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Qnasl vs Flunisolide
Introduction
For patients with allergic rhinitis or other types of nasal allergies, certain drugs that inhibit the inflammatory response can help in managing symptoms and improving quality of life. Qnasl and Flunisolide are two such drugs that are commonly prescribed for nasal allergies. They each impact different aspects of the immune response but both have anti-inflammatory effects in patients with allergies. Qnasl is a corticosteroid inhaler delivering beclomethasone dipropionate directly to the inflamed nasal passages, reducing inflammation quickly. Flunisolide, on the other hand, is another type of corticosteroid spray which also helps reduce swelling and irritation in the nose primarily by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability.
Qnasl vs Flunisolide Side By Side
| Attribute | Qnasl | Flunisolide |
|---|---|---|
| Brand Name | Qnasl | Flunisolide |
| Contraindications | Should not be used if suffering from untreated active infections involving the nose or throat, recent nose injury or surgery. Inform physician about any drugs that weaken the immune system, mifepristone, drugs causing liver enzymes to get rid of flunisolide slower. | Should not be used if suffering from untreated active infections involving the nose or throat, recent nose injury or surgery. Inform physician about any drugs that weaken the immune system, mifepristone, drugs causing liver enzymes to get rid of the drug slower. |
| Cost | Around $200 for one 16.5g inhaler (80mcg), approximately $1.67 per day. | Around $60 for one nasal spray bottle (25 mcg/spray), approximately $0.10/day based on two sprays in each nostril daily. Generic version available at an average cost of about $20-$40/25ml vial. |
| Generic Name | Beclomethasone dipropionate | Flunisolide |
| Most Serious Side Effect | Signs of a serious allergic reaction, vision disturbances, troubling cardiovascular symptoms, lowered blood cortisol levels, indications of a systemic fungal infection. | Signs of allergic reaction, vision problems, unusual tiredness or weakness, nasal discomfort, nosebleeds, increase in wheezing or trouble breathing. |
| Severe Drug Interactions | Certain drugs that weaken the immune system, mifepristone, drugs causing liver enzymes to get rid of the drug slower (such as ketoconazole and macrolide antibiotics including erythromycin). | Certain drugs that weaken the immune system, mifepristone, drugs causing liver enzymes to get rid of the drug slower (such as ketoconazole and macrolide antibiotics including erythromycin). |
| Typical Dose | For adults and adolescents 12 years and older: two sprays in each nostril once daily (total dose 320 mcg/day). For children aged 4 to 11: one spray in each nostril once daily (total dose 80 mcg/day). | Two sprays in each nostril twice daily for adults and children over 6 years old. Can be increased to a maximum of six sprays in each nostril per day. |
What is Qnasl?
Beclomethasone dipropionate (the generic name for Qnasl) was one of the first corticosteroid nasal sprays available, which brought significant improvement over earlier allergy treatments. It was first approved by the FDA in 2012. Qnasl works by reducing inflammation within the nasal passages, effectively diminishing symptoms such as sneezing, itching or a runny nose caused by seasonal or year-around allergies. It is prescribed primarily for treating hay fever and other upper respiratory allergies.
Qnasl has a selective influence on glucocorticoid receptors with only minor influence on mineralocorticoid ones, resulting in it having fewer side effects than other corticosteroids that have stronger effects on these two types of receptors.
On the other hand, Flunisolide (generic name), also a corticosteroid but an older generation drug approved way back in 1981, operates similarly to reduce swelling and irritation in your nose's airways due to allergens exposure. However, compared to newer drugs like Qnasl it has been associated with more frequent side-effects including unpleasant taste and smell sensations among others.
What conditions is Qnasl approved to treat?
Qnasl is approved for the treatment of various nasal symptoms associated with:
- Seasonal allergies in adults and pediatric patients 4 years of age and older
- Perennial (year-round) allergies in adults and pediatric patients 12 years of age and older.
Flunisolide, on the other hand, is indicated for:
- The management of nasal polyps
- The relief from accompanying symptoms such as rhinorrhea (runny nose)
- Nasal itching, sneezing, and congestion among patients aged six or more.
How does Qnasl help with these illnesses?
Qnasl helps to manage symptoms of allergic rhinitis by reducing inflammation in the nasal passages. It achieves this by delivering a synthetic corticosteroid called beclomethasone directly into the nose, where it acts to inhibit inflammatory cells and chemicals that are released when an allergen is present. These inflammatory substances include histamine, leukotrienes, and cytokines among others which can cause uncomfortable symptoms like sneezing, itching, congestion and runny nose. By suppressing their release or activity with Qnasl's anti-inflammatory action, these allergy symptoms can be effectively managed.
