 14.5 L/kg.
Elimination Route
Systemic bioavailability of azelastine hydrochloride following intranasal administration is approximately 40%, reaching Cmax within 2-3 hours. When administered at doses greater than the recommended maximum, greater than proportional increases in both Cmax and AUC were observed.
Half Life
Based on intravenous and oral administration, azelastine demonstrated an elimination half-life of 22 hours. Its primary active metabolite, desmethylazelastine, has an elimination half-life of 54 hours.
Clearance
Based on intravenous and oral administration, azelastine demonstrated a plasma clearance of 0.5 L/h/kg.
Elimination Route
After an oral dose of radio-labeled azelastine hydrochloride, approximately 75% was excreted in the feces, with less than 10% as unchanged azelastine hydrochloride.
Pregnancy & Breastfeeding use
Use in pregnancy: The effects of Nazohist during pregnancy have not been adequately studied. Nazohist should be administered during pregnancy, if the potential benefit justifies the potential risks to fetus.
Use in nursing mother: It is not known whether Nazohist is excreted in human milk. However, caution should be exercised when Nazohist is administered to a nursing mother.
Contraindication
Contraindicated in patients with a known hypersensitivity to Nazohist or any of its components.
Special Warning
Use in children: The safety and effectiveness of Nazohist nasal spray in patients below 5 years of age have not been established.
Storage Condition
Keep out of reach of children. Store in a cool and dry place protected from light. Do not freeze.
Innovators Monograph
You find simplified version here Nazohist
Nazohist contains Azelastine see full prescribing information from innovator Nazohist Monograph, Nazohist MSDS, Nazohist FDA label