NASONEX 50 micrograms nasal spray suspension

2. What you need to know before you use Nasonex

Do not use Nasonex

• if you are allergic to mometasone furoate or any of the other ingredients of this medicine (listed in section 6).
• if you have an untreated nasal infection. Using Nasonex while you have an untreated nasal infection, such as herpes, can make the infection worse. You should wait until the infection has cleared up before starting to use the nasal spray.
• if you have had recent nose surgery or a nose injury. You should not use the nasal spray until your nose has healed.

Warnings and precautions

Consult your doctor or pharmacist before starting to use Nasonex.

• if you have ever had tuberculosis.
• if you have any other infection.
• if you are taking other corticosteroids, either orally or by injection.
• if you have cystic fibrosis.

While you are using Nasonex, consult your doctor

• if your immune system is not working properly (if you have trouble getting over infections) and you come into contact with someone with measles or chickenpox. You should avoid contact with anyone who has these infections.
• if you have a nose or throat infection.
• if you have been using this medicine for several months or longer.
• if you have persistent irritation of the nose or throat.

If corticosteroid nasal sprays are used at high doses for long periods of time, side effects can occur due to the medicine being absorbed into the body.

If your eyes are itchy or irritated, your doctor may advise you to use other treatments at the same time as Nasonex.

Consult your doctor if you experience blurred vision or other visual disturbances.

Children

When used at high doses for long periods of time, corticosteroid nasal sprays can cause side effects, such as slowing down the growth rate in children.

It is recommended to monitor the height of children on long-term treatment with nasal corticosteroids, and if any changes are noticed, you should inform your doctor.

Using Nasonex with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including those obtained without a prescription.

If you are taking other corticosteroids for allergies, either orally or by injection, your doctor may advise you to stop taking them when you start using Nasonex. When stopping corticosteroids, either orally or by injection, some people may experience side effects such as muscle or joint pain, muscle weakness, and depression. You may also develop other allergies, such as itchy, watery eyes, or itchy, red, and blistered skin. If you develop any of these side effects, you should consult your doctor.

Some medicines may increase the effects of Nasonex, so your doctor will monitor you closely if you are taking these medicines (including some for HIV: ritonavir, cobicistat).

Pregnancy and breastfeeding

There is limited or no information on the use of Nasonex in pregnant women. It is not known whether Nasonex is excreted in breast milk.

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, consult your doctor or pharmacist before using this medicine.

Driving and using machines

There is no known information on the effects of Nasonex on driving or using machines.

Nasonex contains benzalkonium chloride

Benzalkonium chloride may cause irritation or inflammation inside the nose, especially when used for long periods of treatment.

3. How to use Nasonex

Follow the instructions for administration of this medicine exactly as told by your doctor. If you are unsure, consult your doctor or pharmacist again. Do not use higher doses or use the spray more often, or for longer than your doctor tells you.

Treatment of hay fever and perennial rhinitis

Use in adults and children over 12 years of age

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

• Once symptoms are under control, your doctor may recommend reducing the dose.
• If you do not start to feel better, you should consult your doctor and they may tell you to increase the dose to the maximum daily dose of four sprays into each nostril once daily.

Use in children aged 3 to 11 years

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

Nasonex may start to relieve symptoms within 12 hours of the first dose; however, it is unlikely that the full benefit of treatment will be seen before the first two days. You should keep using your nasal spray regularly to achieve the full benefit of treatment.

If you or your child has very severe hay fever, your doctor may advise you to start using Nasonex a few days before the start of the pollen season, as this will help to prevent hay fever symptoms from occurring.

Nasal polyps

Use in adults over 18 years of age

The usual initial 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 into each nostril twice daily. Once symptoms are under control, your doctor may recommend reducing the dose.
• If there is no improvement in symptoms after 5-6 weeks of using two sprays into each nostril twice daily, you should consult your doctor.

Preparing the nasal spray for use

Nasonex nasal spray has a cap that protects the nozzle and keeps it clean. Remember to remove it before using the spray and 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 spray is produced:

1. First, shake the bottle carefully.
2. Put your index and middle fingers on either side of the nozzle and your thumb underneath the bottle. Do notpierce the nasal spray.
3. Do not point the nozzle at yourself and then press the pump 10 times until a fine spray is produced.

If you have not used your nasal spray for 14 days or more, you need to "prime" the bottle again by pumping the spray 2 times until a fine spray is produced.