Similarly, Flunisolide also works as a nasal steroid spray for treating seasonal allergies or nonallergic (perennial) rhinitis. Just like Qnasl’s active ingredient Beclomethasone dipropionate , flunisolide inhibits multiple types of cells (like mast cells and eosinophils) and mediators (histamines etc.) involved in allergic reactions thereby easing discomfort caused by sneezing , itching or running nose . Both medications operate on similar principles but might differ slightly in terms of side effects profiles due to differences in their chemical structure.
What is Flunisolide?
Flunisolide is a corticosteroid often used in the form of an intranasal spray to treat seasonal and perennial allergic rhinitis. Its action involves decreasing inflammation by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability. This helps reduce symptoms such as sneezing, itching, and runny nose caused by allergies. Flunisolide was first approved by the FDA in 1981.
Unlike Qnasl (beclomethasone), which is also a corticosteroid nasal spray, flunisolide does not have a strong drying effect on the nasal mucosa or throat. Thus, it can be better tolerated with less irritation than some other products for similar uses.
It's important to note that just like all steroids, flunisolide should be used at the lowest effective dose to minimize side effects such as dryness in the nose or throat, unpleasant taste or smell sensation, and nosebleeds.
What conditions is Flunisolide approved to treat?
Flunisolide is a corticosteroid that's approved for use in the management of:
- Allergic rhinitis, which includes hay fever and perennial allergies
- Non-allergic (vasomotor) rhinitis
It helps to reduce inflammation and alleviate symptoms like sneezing, itching, and congestion.
How does Flunisolide help with these illnesses?
Flunisolide is a corticosteroid that functions by preventing the release of inflammation-causing substances in the body. This corticosteroid plays key roles in many processes in our bodies, notably reducing swelling and irritation, which are heavily involved in allergic reactions to prepare the body for action under stress. Flunisolide works by decreasing the level of these inflammatory substances available in your nasal passages, thereby alleviating some symptoms of allergies such as runny nose, sneezing, itching and congestion. Its action on other anti-inflammatory responses may also play roles in flunisolide's effectiveness as an allergy medication. Since it does not significantly affect histamine levels directly like antihistamines (such as Qnasl), it is sometimes prescribed when a patient does not respond well to typical over-the-counter antihistamines or may be combined with them for more comprehensive relief.
How effective are both Qnasl and Flunisolide?
Both Qnasl (beclomethasone) and Flunisolide are corticosteroids used as nasal sprays, with a proven track record of success in managing symptoms associated with allergic rhinitis. They were approved by the FDA within a few years of each other, with Flunisolide gaining approval in 1981 and beclomethasone (the active ingredient in Qnasl) being approved later on.
As they perform their function through similar mechanisms — reducing inflammation by suppressing the body's immune response — these two medications may be prescribed interchangeably depending on specific patient needs. The effectiveness of both drugs has been studied extensively; one such double-blind clinical trial from 1990 found that both Qnasl and Flunisolide effectively managed symptoms like nasal congestion, itchy nose, runny nose, sneezing etc., while maintaining promising safety profiles.
A review conducted in 2003 reported that beclomethasone demonstrates its efficacy right from the first day of treatment. Its side effect profile was noted to be more favorable over many other corticosteroid nasal sprays due to its lower systemic absorption resulting lesser systemic side effects.
On the other hand, a meta-analysis performed in 2015 suggested that flunisolide is also effective at alleviating allergy symptoms compared to placebo but when directly compared against newer generation steroids like Qnasl or mometasone furoate it showed slightly less efficacy overall. However this difference was not statistically significant enough for flunisolide to lose favor as a first-line treatment option for allergic rhinitis.
Overall though data confirming its standalone efficacy is robust for both fluoxetine and bupropion alike; however there seems to lack evidence suggesting either drug augmenting the effect significantly when co-prescribed alongside another antihistamine medication.
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At what dose is Qnasl typically prescribed?
Dosages of Qnasl for adults and adolescents 12 years and older range from two sprays in each nostril once daily (total dose 320 mcg/day). For children aged 4 to 11, the starting dosage is one spray in each nostril once daily (total dose 80 mcg/day). If there is no adequate response or worsening occurs, the dosage can be increased under medical supervision. The maximum dosage that should not be exceeded is four sprays in each nostril per day. Comparatively, Flunisolide nasal solution for adults usually starts with the administration of two sprays (50 mcg/spray) into each nostril twice daily (totaling about 400 mcg/day). This can also be adjusted but should not exceed eight sprays into each nostril per day.
