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Nasonex 50 Micrograms/Actuation Nasal Spray Suspension

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Document: leaflet MAH BRAND_PLPI 18799-2978 change

Package leaflet: Information for the user

Nasonex® 50 micrograms/actuation Nasal Spray, Suspension

(mometasone furoate)

1. What Nasonex is and what it is used for


3. How to use Nasonex


Please read this leaflet carefully before you start using this medicine because it contains important information for you.

-    Keep this leaflet. You may need to read it again.

-    If you have any further questions, ask your doctor or pharmacist.

-    This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-    If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

The name of your medicine is Nasonex® 50 micrograms/actuation Nasal Spray, Suspension but it will be referred as Nasonex throughout this leaflet.

What is in this leaflet

1.    What Nasonex is and what it is used for

2.    What you need to know before you use Nasonex

3.    How to use Nasonex

4.    Possible side effects

5.    How to store Nasonex

6.    Contents of the pack and other information

What is Nasonex?

Nasonex contains mometasone furoate, one of a group of medicines called corticosteroids. When mometasone furoate is sprayed into the nose, it can help to relieve inflammation (swelling and irritation of the nose), sneezing, itching and a blocked-up or runny nose.

What is Nasonex used for?

Hayfever and perennial rhinitis Nasonex is used to treat the symptoms of hayfever (also called seasonal allergic rhinitis) and perennial rhinitis in adults and children aged 3 and older.

Hayfever, which occurs at certain times of the year, is an allergic reaction caused by breathing in pollen from trees, grasses, weeds and also moulds and fungal spores. Perennial rhinitis occurs throughout the year and symptoms can be caused by a sensitivity to a variety of things including house dust mite, animal hair (or dander), feathers and certain foods. Nasonex reduces the swelling and irritation in your nose and thereby relieving sneezing, itching and a blocked-up or runny nose caused by hayfever or perennial rhinitis.

Nasal polyps

Nasonex is used to treat nasal polyps in adults aged 18 and over.

Nasal polyps are small growths on the lining of the nose and usually affect both nostrils. Nasonex reduces the inflammation in the nose, causing the polyps to gradually shrink, thereby relieving a blocked feeling in the nose which may affect breathing through the nose.

2. What you need to know before you use Nasonex

Do not use Nasonex

•    if you are allergic (hypersensitive) to mometasone furoate or any of the other ingredients of this medicine (listed in section 6).

•    if you have an untreated infection in your nose. Use of Nasonex during an untreated infection in your nose, such as herpes, can worsen the infection. You should wait until the infection is resolved before you start using the nasal spray.

•    if you have recently had an operation on your nose or you have injured your nose. You should not use the nasal spray until your nose has healed.

Warnings and precautions

Talk to your doctor or pharmacist before using Nasonex

•    if you have or have ever had tuberculosis.

•    if you have any other infection.

•    if you are taking other corticosteroid medicines, either by mouth or by injection.

•    if you have cystic fibrosis.

While you are using Nasonex, talk to your doctor

•    if your immune system is not functioning well (if you have difficulty in fighting infection) and you come into contact with anyone with measles or chickenpox. You should avoid coming into contact with anyone who has these infections.

•    if you have an infection of the nose or throat.

•    if you are using the medicine for several months or longer.

• if you have persistent irritation to the nose or throat.

When corticosteroid nasal sprays are used at high doses for long periods of time, side effects may occur due to the drug being absorbed in the body.

If your eyes are itching or irritated, your doctor may recommend that you use other treatments with Nasonex.

Children

When used at high doses for long periods of time, corticosteroid nasal sprays may cause certain side effects, such as slowed growth rate in children.

It is recommended that the height of children receiving long-term treatment with nasal corticosteroids is regularly monitored and if any changes are noted, their doctor should be notified.

Other medicines and Nasonex

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

If you are taking other corticosteroid medicines for allergy, either by mouth or injection, your doctor may advise you to stop taking them once you begin using Nasonex. A few people may find that once they discontinue oral or injected corticosteroids they suffer from some undesirable effects, such as joint or muscular pain, weakness and depression. You may also seem to develop other allergies, such as itchy, watering eyes or patches of red and itchy skin. If you develop any of these effects, you should contact your doctor.

Pregnancy and breast-feeding

There is little or no information on the use of Nasonex in pregnant women. It is not known if mometasone furoate is found in breast milk.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

There is no known information on the effect of Nasonex on the ability to drive or use machinery.

Nasonex contains benzalkonium chloride

Nasonex contains benzalkonium chloride which may cause nasal irritation.

