DUORESP® SPIROMAX® DRY POWDER FOR INHALATION 320 MCG/9 MCG

Product Information

Registration Status: Active

DUORESP® SPIROMAX® DRY POWDER FOR INHALATION 320 MCG/9 MCG is approved to be sold in Singapore with effective from 2020-12-07. It is marketed by DRUG HOUSES OF AUSTRALIA PTE LTD, with the registration number of SIN16057P.

This product contains Budesonide 320mcg/inhalation, and Formoterol Fumarate 9mcg/inhalation in the form of POWDER, METERED. It is approved for RESPIRATORY (INHALATION) use.

This product is manufactured by Norton (Waterford) Limited T/A Teva Pharmaceuticals Ireland in IRELAND.

It is a Prescription Only Medicine that can only be obtained from a doctor or a dentist, or a pharmacist with a prescription from a Singapore-registered doctor or dentist.

Budesonide
Formoterol Fumarate

Description

Budesonide is a glucocorticoid used in the management of asthma, the treatment of various skin disorders, and allergic rhinitis. [PubChem] The extended release oral tablet, marketed as Uceris, was FDA approved on January 14, 2013 for the management of ulcerative colitis. Budesonide is provided as a mixture of two epimers (22R and 22S). Interestingly, the 22R form is two times more active than the 22S epimer. The two forms do not interconvert.

Indication

The oral capsule is used for the treatment of mild to moderate active Crohn's disease. The oral tablet is used for induction of remission in patients with active, mild to moderate ulcerative colitis. The oral inhalation formulation is used for the treatment of asthma, non-infectious rhinitis (including hay fever and other allergies), and for treatment and prevention of nasal polyposis.

Mechanism of Action

Budesonide is an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity. The precise mechanism of corticosteroid actions on inflammation in asthma, Crohn's disease, or ulcerative colitis is not known. Inflammation is an important component in the pathogenesis of asthma. Corticosteroids have been shown to have a wide range of inhibitory activities against multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (eg, histamine, eicosanoids, leukotrienes, and cytokines) involved in allergic and non-allergic-mediated inflammation. These anti-inflammatory actions of corticosteroids may contribute to their efficacy in the aforementioned diseases. Because budesonide undergoes significant first-pass elimination, the both oral preparations are formulated as an extended release tablet. As a result, budesonide release is delyaed until exposure to a pH ≥ 7 in the small intestine.

Pharmacokinetics

Absorption
Absorption is complete following oral administration. The pharmacokinetic parameters of the inhaled powder formulation are as follows: Tmax = 30 minutes; Absolute systemic availability = 39%. When a single oral administration of 9 mg of Uceris are given, the pharmacokinetic parameters are as follows: Tmax = 13.3 ± 5.9 hours; Cmax = 1.35 ± 0.96 ng/mL; AUC = 16.43 ± 10.52 ng·hr/mL. It is important to note that the parameters have a high degree of variability. When a single oral administration of Entocort EC are given, the pharmacokinetic parameters are as follows: Tmax = 3- 600 minutes; Cmax = 5 nmol/L; AUC = 30 nmol•hr/L.
Distribution
Tablet and capsule, healthy subjects and patients = 2.2 - 3.9 L/kg; Powder, metered = 3 L/kg
Metabolism
Following absorption, budesonide is subject to high first pass metabolism (80-90%). Budesonide is rapidly and extensively biotransformed, mainly by CYP3A4, to its 2 major metabolites, 6b-hydroxybudesonide and 16a- hydroxyprednisolone. The glucocorticoid activity of these metabolites is negligible (<1/100) in relation to that of the parent compound.
Elimination

Clearance

Plasma clearance, tablet = 0.9 - 1.8 L/min; Systemic clearance, powder, 22R = 1.4 L/min; Systemic clearance, powder, 22S = 1.0 L/min; 0.5 L/min [Athmatic children 4 to 6 years of age]

Toxicity

Single oral doses of 200 and 400 mg/kg were lethal in female and male mice, respectively. The signs of acute toxicity were decreased motor activity, piloerection and generalized edema.

Active Ingredient/Synonyms

(11beta,16alpha)-16,17-(Butylidenebis(oxy))-11,21-dihydroxypregna-1,4-diene-3,20-dione | Budesonide |


Source of information: Drugbank (External Link). Last updated on: 3rd July 18. *Trade Name used in the content below may not be the same as the HSA-registered product.


Mechanism of Action

4-Methoxyamphetamine is a seratogenic drug of the amphetamine class. The drug acts as a potent and selective serotonin releasing agent. It binds to alpha receptors to mediate these effects.

Active Ingredient/Synonyms

(2RS)-1-(4-methoxyphenyl)propan-2-amine | 4-methoxyamfetamine | D,L-p-methoxyamphetamine | Formoterol fumarate related compound G | P-methoxyamfetamine | P-methoxyamphetamine | Paramethoxyamphetamine | 4-Methoxyamphetamine |


Source of information: Drugbank (External Link). Last updated on: 3rd July 18. *Trade Name used in the content below may not be the same as the HSA-registered product.

References

  1. Health Science Authority of Singapore - Reclassified POM
  2. Drugbank