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Medical Forum / Diseases and Disorders / Sinusitis / August 2005Return of the Aerosol Steroid Nasal Spray!
I just read that Aventis, the maker of Nasacort, has a new aerosol version of Nasacort called "Nasacort HFA", which was approved by the FDA in April 2004. I don't think it's available in the USA yet, don't know why it takes so long after being approved, but I think it is supposed to become available soon. There used to be several aerosol nasal steroids out, in fact I think one of them might have pre-dated the aqueous formulations, which later became much more prevalent. Then, since they were all using the old CFC as a propellant, which is being phased out by the government due to environmental concerns, they had to stop producing them. (I would guess they had much lower sales than the aqueous formulations in any case.) In any case, I think that the last one available in the US was Nasacort, with Rhinocort the second to last. (Or, I might have it backwards.) Well, now Nasacort has come out with this new one, finally using a different approved propellant, HFA. I wonder if the others will follow. I'm not sure, but I think the few times I tried using one of the aerosol versions, it might have worked better for me. Perhaps the aerosol shoots the med farther into the sinuses, I don't know. In any case, when it becomes available, I hope my insurance covers it, and I will ask the doc if I can try it. My Hubby uses Rhinacort AQ now, in fact a couple of years of it. The samples in the doctors office is AQ too. > My Hubby uses Rhinacort AQ now, in fact a couple of years of it. > The samples in the doctors office is AQ too. Yes, Rhinocort AQ has been around for years, I use it myself. That is an aqueous spray, therefore the AQ. Aerosol is a different delivery mechanism, pressurized. As I wrote, there used to be several aerosol versions, as well as aqueous (of the same meds) (there was a Rhinocort Nasal Inhaler, aerosol), but later all aerosol versions went off the market in the USA. And now Nasacort (which has had an AQ version all along), has been approved to market a newly formulated aerosol version again. We'll see if Rhinocort and any of the others will follow--they will probably watch the sales returns of this new aerosol Nasacort. I too liked the aerosol versions as I believe they got deeper in the sinuses. I used to use Nascort. I was so sad when they discontinued the aerosol versions. I've asked my allergy doctor each year and he said they were still working on new propellents. This is good news! >I too liked the aerosol versions as I believe they got deeper in the >sinuses. I used to use Nascort. I was so sad when they discontinued the >aerosol versions. I've asked my allergy doctor each year and he said they >were still working on new propellents. This is good news! Dr. David Kennedy said Nasarel gets deeper into the sinuses than others once you have had surgery.. > Dr. David Kennedy said Nasarel gets deeper into the sinuses than others once > you have had surgery.. Yes, I recall you writing that before. Did he ever tell you why? Did you try it? If so, did you notice any difference? Nasarel is an aqueous solution. In fact, it is the exact same medication as one of the oldest nasal steroid sprays, Nasalide. The other chemicals in the solution might be different. (I vaguely recall something in their literature about not needing shaking, or not needing priming, or something unusual like that.) But it is an aqueous spray, so I don't understand how it would get deeper into the sinuses than other aqueous sprays. (Could it be a thicker viscosity, so once sprayed it, it sticks to the nasal tissue longer, rather than dripping out?) I don't think it is a frequently used one here in the US. In any case, I am curious as to why Dr. Kennedy said that, and whether people who have used it noticed anything different about its efficacy. If you have any more info, please let us know. Thank you. >Nasarel is an aqueous solution. In fact, it is the exact same medication as >one of the oldest nasal steroid sprays, Nasalide. The other chemicals in the [quoted text clipped - 9 lines] >noticed anything different about its efficacy. If you have any more info, >please let us know. Thank you. Unfortunately I have not seen him in the past few years so I have not had a chance to ask him. He was very emphatic about it though. > Unfortunately I have not seen him in the past few years so I have not had a > chance to ask him. He was very emphatic about it though. Well, if you (or anyone else reading) have a chance to ask him about that, please do so, and report it here. I looked on the web, and couldn't find a reference to that anywhere else (to Nasarel working better than others in getting to the sinuses, or anything of that sort). > I too liked the aerosol versions as I believe they got deeper in the > sinuses. I used to use Nascort. I was so sad when they discontinued the > aerosol versions. I've asked my allergy doctor each year and he said they > were still working on new propellents. This is good news! I don't understand that though. New propellants have been around for a long time. Long before the use of CFCs in nasal inhalers was banned, it was banned in other products. There have been aerosol spray cans with shaving cream, whipped cream, and many other products, all with new propellants (no CFCs) around fro many years. Why did it take so long, including waiting years after all the aerosol nasal inhalers were off the market in the USA, to come out with one using a non-CFC propellant? I suspect the drug companies just wanted to focus more on selling the aqueous versions, and decided to phase out the aerosol ones anyhow. Now Aventis has probably received so many requests from consumers to offer an aerosol version again, they decided to try one out, and see how it sells. (One wonders, however, why they are taking so long to get it to market, since it was approved by the FDA in April 2004.) Interestingly, the aerosol asthma inhalers have never been banned (I don't think there are aqueous versions that would work for that), and have been continuously on the market, I think with CFC propellant. (I don't know why they haven't switched to non-CFC propellant for those as well.) > There have been aerosol spray cans with shaving cream, whipped > cream, and many other products, all with new propellants (no CFCs) > around fro many years. Why did it take so long, including waiting > years after all the aerosol nasal inhalers were off the market in > the USA, to come out with one using a non-CFC propellant? The propellant in a lot of the newere spray cans is butane, the gas used in many cigarette lighters. Since butane is volatile, it might be okay for whipped cream but not for spraying up your nose.  