Always use Nasonex exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Do not use a larger dose or use the spray more often or for longer than your doctor tells you to.

Treatment of Hayfever and Perennial Rhinitis

Use in adults and children over 12 years old

The usual dose is two sprays into each nostril once a day.

•    Once your symptoms are under control, your doctor may advise you to decrease the dose.

•    If you do not start to feel any better, you should see your doctor and he or she may tell you to increase the dose; the maximum daily dose is four sprays into each nostril once a day.

Use in children aged 3 to 11 years

The usual dose is one spray into each nostril once daily.

In some patients Nasonex begins to relieve symptoms within 12 hours after the first dose; however full benefit of treatment may not be seen in the first two days. Therefore, you should continue regular use to achieve full benefit of treatment.

If you or your child suffer badly from hayfever, your doctor may tell you to start using Nasonex some days before the start of the pollen season, as this will help to prevent your hayfever symptoms from occurring.

Nasal Polyps

Use in adults over 18 years old

The usual starting dose is two sprays into each nostril once daily.

•    If symptoms are not controlled after 5 to 6 weeks, the dose may be increased to two sprays in each nostril twice daily. Once symptoms are under control, your doctor may advise you to decrease your dose.

•    If no improvement in symptoms is seen after 5 to 6 weeks of twice daily administration, you should contact your doctor.




5. How to store Nasonex


Preparing your nasal spray for use

Your Nasonex Nasal Spray has a dust cap which protects the nozzle and keeps it clean. Remember to take this off before using the spray and to replace it after use. If you are using the spray for the first time you need to ‘prime' the bottle by pumping the spray 10 times until a fine mist is produced:

1.    Gently shake the bottle.

2.    Put your forefinger and middle finger either side of the nozzle and your thumb underneath the bottle. Do Not pierce the nasal applicator.

3.    Point the nozzle away from you and then press down with your fingers to pump the spray 10 times until a fine mist is produced.

If you have not used the spray for 14 days or more, you need to ‘re-prime' the bottle by pumping the spray 2 times until a fine mist is produced.

How to use your nasal spray

1.    Shake the bottle gently and remove the dust cap. (Figure 1)

2.    Gently blow your nose.

3.    Close one nostril and put the nozzle into the other nostril as shown. (Figure 2)

Tilt your head forward slightly, keeping the bottle upright.

4.    Start to breathe in gently or slowly through your nose and whilst you are breathing in squirt a spray of fine mist into your nose by pressing down ONCE with your fingers.

5.    Breathe out through your mouth. Repeat step 4 to inhale a second spray in the same nostril if applicable.

6.    Remove the nozzle from this nostril and breathe out through the mouth.

7.    Repeat steps 3 to 6 for the other nostril (Figure 3).

After using the spray, wipe the nozzle carefully with a clean handkerchief or tissue and replace the dust cap.

Cleaning your nasal spray

•    It is important to clean your nasal spray regularly, otherwise it may not work properly.

•    Remove the dust cap and gently pull off the nozzle.

•    Wash the nozzle and dust cap in warm water and then rinse under a running tap.

•    Do not try to unblock the nasal applicator by inserting a pin or other sharp object as this will damage the applicator and cause you not to get the right dose of medicine.

•    Allow the dust cap and nozzle to dry in a warm place.

•    Push the nozzle back onto the bottle and replace the dust cap.

•    The spray will need to be primed again with 2 sprays when first used after cleaning.

If you use more Nasonex than you should

Tell your doctor if you accidentally use more than you were told.

If you use steroids for a long time or in large amounts they may, rarely, affect some of your hormones. In children this may affect growth and development.

If you forget to use Nasonex

If you forget to use your nasal spray at the right time, use it as soon as you remember, then carry on as before. Do not take a double dose to make up for a forgotten dose.

If you stop using Nasonex

In some patients Nasonex should begin to relieve symptoms 12 hours after the first dose; however full benefit of treatment may not be seen for up to two days. It is very important that you use your nasal spray regularly. Do not stop your treatment even if you feel better unless told to do so by your doctor.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

When corticosteroid nasal sprays are used at high doses for long periods of time, side effects may occur due to the drug being absorbed in the body.

Other side effects

Most people do not have any problems after using the nasal spray.

