Olopatadine (Nasal Spray)

INTRODUCTION

Indications

Relief of symptoms of allergic rhinitis.

Action

Antagonizes the effects of histamine at histamine₁ receptor sites; does not bind to or inactivate histamine. Therapeutic Effects: Decreased symptoms of histamine excess, including rhinorrhea, sneezing, and nasal itching.

Adverse Reactions/Side Effects

CNS: drowsiness, headache. EENT: epistaxis, nasal perforation, nasal ulcerations, pharyngolaryngeal pain, postnasal drip. GI: bitter taste. Resp: cough.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Report signs of nasal or pharyngeal problems such as nosebleeds, nasal pain, ulceration, or increased postnasal drip.

Patient/Client-Related Instruction

• Advise patient not to exceed the recommended dose or frequency of intranasal applications.

• Advise patient to avoid alcohol and other CNS depressants because of the increased risk of sedation and adverse effects.

• Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged headache, drowsiness, cough, or bitter taste.

Pharmacokinetics

Absorption: 57% absorbed from nasal mucosa.

Distribution: Unknown.

Metabolism and Excretion: Minimal metabolism; 70% eliminated in urine mostly as unchanged drug; 17% fecal elimination.

Half-life: 8–12 hr.

Contraindications/Precautions

Contraindicated in: None noted.

Use Cautiously in: Nasal pathology other than allergic rhinitis; Geri: Dose cautiously in elderly patients; consider age-related decrease in organ function and concurrent medications; Lactation/OB: Use in pregnancy or lactation only when maternal benefit outweighs fetal risk; Pedi: Safe use in children <12 yr not established.

Interactions

Drug-Drug: ↑ CNS depression may occur with alcohol; avoid concurrent use.

Route/Dosage

Intranasal (Adults and Children ≥12 yr): 2 sprays in each nostril bid.

Availability

Nasal spray: 665 mcg/100 μL (0.6%) spray in 30.5-g bottle (provides 240 metered sprays).