General Information

Patanase is an antihistamine with selective H1 -receptor antagonist activity: its principal effects are mediated via inhibition of H1 receptors.

Patanase is specifically indicated for the relief of the symptoms of seasonal allergic rhinitis in patients 12 years of age and older.

Patanase is supplied as a metered-dose manual spray pump designed for intranasal administration. The recommended initial dose of the drug is two sprays per nostril twice daily. Patanase must be primed before initial use and when it has not been used for more than 7 days.

Mechanism of Action

Patanase is an antihistamine with selective H1 -receptor antagonist activity: its principal effects are mediated via inhibition of H1 receptors. These drugs selectively bind to but do not activate histamine H1 receptors, thereby blocking the actions of endogenous histamine. They act in the bronchi, capillaries, and other smooth muscles. Histamine acts as a pro-inflammatory signal released from mast cells in response to allergic reactions or tissue damage.

Side Effects

Adverse reactions associated with the use of Patanase may include, but are not limited to, the following:

• Bitter taste
• Headache
• Epistaxis
• Pharyngolaryngeal Pain
• Post-nasal drip
• Cough
• Urinary tract infection

Clinical Trial Results

FDA approval of Patanase was based on the results of three clinical trials. These randomized, double blind, parallel group, multicenter, placebo (vehicle nasal spray)-controlled clinical trials 1,598 subjects, aged 12 years and older, in the United States. The subjects received Patanase Nasal Spray 0.6%, Patanase Nasal Spray 0.4%, or vehicle nasal spray, two sprays per nostril, twice-daily. The duration of the study was two weeks. Efficacy was based on patient recording of 4 individual nasal symptoms (nasal congestion, rhinorrhea, itchy nose, and sneezing) on a 0 to 3 categorical severity scale (0 = absent, 3 = severe) as reflective or instantaneous scores. Reflective scoring recorded symptom severity over the previous 12 hours; instantaneous scoring recorded symptom severity at the time of recording. The primary efficacy endpoint was the difference from placebo in the percent change from baseline in the sum of morning and evening reflective total nasal symptom score (rTNSS) at the end of the treatment period. In all studies Patanase exhibited statistically significantly greater decreases in rTNSS compared to vehicle nasal spray. Study One: In the Patanase 0.6% and 0.4% groups, the change from baseline was -3.63 and -3.38, respectively, compared to -2.67 for the placebo group (p <0.0001 for the high dose group). Study Two: In the Patanase 0.6% and 0.4% groups, the change from baseline was -2.90 and -2.63, respectively, compared to -1.92 in the placebo group (p<0.0001 for the high dose group).

Onset of action was evaluated in three environmental exposure unit studies. In these studies, subjects with seasonal allergic rhinitis were exposed to high levels of pollen in an environmental exposure unit and then treated with either Patanase Nasal Spray or vehicle nasal spray, two sprays in each nostril. Afterwards they self-reported their allergy symptoms hourly as instantaneous scores for the subsequent 12 hours. Patanase 0.6% was found to have an onset of action of 30 minutes after dosing in the environmental exposure unit and a twelve hour duration of effect.