At what dose is Flunisolide typically prescribed?
Flunisolide treatment generally starts with two sprays in each nostril twice daily for adults and children over 6 years old. This dosage can be increased to a maximum of six sprays in each nostril per day. If there's no response after a few weeks, your doctor may reassess the medication plan or suggest additional therapies. Remember not to exceed the recommended dose without consulting your healthcare provider first. The effects of Flunisolide begin within hours but full therapeutic benefits may take up several days or longer depending on the nature and severity of symptoms being treated.
What are the most common side effects for Qnasl?
Common side effects of Qnasl and Flunisolide can vary, but may include:
- Nasal discomfort or irritation
- Headache
- Epistaxis (nosebleeds)
- Pharyngitis (inflammation in the back of the throat)
- Sinusitis (inflammation of the sinus cavities in the head)
- Nausea
- Cough
- Fever
- Asthenia (general weakness and fatigue)
While these are some possible side effects, individuals may experience different ones or none at all. Please consult with your doctor if you have any concerns regarding medication side effects.
Are there any potential serious side effects for Qnasl?
When comparing Qnasl to Flunisolide, potential side effects are important considerations. For both medications, severe side effects can occur in rare instances:
- Signs of a serious allergic reaction such as: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Vision disturbances such as blurred vision or seeing halos around lights
- Troubling cardiovascular symptoms including fast or pounding heartbeats and shortness of breath that may be accompanied by feelings like you might pass out
- Lowered blood cortisol levels which could cause extreme tiredness, weight loss, skin discoloration
- Indications of a systemic fungal infection include fever, fatigue and unexplained weight loss
If you experience any severe reactions while taking these nasal sprays it is crucial to seek medical attention immediately. Remember that your healthcare provider has prescribed these medications because they believe the benefit outweighs the risk. Always consult with them before discontinuing use.
What are the most common side effects for Flunisolide?
Flunisolide nasal spray, when compared to Qnasl, can cause a range of side effects which may include:
- A bitter taste or smell
- Sneezing or nosebleeds
- Headache, back pain
- Nausea and stomach upset
- Sore throat, cough
- Stuffy nose due to irritation from the spray
It should be noted that while these are potential side effects of Flunisolide, it does not mean that every individual who takes this medication will experience all of them. It's important to consult with your healthcare provider if any discomfort arises after using Flunisolide.
Are there any potential serious side effects for Flunisolide?
While Flunisolide is generally well-tolerated, it's important to monitor for any unusual side effects. These may include:
- Signs of allergic reaction such as hives, itching, difficulty breathing or swelling in the face, lips or throat
- Vision problems including blurred vision and eye pain
- Unusual tiredness or weakness which might be a sign of infection
- Nasal discomfort such as dryness and burning sensation
- Nosebleeds -In rare cases, an increase in wheezing or trouble breathing
If you experience any of these symptoms while using Flunisolide nasal spray, stop use immediately and consult your healthcare provider.
Contraindications for Qnasl and Flunisolide?
Both Qnasl and Flunisolide, like other corticosteroid nasal sprays, can potentially worsen symptoms of certain conditions. If you notice increased difficulty breathing, vision problems, or signs of infection such as fever or persistent sore throat while using these medications, seek immediate medical attention.
Neither Qnasl nor Flunisolide should be used if you are suffering from untreated active infections involving the nose or throat. Also inform your physician about any recent nose injury or surgery which may require time to heal before the use of these medicines.
Certain drugs that weaken the immune system (such as cancer chemotherapy), mifepristone, drugs causing liver enzymes to get rid of flunisolide slower (such as ketoconazole and macrolide antibiotics including erythromycin) can interact with Qnasl and Flunisolide leading to serious side effects; thus its mandatory to share your medication list with your healthcare provider before starting treatment.
It's also important not to suddenly stop using this medication without consulting your doctor because this could cause withdrawal symptoms- primarily in cases where you have been on long-term treatment.
How much do Qnasl and Flunisolide cost?
For the brand name versions of these drugs:
- The price for one 16.5g inhaler of Qnasl (80mcg) averages around $200, and since each inhaler provides about 120 doses, this works out to approximately $1.67 per day.
- The price for one nasal spray bottle of Flunisolide (25 mcg/spray) averages around $60 for a bottle containing roughly 600 sprays, which works out to about $0.10/day based on two sprays in each nostril daily.
