Viarex

Maintenance treatment of asthma as prophylactic therapy in adults and children (≥5 years). For asthma patients who require systemic corticosteroid administration where adding Viarex may reduce or eliminate the need for the systemic corticosteroids.

Viarex is not indicated for the relief of acute bronchospasm.

Viarex is a steroid. It prevents the release of substances in the body that cause inflammation.

Viarex nasal is used to treat nasal symptoms such as congestion, sneezing, and runny nose caused by seasonal or year-round allergies. The Viarex brand of this medication is also used to keep nasal polyps from coming back after surgery to remove them.

Viarex may also be used for purposes not listed in this medication guide.

Management of Chronic Asthma: Adults and Children >12 years: 100-400 mcg twice daily. Maximum: 1000 mcg twice daily.

Children (5-12 years): 100-200 mcg twice daily. Maximum: 200-400 mcg twice daily.

Prophylaxis of Asthma: Adults and Children >12 years: 50-200 mcg twice daily. Increase if necessary to maximum 400 mcg twice daily.

Children (5-12 years): The usual starting dose is 100 mcg twice daily. Depending on the severity of asthma, the daily dose may be increased up to 400 mcg administered in 2-4 divided doses.

When patient's symptoms remain under satisfactory control, the dose should be titrated to the lowest dose at which effective control of asthma is maintained.

Therapy in New Patients: Mild Asthma: 50-100 mcg twice daily.

Moderate Asthma: 100-200 mcg twice daily.

Severe Asthma: 200-400 mcg twice daily.

When switching a patient with well-controlled asthma from another corticosteroid inhaler, initially Viarex 100 mcg puff should be prescribed for Viarex (CFC) or budesonide 200-250 mcg; fluticasone propionate 100 mcg.

When switching a patient with poorly-controlled asthma from another corticosteroid inhaler, initially Viarex 100 mcg puff should be prescribed for Viarex (CFC) or budesonide or fluticasone propionate 100 mcg. The dose of Viarex should be adjusted to response.

Use in the elderly or patients with hepatic or renal impairment: There are no special dosage recommendations for use in the elderly or in patients with hepatic or renal impairment.

Hypersensitivity to Viarex diproprionate or to any of the excipients of Viarex.

Viarex is used to treat runny nose, swelling and itching of the nose due to allergy (allergic rhinitis), hay fever and ulcerative colitis. Viarex reduces inflammation, swelling and irritation in nose and helps to relieve itching, sneezing and blocked or runny nose. It is also used in asthma and ulcerative colitis.

See also:
What other drugs will affect Viarex?

Due to the very low plasma concentration achieved after inhaled dosing, clinically significant drug interactions are in general unlikely. Care should be taken when co-administering with known strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, nelfinavir, ritonavir) as there is a potential for increased systemic exposure to Viarex.

See also:
What are the possible side effects of Viarex?

Nasal Inhaler

In general, side effects in clinical studies have been primarily associated with the nasal mucous membranes.

Adverse reactions reported in controlled clinical trials and long-term open studies in patients treated with Viarex dipropionate nasal inhaler are described below.

Sensations of irritation and burning in the nose (11 per 100 patients) following the use of Viarex dipropionate nasal inhaler have been reported. Also, occasional sneezing attacks (10 per 100 adult patients) have occurred immediately following the use of the intranasal inhaler. This symptom may be more common in children. Rhinorrhea may occur occasionally (1 per 100 patients).

Localized infections of the nose and pharynx with Candida albicans have occurred rarely.

Transient episodes of epistaxis have been reported in 2 per 100 patients.

Rare cases of ulceration of the nasal mucosa and instances of nasal septum perforation have been spontaneously reported.

Reports of headache, light-headedness, dryness and irritation of the nose and throat, and unpleasant taste and smell have been received. There are rare reports of loss of taste and smell.

Rare instances of wheezing, cataracts, glaucoma and increased intraocular pressure have been reported following the intranasal application of aerosolized corticosteroids.

Rare cases of immediate and delayed hypersensitivity reactions, including urticaria, angioedema, rash, and bronchospasm, have been reported following the oral and intranasal inhalation of Viarex.

Systemic corticosteroid side effects were not reported during the controlled clinical trials. If recommended doses are exceeded, however, or if individuals are particularly sensitive, symptoms of hypercorticism (i.e., Cushing's syndrome, could occur).

Nasal Spray

In general, side effects in clinical studies have been primarily associated with irritation of the nasal mucous membranes. Rare cases of immediate and delayed hypersensitivity reactions, including urticaria, angioedema, rash, and bronchospasm, have been reported following the oral and intranasal inhalation of Viarex dipropionate.

Adverse reactions reported in controlled clinical trials and open studies in patients treated with Viarex dipropionate nasal spray are described below.

Mild nasopharyngeal irritation following the use of Viarex aqueous nasal spray has been reported in up to 24% of patients treated, including occasional sneezing attacks (about 4%) occurring immediately following use of the spray. In patients experiencing these symptoms, none had to discontinue treatment. The incidence of transient irritation and sneezing was approximately the same in the group of patients who received placebo in these studies, implying that these complaints may be related to vehicle components of the formulation.

Fewer than 5 per 100 patients reported headache, nausea, or lightheadedness following the use of Viarex dipropionate nasal spray. Fewer than 3 per 100 patients reported nasal stuffiness, nosebleeds, rhinorrhea, or tearing eyes.

Rare cases of ulceration of the nasal mucosa and instances of nasal septum perforation have been spontaneously reported.

Reports of dryness and irritation of the nose and throat, and unpleasant taste and smell have been received. There are rare reports of loss of taste and smell.

Rare instances of wheezing, cataracts, glaucoma, and increased intraocular pressure have been reported following the use of intranasal Viarex.

The dose which the patient gets through the mouthpiece of the device is 180 mcg.

Viarex contains 200 doses of finely powdered Viarex dipropionate mixed in a small quantity of lactose. The amount of drug received by the patient (180 mcg/dose) corresponds to that from 2 puffs of the freon-based Viarex inhalation aerosol with a metered dose of 100 mcg/dose. The dose to be inhaled is released from the container by pressing the device between the thumb and the forefinger. This is followed by inhalation through the device. As a result, Viarex dipropionate particles are transferred to their target, the lungs. Use of the Viarex does not require coordination of actuation of the dose and inhalation.