CORTRIEF NASAL SP 64/MCG/DOSE

Dosage & Administration

Dosing by Condition

Allergic rhinitis (adults and adolescents ≥12 years): Initially one spray in each nostril once daily; dose may be increased as needed, but usually not more than 4 sprays in each nostril per day. Children 6-11 years: Initially one spray in each nostril once daily; dose may be increased as needed, but usually not more than 2 sprays in each nostril per day.

Initial Dose

For adults, teenagers, and children 12 years of age and older: Initially one spray in each nostril once a day (64 µg/day); dose may be increased as needed, but usually not more than 4 sprays in each nostril per day

Maximum Dose

Adults and children ≥12 years: 256 mcg per day. Children 6 to <12 years: 128 mcg per day.

Children's Dosage

Children 6 to 11 years: Initially one spray in each nostril once daily; dose may be increased as needed, but usually not more than 2 sprays in each nostril per day. Children younger than 6 years: Use and dose must be determined by your doctor; safety and efficacy have not been established.

Dose Adjustment Notes

Titrate to the lowest effective dose once symptom control is achieved; no routine renal dose adjustment is needed for intranasal use, and clinically significant hepatic adjustment is generally not required at usual intranasal doses (caution with strong CYP3A4 inhibitors).

How to Take

For nasal use only. Shake gently before each use. Prime the pump before first use (and re-prime if not used for several days per product leaflet). Blow nose gently, keep head slightly forward, insert nozzle into one nostril aiming away from the nasal septum, occlude the other nostril, and spray while breathing in gently; repeat for the other nostril. Wipe/clean the nozzle after use and replace the cap.

How to Prepare

Follow the CORTRIEF package leaflet for exact priming/re-priming counts; in general for budesonide nasal spray suspensions: shake well, prime before first use until a fine mist appears, and re-prime after a period of non-use (often 1-2 sprays) before dosing.

Safety & Warnings

Warnings & Precautions

Caution with recent nasal ulcers/surgery/trauma until healed; monitor for epistaxis, mucosal irritation and Candida; avoid/monitor in untreated infections (including TB) and ocular herpes simplex; monitor for systemic corticosteroid effects (hypercorticism/adrenal suppression) and growth in children with long-term use; use caution in glaucoma/cataracts; if switching from long-term systemic steroids, do not stop systemic steroids abruptly.

Age Restriction

Approved for use in children 6 years of age and older (not recommended/insufficient data under 6 years).

Special Populations

Pregnancy

Consult Doctor

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Children

Children 6 to 11 years: Initially one spray in each nostril once daily; dose may be increased as needed, but usually not more than 2 sprays in each nostril per day. Children younger than 6 years: Use and dose must be determined by your doctor; safety and efficacy have not been established.

Elderly

Standard adult dosing; no specific adjustment required

Liver Impairment

No specific dose adjustment is defined; use with caution in hepatic impairment (especially moderate-severe) and monitor for systemic corticosteroid effects.

Storage & Patient Advice

Preparation Instructions

Follow the CORTRIEF package leaflet for exact priming/re-priming counts; in general for budesonide nasal spray suspensions: shake well, prime before first use until a fine mist appears, and re-prime after a period of non-use (often 1-2 sprays) before dosing.

Missed Dose

Use the missed dose as soon as remembered the same day; if it is close to the next scheduled dose, skip the missed dose and resume the regular schedule-do not double doses.

Pharmacology

Mechanism of Action

Binds glucocorticoid receptors in nasal mucosa, downregulating inflammatory gene transcription and mediator release (e.g., cytokines, eicosanoids), reducing mucosal edema and secretions.

Onset of Action

Some symptom relief may occur within 8-24 hours, but maximal benefit typically requires several days and up to 1-2 weeks of regular daily use.

Product Information

Available Dosage Forms

Nasal spray, suspension (this product).

Symptom Target

Allergy, Congestion, Runny Nose

Sedating

No

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