Therefore, if you're taking the maximum recommended dose of Qnasl (four sprays in each nostril once daily), then brand-name Flunisolide is less expensive on a per-day treatment basis. However, cost should not be your primary consideration when deciding between these medications.
As it stands now there are no generic equivalents available for either drug:
- Even though there's currently no generic version available for Qnasl, some insurance plans may cover it or offer coupons that can help reduce the overall cost.
- Similarly, while flunisolide does have a generic version available at an average cost of about $20-$40/25ml vial with roughly 500 sprays/vial ($0.04 - $0.08/day), depending on dosage and frequency requirements costs could potentially increase slightly; nevertheless remaining significantly lower than those associated with Qnasl use even at maximum dosage recommendations.
Please consult your healthcare provider or pharmacist to determine which medication would best suit your individual needs while also considering any potential side effects and benefits offered by each option too before making any decisions regarding their use in managing allergic rhinitis symptoms effectively over time as well!
Popularity of Qnasl and Flunisolide
Qnasl (beclomethasone dipropionate) and Flunisolide are both corticosteroid nasal sprays used to alleviate symptoms associated with allergic rhinitis, including itchiness, runny nose, and sneezing.
In 2020, Qnasl was prescribed to approximately 1.2 million people in the United States. This accounts for around 3% of all prescriptions for intranasal corticosteroids in the US. Though not among the most commonly-prescribed medications of its class, usage of Qnasl has been steadily increasing since its approval by the FDA in 2012.
Flunisolide is less frequently prescribed than Qnasl; it was only dispensed to about half a million patients in the US throughout 2020. Despite this lower prescription volume, flunisolide occupies an important niche within intranasal corticosteroid treatment options due to its affordability compared with other similar drugs such as Qnasl. The prevalence of flunisolide use has remained relatively steady over recent years.
Conclusion
Both Qnasl (beclomethasone) and Flunisolide are corticosteroid nasal sprays widely used to treat symptoms of allergies, such as sneezing, itching, and runny or stuffy nose. They function by reducing inflammation in the nasal passages. Both have been proven effective through numerous clinical studies and meta-analyses.
The two drugs work similarly but differ slightly in their potency and dosing schedule. Qnasl is often prescribed for once-daily use due to its potent formula, while flunisolide may be administered twice daily.
Flunisolide has a longer history of use than Qnasl and is available in generic form which can lead to significant cost savings - especially beneficial for patients who must pay out-of-pocket. On the other hand, Qnasl only comes as a brand-name medication which could mean higher costs.
As with any corticosteroids, both medications do carry some risk of side effects including nosebleeds, headaches, throat irritation or an unpleasant taste or smell. It's important that patients using these treatments closely monitor their symptoms; if there are signs of increased difficulty breathing or infection such as fever or persistent sore throat they should seek medical attention immediately.
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Refrences
- Pakes, G. E., Brogden, R. N., Heel, R. C., Speight, T. M., & Avery, G. S. (1980, June). Flunisolide. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-198019060-00001
- KAMMERMEYER, J., RAJTORA, D., ANURAS, J., & RICHERSON, H. (1977, April). Clinical evaluation of intranasal topical flunisolide therapy in allergic rhinitis. Journal of Allergy and Clinical Immunology. Elsevier BV.http://doi.org/10.1016/0091-6749(77)90049-5
- Sy, R. K. (1979, November 1). Flunisolide Intranasal Spray in the Treatment of Perennial Rhinitis. Archives of Otolaryngology - Head and Neck Surgery. American Medical Association (AMA).http://doi.org/10.1001/archotol.1979.00790230019004
- Ratner, P., van Bavel, J., Gross, G., Bynum, L., & Munshi, A. (1996, May 1). New Formulation of Aqueous Flunisolide Nasal Spray in the Treatment of Allergic Rhinitis: Comparative Assessment of Safety, Tolerability, and Efficacy. Allergy and Asthma Proceedings. Oceanside Publications Inc.http://doi.org/10.2500/108854196779165049
- SAHAY, J. N., CHATTERJEE, S. S., & ENGLER, C. (1980, January). A comparative trial of flunisolide and beclomethasone dipropionate in the treatment of perennial allergic rhinitis. Clinical & Experimental Allergy. Wiley.http://doi.org/10.1111/j.1365-2222.1980.tb02081.x
- Langrick, A. F. (1984, January). Comparison of flunisolide and beclomethasone dipropionate in seasonal allergic rhinitis. Current Medical Research and Opinion. Informa Healthcare.http://doi.org/10.1185/03007998409109594