RHINOMAX 64 mcg Price

Overview

Welcome to Dwaey, specifically on RHINOMAX 64 mcg page.
This medicine contains an important and useful components, as it consists of
Budesonide micronisedeis available in the market in concentration

Name

Methoxsalen

Precaution

Before starting methoxsalen therapy, it is essential to consult with a healthcare provider to ensure its safety and appropriateness for individual conditions. Some important precautions to be aware of include: - **Photosensitivity**: Methoxsalen can increase the skin’s sensitivity to **UV light**, making patients more prone to **sunburns** or **skin damage**. It is crucial to avoid direct sunlight or artificial UV light for a prolonged period during treatment. Protective measures, such as wearing sunscreen, covering the skin, and limiting sun exposure, are strongly recommended. - **Pregnancy and Breastfeeding**: Methoxsalen should be avoided during pregnancy unless absolutely necessary, as it may cause harm to the fetus. It is also not recommended during breastfeeding, as it may be excreted in breast milk and affect the infant. - **Eye Protection**: Methoxsalen may cause **eye irritation** or **cataract formation** if not used with proper eye protection during ultraviolet (UV) light therapy. Patients should wear protective eyewear when undergoing phototherapy. - **Pre-existing Skin Conditions**: Individuals with **skin cancer** or other severe skin conditions should use methoxsalen with caution, as UV exposure can worsen these conditions. - **Liver and Kidney Disease**: Methoxsalen should be used cautiously in patients with impaired liver or kidney function, as it may affect drug metabolism and increase the risk of toxicity.

Indication

Methoxsalen is primarily used in the treatment of **psoriasis**, **vitiligo**, and certain other skin disorders, where ultraviolet light therapy (photochemotherapy) is part of the treatment regimen. Specific indications include: - **Psoriasis**: Methoxsalen is often used in combination with **UVA light** therapy (PUVA therapy) to treat **chronic plaque psoriasis** by slowing down the overactive skin cell turnover. - **Vitiligo**: Used in conjunction with UVA light, methoxsalen helps to repigment the skin in patients with **vitiligo**, a condition where skin loses its pigmentation. - **Other Dermatoses**: Methoxsalen may be used to treat other skin disorders, including **eczema** or **dermatitis**, when traditional treatments are ineffective. - **Cutaneous T-Cell Lymphoma (CTCL)**: As part of a combined photochemotherapy regimen, methoxsalen can be used for **CTCL**, a rare type of skin cancer.

Contra indication

Methoxsalen should be avoided in the following conditions: - **Hypersensitivity**: Patients who are **allergic** to methoxsalen or other psoralen compounds should not use this medication. - **Pregnancy and Lactation**: Due to potential risks to the fetus and infant, methoxsalen is contraindicated in pregnant and breastfeeding women. - **Severe Liver Disease**: Methoxsalen is metabolized in the liver, and patients with **severe liver disease** (e.g., cirrhosis) may experience reduced clearance, leading to higher drug concentrations and increased risk of toxicity. - **Severe Renal Impairment**: Impaired kidney function can also impact methoxsalen's metabolism, increasing the risk of side effects and toxicity. - **History of Skin Cancer**: Methoxsalen is contraindicated in patients with a history of **skin cancer**, as UV exposure may increase the risk of cancer recurrence or new skin malignancies. - **Pregnancy Category C**: The drug is categorized as **pregnancy category C**, meaning that its use during pregnancy should be avoided unless the benefits outweigh the potential risks.

Side Effect

While methoxsalen is generally well-tolerated when used correctly, it can cause side effects, especially with UV exposure: - **Skin Reactions**: The most common side effects include **redness**, **itching**, and **sunburn-like symptoms** after UV exposure. These are often mild but should be monitored. - **Eye Irritation**: Prolonged use of methoxsalen, especially in the absence of eye protection during phototherapy, can cause **eye irritation** and increase the risk of **cataract formation** over time. - **Nausea and Vomiting**: Some patients may experience gastrointestinal discomfort, including **nausea** or **vomiting** after taking methoxsalen orally. - **Headache and Dizziness**: **Headaches** and **dizziness** are common but generally mild side effects. - **Hyperpigmentation or Hypopigmentation**: Long-term use of methoxsalen for vitiligo or psoriasis may lead to **uneven pigmentation**, either darkening or lightening of the treated areas. - **Skin Cancer**: There is a potential risk for increased **skin cancer** due to repeated UV exposure when using methoxsalen, especially in individuals with a history of skin malignancies. - **Liver Toxicity**: In rare cases, methoxsalen can cause **liver toxicity**, leading to elevated liver enzymes, jaundice, or other liver-related symptoms.