However, some people after using Nasonex or other corticosteroid nasal sprays, may find that they suffer from:

Common side effects (may affect up to 1

in 10 060016):

•    headache

•    sneezing

•    nose bleeds [occurred very commonly (may affect more than 1 in 10 people) in people with nasal polyps receiving Nasonex two sprays in each nostril twice a day]

•    sore nose or throat

•    ulcers in the nose

•    respiratory tract infection

Not known (frequency cannot be estimated from the available data):

•    increase in pressure in the eye (glaucoma) and/or cataracts causing visual disturbances,

•    damage to the partition in the nose which separates the nostrils

•    changes in taste and smell

•    difficulty in breathing and/or wheezing Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report any side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects, you can help provide more information on the safety of this medicine.

•    Keep out of the sight and reach of children.

•    Do not store above 25°C. Do not freeze.

•    This medicine should be used within 2 months of first opening. Only open one bottle at a time.

•    Do not use the nasal spray after the expiry date which is stated on the carton and bottle label after ‘Exp'. The expiry date refers to the last day of that month.

•    If the nasal spray shows any signs of damage, seek the advice of your pharmacist.

•    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment

6. Contents of the pack and other information

What Nasonex contains

The active substance in Nasonex is mometasone furoate.

Each metered actuation delivers 50 micrograms of mometasone furoate, as the monohydrate.

The other ingredients are dispersible cellulose RC 591, glycerol, sodium citrate, citric acid monohydrate, polysorbate 80, benzalkonium chloride, purified water.

What Nasonex looks like and contents of the pack

Nasonex is a white to off-white opaque nasal spray suspension in a white metered-dose and a manual plastic spray pump actuator with a green colour cap.

Nasonex is available in bottle pack of 140 actuations.

Manufactured by: Schering-Plough Labo N.V, Industriepark 30, 2220 Heist-op-den-Berg, Belgium.

Procured from within the EU and repackaged by the Product Licence holder: B&S Healthcare, Unit 4,

Bradfield Road, Ruislip, Middlesex,

HA4 0NU, UK.

Nasonex® 50 micrograms/actuation Nasal Spray, Suspension;

PL 18799/2978    _

POM

Leaflet date: 17.11.2016    _

Nasonex is the registered trademark of the Merck Sharp & Dohme Corp.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Immediate hypersensitivity (allergic) reactions may occur after use of this product. These reactions may be severe. You should stop taking Nasonex and get immediate medical help if you experience symptoms such as:

•    swollen face, tongue or pharynx

•    trouble swallowing

•    hives

•    wheezing or trouble breathing

Mometasone furoate 50 micrograms/actuation Nasal Spray, Suspension

1. What Mometasone furoate is and what it is used for


Please read this leaflet carefully before you start using this medicine because it contains important information for you.

-    Keep this leaflet. You may need to read it again.

-    If you have any further questions, ask your doctor or pharmacist.

-    This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

-    If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

The name of your medicine is Mometasone furoate 50 micrograms/actuation Nasal Spray, Suspension but it will be referred as Mometasone furoate throughout this leaflet.

What is in this leaflet

1.    What Mometasone furoate is and what it is used for

2.    What you need to know before you use Mometasone furoate

3.    How to use Mometasone furoate

4.    Possible side effects

5.    How to store Mometasone furoate

6.    Contents of the pack and other information

What is Mometasone furoate ?

Mometasone furoate contains mometasone furoate, one of a group of medicines called corticosteroids. When mometasone furoate is sprayed into the nose, it can help to relieve inflammation (swelling and irritation of the nose), sneezing, itching and a blocked-up or runny nose.

What is Mometasone furoate used for?

Hayfever and perennial rhinitis Mometasone furoate is used to treat the symptoms of hayfever (also called seasonal allergic rhinitis) and perennial rhinitis in adults and children aged 3 and older.

Hayfever, which occurs at certain times of the year, is an allergic reaction caused by breathing in pollen from trees, grasses, weeds and also moulds and fungal spores. Perennial rhinitis occurs throughout the year and symptoms can be caused by a sensitivity to a variety of things including house dust mite, animal hair (or dander), feathers and certain foods. Mometasone furoate reduces the swelling and irritation in your nose and thereby relieving sneezing, itching and a blocked-up or runny nose caused by hayfever or perennial rhinitis.

Nasal polyps

Mometasone furoate is used to treat nasal polyps in adults aged 18 and over.

Nasal polyps are small growths on the lining of the nose and usually affect both nostrils. Mometasone furoate reduces the inflammation in the nose, causing the polyps to gradually shrink, thereby relieving a blocked feeling in the nose which may affect breathing through the nose.

2. What you need to know before you use Mometasone furoate

Do not use Mometasone furoate

•    if you are allergic (hypersensitive) to mometasone furoate or any of the other ingredients of this medicine (listed in section 6).