How to use your nasal spray

1. Shake the bottle carefully and remove the cap (Figure 1).
2. Blow your nose gently.
3. Block one nostril and put the nozzle in the other nostril as shown (Figure 2).

Tilt your head slightly forward, keeping the bottle upright.

1. Start to breathe in slowly through your nose and while you are breathing in, press the pump ONCEwith your fingers to allow the spray to enter your nose.
2. Breathe out through your mouth. Repeat step 4 to inhale a second spray into the same nostril, if necessary.
3. Remove the nozzle from this nostril and breathe out through your mouth.
4. Repeat steps 3 to 6 in the other nostril (Figure 3).

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

Cleaning your nasal spray

• It is important to clean your nasal spray regularly, otherwise, it may not work properly.
• Remove the cap and gently pull the nozzle.
• Wash the nozzle and cap with warm water and then rinse with running water.
• Do not try to unblock the nasal applicator by inserting a needle or other pointed object as this may damage the applicator so that you do not receive the correct dose of medicine.
• Put the cap and nozzle to dry in a warm place.
• Press the nozzle onto the bottle and replace the cap.
• The spray will need to be primed again with 2 sprays when used for the first time after cleaning.

If you use more Nasonex than you should

If you accidentally use more than you should, tell your doctor.

If you use corticosteroids for a long time or in large amounts, it can, on rare occasions, affect some of your hormones. In children, it can affect growth and development.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, stating the medicine and the amount taken. Telephone: 91 562 04 20

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, and then follow your normal routine. Do not use a double dose to make up for forgotten doses.

If you stop using Nasonex

In some patients, Nasonex may start to relieve symptoms 12 hours after the first dose; however, it may take two days for the full benefit of treatment to be seen. It is very important that you use your nasal spray regularly. Do not stop treatment even if you feel better, unless your doctor tells you to.

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

4. Possible side effects

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

Immediate allergic reactions (hypersensitivity) can occur after using this medicine. These reactions can be serious. You should stop using Nasonex and seek medical help immediately if you experience symptoms such as:

• swollen face, tongue, or pharynx
• difficulty swallowing
• hives
• fatigue or difficulty breathing

If corticosteroid nasal sprays are used at high doses for long periods of time, side effects can occur due to the medicine being absorbed into 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 experience:

Common side effects (may affect up to 1 in 10 people)

• headache
• sneezing
• nasal bleeding [very common (may affect more than 1 in 10 people) in people with nasal polyps who are using two sprays of Nasonex into each nostril twice daily.]
• pain in the nose or throat
• ulcers in the nose
• respiratory infection

Frequency not known (cannot be estimated from the available data)

• increased eye pressure (glaucoma) and/or cataracts that can lead to visual disturbances

• damage to the nasal septum that separates the nostrils
• changes in taste and smell
• difficulty breathing and/or fatigue
• blurred vision

Reporting of side effects:

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Spanish Medicines Surveillance System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Nasonex

• Keep this medicine out of the sight and reach of children.
• Do not store above 25°C. Do not freeze.
• Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date is the last day of the month stated.
• The bottle should be used within 2 months of first use. Open only one bottle at a time.

Medicines should not be disposed of via wastewater or household waste. Dispose of the packaging and any unused medicine in the SIGRE collection point at your pharmacy. If you are unsure, ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Contents of the pack and other information

What is in Nasonex

• The active substance is mometasone furoate. Each spray contains 50 micrograms of mometasone furoate as monohydrate.
• The other ingredients are dispersible cellulose, glycerol, sodium citrate, citric acid monohydrate, polysorbate 80, benzalkonium chloride, purified water.
• This medicine contains 0.02 mg of benzalkonium chloride in each spray.

Appearance and packaging

Nasonex is a nasal spray suspension.

Each bottle contains 60 or 140 sprays.

Bottles containing 60 sprays are presented in individual packs.

Bottles containing 140 sprays are presented in packs of 1, 2, or 3 bottles.

Not all pack sizes may be marketed.

Marketing authorisation holder and manufacturer

This medicine is authorised in the Member States of the European Economic Area under the following names:

Austria: Nasonex aquosum – Nasenspray

Belgium, Croatia, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Slovenia, Sweden, United Kingdom: Nasonex

Bulgaria, Czech Republic, Romania, Slovakia: NASONEX

Latvia: Nasonex 50 mikrogrami/deva deguna aerosols, suspensija

Portugal: Nasomet

Spain: NASONEX 50 micrograms nasal spray suspension

Date of last revision of this leaflet:03/2020

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/