Pregnancy Category ID

3

Mode of Action

Methoxsalen is a **psoralen compound** that works by making the skin cells more sensitive to **UVA light**. This is how it facilitates **photochemotherapy** (PUVA therapy) for conditions like psoriasis and vitiligo: - **DNA Intercalation**: Methoxsalen binds to **DNA** in the skin cells, making them more susceptible to **UV radiation**. When exposed to UVA light, the methoxsalen-DNA complex forms cross-links in the DNA, which inhibits cell replication and slows down the overproduction of skin cells in conditions like psoriasis. - **Immunomodulation**: The drug has an immunosuppressive effect, which helps reduce the inflammatory response seen in autoimmune skin conditions like psoriasis and vitiligo. - **Repigmentation**: In vitiligo, methoxsalen combined with UV exposure stimulates the production of **melanin** in depigmented areas of the skin, helping to restore normal skin color.

Interaction

Methoxsalen may interact with other drugs or substances, leading to increased side effects or reduced effectiveness. Some notable interactions include: - **Corticosteroids**: Concurrent use with corticosteroids may increase the risk of **skin thinning** and **adverse reactions** from UV exposure. - **Antibiotics**: Some antibiotics, such as **tetracyclines** or **sulfonamides**, may increase the risk of photosensitivity when used with methoxsalen. - **Photosensitizing Agents**: Methoxsalen should not be combined with other photosensitizing drugs, such as **diuretics** or certain **antidepressants** like **fluoxetine**, as this may increase the risk of **severe sunburn** or skin damage. - **Warfarin**: Methoxsalen may interfere with the effects of **warfarin**, a blood thinner, potentially altering blood clotting. - **Other UVA Light Therapy**: Using methoxsalen alongside other forms of **UV light therapy** or tanning treatments may increase the risk of skin damage or burns.

Pregnancy Category Note

Information not available

Adult Dose

The dosing of methoxsalen depends on the condition being treated and the route of administration: - **Psoriasis**: Oral methoxsalen is typically administered **30 mg** 1–2 hours before UVA exposure, with the dose adjusted based on individual response and UV light sensitivity. - **Vitiligo**: A typical starting dose is **0.6–1.2 mg/kg** of methoxsalen, taken 1-2 hours before UVA exposure, with dosages adjusted based on patient tolerance and response. - **Other Dermatoses**: The dose varies depending on the disease severity, but generally ranges from **30-60 mg** of oral methoxsalen before each phototherapy session.

Child Dose

Methoxsalen use in children is generally reserved for severe cases of **psoriasis** or **vitiligo** when conventional treatments are ineffective: - **Psoriasis**: Children may be given methoxsalen at a dose of **0.6 mg/kg** body weight, taken orally 1–2 hours before phototherapy. The dose is usually adjusted based on the child’s age, weight, and the severity of the disease. - **Vitiligo**: For children with vitiligo, methoxsalen doses typically start at **0.6 mg/kg**, with the possibility of increasing or decreasing depending on response and tolerance. --- **Important Note**: Before using methoxsalen, it is crucial to consult with a healthcare provider, as this medication requires careful consideration of potential risks and interactions, especially related to **sun exposure** and **photosensitivity**. Proper monitoring during treatment is essential to minimize side effects and optimize therapeutic benefits.

Renal Dose

For patients with **renal impairment**, methoxsalen dosing may need to be adjusted. However, it is generally recommended to avoid using methoxsalen in patients with **severe kidney disease**, as impaired kidney function can lead to prolonged drug action and increased risk of toxicity. **Dose reduction** and close monitoring may be necessary for mild to moderate renal dysfunction.

Administration

Information not available