•    if you have an untreated infection in your nose. Use of Mometasone furoate during an untreated infection in your nose, such as herpes, can worsen the infection. You should wait until the infection is resolved before you start using the nasal spray.

•    if you have recently had an operation on your nose or you have injured your nose. You should not use the nasal spray until your nose has healed.

Warnings and precautions

Talk to your doctor or pharmacist before using Mometasone furoate

•    if you have or have ever had tuberculosis.

•    if you have any other infection.

•    if you are taking other corticosteroid medicines, either by mouth or by injection.

•    if you have cystic fibrosis.

While you are using Mometasone furoate , talk to your doctor

•    if your immune system is not functioning well (if you have difficulty in fighting infection) and you come into contact with anyone with measles or chickenpox. You should avoid coming into contact with anyone who has these infections.

•    if you have an infection of the nose or throat.

•    if you are using the medicine for several months or longer.

•    if you have persistent irritation to the nose or throat.

When corticosteroid nasal sprays are used at high doses for long periods of time, side effects may occur due to the drug being absorbed in the body.

If your eyes are itching or irritated, your doctor may recommend that you use other treatments with Mometasone furoate .

Children

When used at high doses for long periods of time, corticosteroid nasal sprays may cause certain side effects, such as slowed growth rate in children.

It is recommended that the height of children receiving long-term treatment with nasal corticosteroids is regularly monitored and if any changes are noted, their doctor should be notified.

Other medicines and Mometasone furoate

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

If you are taking other corticosteroid medicines for allergy, either by mouth or injection, your doctor may advise you to stop taking them once you begin using Mometasone furoate . A few people may find that once they discontinue oral or injected corticosteroids they suffer from some undesirable effects, such as joint or muscular pain, weakness and depression. You may also seem to develop other allergies, such as itchy, watering eyes or patches of red and itchy skin. If you develop any of these effects, you should contact your doctor.

Pregnancy and breast-feeding

There is little or no information on the use of Mometasone furoate in pregnant women. It is not known if mometasone furoate is found in breast milk.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

There is no known information on the effect of Mometasone furoate on the ability to drive or use machinery.

Mometasone furoate contains benzalkonium chloride

Mometasone furoate contains benzalkonium chloride which may cause nasal irritation.

3. How to use Mometasone furoate

Always use Mometasone furoate exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Do not use a larger dose or use the spray more often or for longer than your doctor tells you to.

Treatment of Hayfever and Perennial Rhinitis

Use in adults and children over 12 years old

The usual dose is two sprays into each nostril once a day.

•    Once your symptoms are under control, your doctor may advise you to decrease the dose.

•    If you do not start to feel any better, you should see your doctor and he or she may tell you to increase the dose; the maximum daily dose is four sprays into each nostril once a day.

Use in children aged 3 to 11 years The usual dose is one spray into each nostril once daily.

In some patients Mometasone furoate begins to relieve symptoms within 12 hours after the first dose; however full benefit of treatment may not be seen in the first two days. Therefore, you should continue regular use to achieve full benefit of treatment.

If you or your child suffer badly from hayfever, your doctor may tell you to start using Mometasone furoate some days before the start of the pollen season, as this will help to prevent your hayfever symptoms from occurring.

Nasal Polyps

Use in adults over 18 years old

The usual starting dose is two sprays into each nostril once daily.

•    If symptoms are not controlled after 5 to 6 weeks, the dose may be increased to two sprays in each nostril twice daily. Once symptoms are under control, your doctor may advise you to decrease your dose.



5. How to store Mometasone furoate


•    If no improvement in symptoms is seen after 5 to 6 weeks of twice daily administration, you should contact your doctor.

Preparing your nasal spray for use

Your Mometasone furoate Nasal Spray has a dust cap which protects the nozzle and keeps it clean. Remember to take this off before using the spray and to replace it after use.

If you are using the spray for the first time you need to ‘prime' the bottle by pumping the spray 10 times until a fine mist is produced:

1.    Gently shake the bottle.

2.    Put your forefinger and middle finger either side of the nozzle and your thumb underneath the bottle. Do Not pierce the nasal applicator.

3.    Point the nozzle away from you and then press down with your fingers to pump the spray 10 times until a fine mist is produced.

If you have not used the spray for 14 days or more, you need to ‘re-prime' the bottle by pumping the spray 2 times until a fine mist is produced.

How to use your nasal spray

1.    Shake the bottle gently and remove the dust cap. (Figure 1)

2.    Gently blow your nose.

3.    Close one nostril and put the nozzle into the other nostril as shown. (Figure 2)

Tilt your head forward slightly, keeping the bottle upright.

