Thursday, January 3, 2013

The 12 most Frequent Questions and answers of Nasodren

The 12 most Frequent Questions and answers of Nasodren

  1. What is Nasodren and what is its composition?

Nasodren is a product indicated for the symptomatic treatment of acute and chronic Rhinosinusitis, postoperative care after sinonasal surgery, and otitis media with effusion.  
It is composed of saponins (active substance) from a Cyclamen extract that give fast relief from Rhinosinusitis symptoms, like nasal blockage, obstruction, congestion, nasal discharge and loss of smell.

  1. Why is Nasodren different?
Nasodrenâ/Sinuforteâ is different because it has a unique and physiologic mechanism of action that produces a reflex secretion to clean and drain the nose and sinuses from accumulated mucus.
  1. How does Nasodren work?

Nasodren has a dual mechanism of action: one direct and one indirect effect.
Saponins are well-established, surface-active agents that reduce the surface tension of the cell membrane of the nasal mucosa, thereby facilitating mucin secretion and decreasing nasal mucosa and congestion through a direct osmotic effect. Once administered into each nostril, saponins do not penetrate the membrane, acting as a topical surfactant agent that is neither absorbed nor permeates.

Cyclamen extract also stimulates the nociceptive terminals of the trigeminal nerve (indirect effect), which leads to a seromucous discharge, reducing  inflammation of the mucosa and opening the ostiums (the passages that communicate the sinuses to the nasal cavity), thus cleaning sinuses and nasal cavity. Hence, Nasodren performs by activating the physiological mechanisms of the upper airways (increased mucus secretion, greater ciliary cleansing activity and increased arterial blood flow), which are impaired during Rhinosinusitis.
  1. Is Nasodren a safe product?
Following instillation into the nostrils, Cyclamen extract does not disperse over the entire mucous surface, since it does not penetrate into the paranasal cavities; its activity is confined to the vestibular area and,, the inferior nasal meatus. Consequently, Nasodren is a very safe product since its main ingredient, saponins, are not absorbed1 and consequently do not reach the bloodstream, its not metabolised and  not produce adverse effects, i.e. do not affect the liver, kidneys or other organs.
  1. What concomitant/undesirable effects may Nasodren produce?
Nasodren acts physiologically, stimulating the terminal endings of the trigeminal nerve in the nasal mucosa. This specific mechanism of action can produce some itching, sneezing, a brief sensation of mild to moderate burning in the nasopharynx and more rarely, a brief lacrimation and flushing of the face. These are manifestations of the positive response to the product.  All these effects usually diminish during the course of treatment.
  1. How many applications of Nasodren does a patient need to feel relief?
According to clinical data, many patients feel symptom relief from the first application. After the 2nd day of application, symptoms such as facial pain will be significantly reduced; the mucopurulent secretions will stop after the 4th day. It is recommended that you use Nasodrenâ/Sinuforteâ daily during 7 to 10 days.
  1. I have not improved after several days of treatment. Why?

There are some reasons why Nasodren may show a lack of efficacy. 
Firstly, an idiopathic (unknown) reason, i.e. any product may be efficient in a high percentage of patients but for unknown reasons be inefficient in a small percentage of patients.
If patients have huge polyps, these may block the opening of the sinuses and the nasal passage impeding mucus drainage. Other anatomical malformations can produce similar results.
Another cause that affects the efficacy of Nasodren is when only a short time is left between the administration of nasal decongestants (vasoconstrictive nasal drops) and Nasodren. This effect is seen when nasal drops act on the mucous membrane. This seems to be related to the blocking of unicellular glands caused by the action of the nasal drops.  There is no need to use a decongestant when using Nasodren, but in cases where the patient wants to use both, a gap of at least 2 hours should be left between product application.

  1. Does Nasodren work for chronic sinusitis?
Yes, Nasodren is indicated for the symptomatic treatment of acute Rhinosinusitis and  exacerbations of chronic Rhinosinusitis.  
  1. Can I use Nasodrenâ/Sinuforteâ if I have polyps?
Yes, you can, although Nasodren will not shrink the polyps. In cases where polyps are too large, they can obstruct the sinus conducts and impede mucus drainage.
  1. Can I use Nasodren as monotherapy?
Yes, Nasodren used by itself cleans and drains accumulated mucus in the sinonasal area. Clinical trials have shown the efficacy of Nasodren in monotherapy as well as in combination with other Rhinosinusitis treatments (antibiotics, corticosteroids, etc.)
  1. Can I be allergic to Cyclamen?
Yes. Although it is infrequent, some persons can develop an allergy to Primulaceae, the family of plants Cyclamen europaeum (Nasodren active substance) belongs to. Unfortunately, allergy cannot be foreseen. If it does occur, it is advisable to visit the allergist to confirm the diagnosis.
  1. When is Nasodren indicated?

As soon as a patient feels nasal blockage, obstruction, congestion or nasal discharge, facial pain/pressure or a reduction of smell.
1. Sollmann T. Pharmacology and its application to Therapeutics and Toxicology,  Saunders, Philadelphia, 1957, pp 666-667

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