BNF for Children 2011-2012

540 12.2.1 Drugs used in nasal allergy BNFC 2011–201212 Ear, nose, and oropharynxBudesonide (Non-proprietary) ANasal spray, budesonide 100 micrograms/meteredspray, net price 100-spray unit = £5.90DoseProphylaxis and treatment of allergic and vasomotorrhinitisChild 12–18 years apply 200 micrograms (2 sprays) intoeach nostril once daily in the morning or 100 micrograms(1 spray) into each nostril twice daily; when controlachieved reduce to 100 micrograms (1 spray) into eachnostril once dailyNasal polypsChild 12–18 years apply 100 micrograms (1 spray) intoeach nostril twice daily for up to 3 monthsRhinocort Aqua c (AstraZeneca) ANasal spray, budesonide 64 micrograms/meteredspray. Net price 120-spray unit = £2.49Excipients include disodium edetate, polysorbate 80, potassium sorbateDoseRhinitisChild 12–18 years 128 micrograms (2 sprays) into eachnostril once daily in the morning or 64 micrograms (1spray) into each nostril twice daily; when controlachieved reduce to 64 micrograms (1 spray) into eachnostril once daily; max. duration of treatment 3 monthsNasal polypsChild 12–18 years 64 micrograms (1 spray) into eachnostril twice daily for up to 3 monthsFLUNISOLIDECautions see notes aboveSide-effects see notes aboveIndication and doseProphylaxis and treatment of allergic rhinitisChild 5–14 years initially 25 micrograms (1 spray)into each nostril up to 3 times daily then reducedfor maintenanceChild 14–18 years 50 micrograms (2 sprays) intoeach nostril twice daily, increased if necessary tomax. 3 times daily then reduced for maintenanceSyntaris c (IVAX) AAqueous nasal spray, flunisolide 25 micrograms/metered spray. Net price 240-spray unit with pumpand applicator = £5.05Excipients include benzalkonium chloride, butylated hydroxytoluene,disodium edetate, polysorbate 20, propylene glycolFLUTICASONE PROPIONATECautions see notes above; interactions: Appendix 1(corticosteroids)Side-effects see notes aboveIndication and doseProphylaxis and treatment of allergic rhinitisChild 4–12 years 50 micrograms (1 spray) intoeach nostril once daily, preferably in the morning,increased to max. twice daily if requiredChild 12–18 years 100 micrograms (2 sprays)into each nostril once daily, preferably in themorning, increased to max. twice daily if required;when control achieved reduce to 50 micrograms (1spray) into each nostril once dailyNasal polyps see Flixonase Nasule c belowFlixonase c (A&H) AAqueous nasal spray, fluticasone propionate50 micrograms/metered spray. Net price 150-sprayunit with applicator = £11.01Excipients include benzalkonium chloride, polysorbate 80Flixonase Nasule c (A&H) ANasal drops, fluticasone propionate 400 micrograms/unitdose, net price 28 0.4-mL units =£12.99Excipients include polysorbate 20DoseNasal polypsChild 16–18 years instil 200 micrograms (approx. 6drops) into each nostril once or twice daily; consideralternative treatment if no improvement after 4–6 weeksNasofan c (IVAX) AAqueous nasal spray, fluticasone propionate50 micrograms/metered spray. Net price 150–sprayunit = £8.41Excipients include benzalkonium chloride, polysorbate 80Fluticasone furoateAvamys c (GSK) TANasal spray, fluticasone furoate 27.5 micrograms/metered spray, net price 120-spray unit = £6.44Excipients include benzalkonium chloride, disodium edetate, polysorbate80DoseProphylaxis and treatment of allergic rhinitisChild 6–12 years 27.5 micrograms (1 spray) into eachnostril once daily, increased if necessary to 55 micrograms(2 sprays) into each nostril once daily; whencontrol achieved reduce to 27.5 micrograms (1 spray)into each nostril once dailyChild 12–18 years 55 micrograms (2 sprays) into eachnostril once daily; when control achieved reduce tominimum effective dose, 27.5 micrograms (1 spray) intoeach nostril once daily may be sufficientMOMETASONE FUROATECautions see notes aboveSide-effects see notes aboveIndication and doseSee under preparationNasonex c (Schering-Plough) ANasal spray, mometasone furoate 50 micrograms/metered spray. Net price 140-spray unit = £7.68Excipients include benzalkonium chloride, polysorbate 80DoseProphylaxis and treatment of allergic rhinitisChild 6–12 years 50 micrograms (1 spray) into eachnostril once dailyChild 12–18 years 100 micrograms (2 sprays) into eachnostril once daily, increased if necessary to max.200 micrograms (4 sprays) into each nostril once daily;when control achieved reduce to 50 micrograms (1 spray)into each nostril once dailyTRIAMCINOLONE ACETONIDECautions see notes aboveSide-effects see notes aboveLicensed use not licensed for use in children under 6years