4.    Start to breathe in gently or slowly through your nose and whilst you are breathing in squirt a spray of fine mist into your nose by pressing down ONCE with your fingers.

5.    Breathe out through your mouth. Repeat step 4 to inhale a second spray in the same nostril if applicable.

6.    Remove the nozzle from this nostril and breathe out through the mouth.

7.    Repeat steps 3 to 6 for the other nostril (Figure 3).

After using the spray, wipe the nozzle carefully with a clean handkerchief or tissue and replace the dust cap.

Cleaning your nasal spray

•    It is important to clean your nasal spray regularly, otherwise it may not work properly.

•    Remove the dust cap and gently pull off the nozzle.

•    Wash the nozzle and dust cap in warm water and then rinse under a running tap.

•    Do not try to unblock the nasal applicator by inserting a pin or other sharp object as this will damage the applicator and cause you not to get the right dose of medicine.

•    Allow the dust cap and nozzle to dry in a warm place.

•    Push the nozzle back onto the bottle and replace the dust cap.

•    The spray will need to be primed again with 2 sprays when first used after cleaning.

If you use more Mometasone furoate than you should

Tell your doctor if you accidentally use more than you were told.

If you use steroids for a long time or in large amounts they may, rarely, affect some of your hormones. In children this may affect growth and development.

If you forget to use Mometasone furoate

If you forget to use your nasal spray at the right time, use it as soon as you remember, then carry on as before. Do not take a double dose to make up for a forgotten dose.

If you stop using Mometasone furoate

In some patients Mometasone furoate should begin to relieve symptoms 12 hours after the first dose; however full benefit of treatment may not be seen for up to two days. It is very important that you use your nasal spray regularly. Do not stop your treatment even if you feel better unless told to do so by your doctor.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Immediate hypersensitivity (allergic) reactions may occur after use of this product. These reactions may be severe. You should stop taking Mometasone furoate and get immediate medical help if you experience symptoms such as:

•    swollen face, tongue or pharynx

•    trouble swallowing

•    hives

•    wheezing or trouble breathing

When corticosteroid nasal sprays are used at high doses for long periods of time, side effects may occur due to the drug being absorbed in the body.

Other side effects

Most people do not have any problems after using the nasal spray.

However, some people after using Mometasone furoate or other corticosteroid nasal sprays, may find that they suffer from:

Common side effects (may affect up to 1

in 10 060016):

•    headache

•    sneezing

•    nose bleeds [occurred very commonly (may affect more than 1 in 10 people) in people with nasal polyps receiving Mometasone furoate two sprays in each nostril twice a day]

•    sore nose or throat

•    ulcers in the nose

•    respiratory tract infection

Not known (frequency cannot be estimated from the available data):

•    increase in pressure in the eye (glaucoma) and/or cataracts causing visual disturbances,

•    damage to the partition in the nose which separates the nostrils

•    changes in taste and smell

•    difficulty in breathing and/or wheezing Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report any side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects, you can help provide more information on the safety of this medicine.

•    Keep out of the sight and reach of children.

•    Do not store above 25°C. Do not freeze.

•    This medicine should be used within 2 months of first opening. Only open one bottle at a time.

•    Do not use the nasal spray after the expiry date which is stated on the carton and bottle label after ‘Exp'. The expiry date refers to the last day of that month.

•    If the nasal spray shows any signs of damage, seek the advice of your pharmacist.

•    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment

6. Contents of the pack and other information

What Mometasone furoate contains

The active substance in Mometasone furoate is mometasone furoate.

Each metered actuation delivers 50 micrograms of mometasone furoate, as the monohydrate.

The other ingredients are dispersible cellulose RC 591, glycerol, sodium citrate, citric acid monohydrate, polysorbate 80, benzalkonium chloride, purified water.

What Mometasone furoate looks like and contents of the pack

Mometasone furoate is a white to off-white opaque nasal spray suspension in a white metered-dose and a manual plastic spray pump actuator with a green colour cap.

Mometasone furoate is available in bottle pack of 140 actuations.

Manufactured by: Schering-Plough Labo N.V, Industriepark 30, 2220 Heist-op-den-Berg, Belgium.

Procured from within the EU and repackaged by the Product Licence holder: B&S Healthcare, Unit 4,

Bradfield Road, Ruislip, Middlesex,

HA4 0NU, UK.

Mometasone furoate 50 micrograms/ actuation Nasal Spray, Suspension;

PL 18799/2978

Leaflet date: 17.11.2016

POM