SignatureAlison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Mr. Wilson [ . . . ] and even his wife's outing have as much to do with the real story here as Janet Leigh's theft of office cash has to do with the mayhem that ensues at the Bates Motel in "Psycho." -- Frank Rich, NY Times, July 17 > The propellant in a lot of the newere spray cans is butane, the gas > used in many cigarette lighters. Since butane is volatile, it might > be okay for whipped cream but not for spraying up your nose. Really? Butane? One wouldn't think any product would be approved that would be volatile, that could explode, burst in flames, increase fire danger, etc., whether shaving cream, whipped cream, deodorant, or any other aerosol product. (These changed from CFCs many years ago. Apparently the pharmaceutical industry got some kind of extension to that, and the ban on CFCs in prescription nasal sprays just went into effect a couple years ago, and apparently the extension is still longer with asthma inhalers, as they still use CFCs. One would think the drug industry could have had a new aerosol formulation ready in time for when they could no longer sell the old nasal inhalers, they had many years advance knowledge of the ban. I assume they decided to concentrate on the marketing the aqueous nasal sprays, and phase out the aerosol nasal inhalers.) Probably though, many consumers complained that they would still like an aerosol version, and Aventis has decided to try it with its Nasacort, which I think was also the last company to drop their prior aerosol version. Well, let's hope it actually becomes available. One wonders, since it was approved by the FDA in April 2004, and still is not available here. (I don't know if it is available in other countries.) The announced date for it to become available in the US is Q3 2005, and we are already in the second month of that quarter. I wrote: >> The propellant in a lot of the newere spray cans is butane, the gas >> used in many cigarette lighters. Since butane is volatile, it might >> be okay for whipped cream but not for spraying up your nose. > Really? Butane? Yes, butane. I've lit the spray from many cans containing active ingredients you wouldn't expect to be flammable. Of course I recommend that you DO NOT do this yourself. It's dangerous! > One wouldn't think any product would be approved that would be > volatile, that could explode, burst in flames, increase fire danger, > etc., whether shaving cream, whipped cream, deodorant, or any other > aerosol product. I find the choice of butane surprising myself. I suppose that the constraints on the choice of propellant gas must eliminate most other choices. SignatureAlison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Mr. Wilson [ . . . ] and even his wife's outing have as much to do with the real story here as Janet Leigh's theft of office cash has to do with the mayhem that ensues at the Bates Motel in "Psycho." -- Frank Rich, NY Times, July 17 Ms - I read on the EPA or CDC web site that CFCs were allowed in asthma inhalers because they were considered 'life saving' medicines while the nasal inhalers weren't allowed past the Montreal protocols deadline because 1) they weren't considered life saving and 2) there were the aqua versions that were considered just as good. I think the drug companies thought they could just sell the water based ones. My allergist told me that only 10 of his patients (including me) ever said anything about thinking the aerosol ones worked better. The others just accepted the aqua ones. So unless there is demand I think they won't make the other version. > So unless there is demand I think they won't make the other version. As I pointed out, it looks like Nasacort is coming out with an aerosol again. They are taking a long time though, for a product approved by the FDA in April 2004! (I wonder if they are having second thoughts about marketing it?) MS I was able to find it in my list of drugs covered by my insurance. I have an upcoming appointment with my allergist and plan to ask him about it. Also plan to call the pharmacy. Have you tried asking your doctor or checking a pharmacy? > MS I was able to find it in my list of drugs covered by my insurance. I > have an upcoming appointment with my allergist and plan to ask him about > it. Also plan to call the pharmacy. Have you tried asking your doctor or > checking a pharmacy? I also checked my formulary from my insurance, and saw it there. (Not with "HAFT" in the name, however, just Nasacort inhaler, so I don't know if they just haven't removed the old one yet.) I also see it listed now at Rxlist.com, as NC HAFT: http://www.rxlist.com/cgi/generic/triamnas_pi.htm However, if one goes to www.nasacort.com, still only the AQ version is mentioned there. Aventis (the manufacturer) does list it otherwise on their web site though: http://www.aventispharma-us.com/PIs/nasacort_hfa_TXT.html So, I don't know if it's actually available yet. Let us know what you find out. > MS I was able to find it in my list of drugs covered by my insurance. I > have an upcoming appointment with my allergist and plan to ask him about > it. Also plan to call the pharmacy. Have you tried asking your doctor or > checking a pharmacy? I just called the USA branch of the manufacturer, Aventis, and inquired about it. The rep looked it up, and told me it isn't available yet. I asked when it will become available. Reply--"I don't know." I asked why it is taking so long to come to market, since it was approved by the FDA in April 2004. Reply--"I don't know". So--it looks like it is not yet available, with no info as to when it will be available, and why it is taking so long. Who knows--it could become available next week? Let us know anything you find out. I still am worried that, although they spent money developing and testing this new delivery device for Nasacort, that now they are having second thoughts about bringing it to market, not sure if it will sell enough, thinking that people are used to the aqueous versions now, not many would change to (or back to) aerosol, etc. Just speculation, I hope it's not the case, and this becomes available soon. It wouldn't hurt if you (and anyone else interested in this product) also call them, and express your interest. I don't know if such calls get registered, but if they see many people calling and inquiring about the product, it might make them more optimistic about its sales potential. The number I called for Aventis is: 1-800-633-1610 (You might possibly get a more knowledgeable rep as well, and get more info.) Let us know what you find out. Thank you.
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