Table of Contents

PATANASE (Nasal) — Comprehensive Medical Overview

Introduction

Patanase is a prescription nasal spray containing the active ingredient olopatadine hydrochloride, classified as a second-generation antihistamine with mast cell stabilizing properties. It is specifically designed to treat the symptoms of seasonal allergic rhinitis (hay fever), including nasal congestion, sneezing, runny nose, and itchy nose.

Patanase’s intranasal administration allows targeted delivery of the medication directly to the nasal mucosa, enabling rapid symptom relief with fewer systemic side effects compared to oral antihistamines. Its unique dual action—blocking histamine receptors and stabilizing mast cells—makes it effective both for immediate and delayed allergic responses.

This article presents a comprehensive review of Patanase nasal spray, covering its pharmacology, clinical uses, dosing, safety profile, warnings, drug interactions, and practical patient information.

Uses & Indications

Primary Indication:

Treatment of nasal symptoms associated with seasonal allergic rhinitis in adults and children aged 6 years and older.

Off-label and Investigational Uses:

Management of perennial allergic rhinitis (year-round allergies) though official approval varies by region.
Possible adjunctive treatment in other allergic conditions affecting nasal mucosa.

Patanase is often favored in patients who experience nasal allergy symptoms that are not well controlled by oral antihistamines or in those who prefer intranasal therapy with minimal sedation risk.

Mechanism of Action

Patanase contains olopatadine hydrochloride, which exerts its effects through two primary mechanisms:

Histamine H1 Receptor Antagonism:
- Olopatadine selectively blocks H1 histamine receptors in the nasal mucosa, preventing histamine from binding and triggering allergy symptoms such as sneezing, itching, and rhinorrhea.
Mast Cell Stabilization:
- It inhibits the release of histamine and other inflammatory mediators (e.g., leukotrienes, prostaglandins) from mast cells by stabilizing their membranes, thereby reducing late-phase allergic inflammation.

This dual action provides immediate relief from histamine-mediated symptoms and reduces prolonged inflammatory responses that sustain allergic rhinitis.

Pharmacokinetics

Absorption: Olopatadine administered intranasally exhibits minimal systemic absorption, reducing the risk of systemic side effects. Peak plasma concentrations occur within 20-30 minutes but remain very low.
Distribution: The drug concentrates in the nasal mucosa where it exerts its effects.
Metabolism: Minimal hepatic metabolism; most of the drug is excreted unchanged.
Elimination: Primarily excreted via the kidneys.

The low systemic bioavailability of olopatadine makes Patanase a safer alternative in patients sensitive to systemic antihistamines.

Dosage and Administration

Recommended Dosage:

For adults and children 6 years and older: 2 sprays (each delivering 0.57 mg olopatadine) into each nostril twice daily (morning and evening), totaling 4 sprays per nostril per day.

Administration Instructions:

Gently blow your nose to clear nasal passages before use.
Shake the bottle gently if recommended by the manufacturer.
Insert the spray nozzle into one nostril, close the other nostril, and spray while inhaling gently through the nose.
Repeat in the other nostril.
Avoid sneezing or blowing nose immediately after spraying to allow the medication to be absorbed.

Treatment Duration:

Use continuously during allergy seasons or as prescribed by the healthcare provider.
Avoid abrupt discontinuation if symptoms improve gradually.

Clinical Efficacy

Multiple randomized controlled trials demonstrate that Patanase:

Significantly reduces nasal symptoms including sneezing, nasal itching, rhinorrhea, and congestion.
Improves patient-reported quality of life during allergy seasons.
Exhibits rapid onset of action, with symptom relief as early as 30 minutes after administration.
Provides sustained symptom control with twice-daily dosing.

Compared to oral antihistamines, Patanase is associated with fewer sedative effects, making it suitable for patients requiring alertness during the day.

Side Effects

Common Side Effects:

Nasal irritation or burning sensation.
Dryness or stinging inside the nose.
Headache.
Bitter or unpleasant taste.
Sneezing immediately post-spray.

Less Common or Rare Side Effects:

Epistaxis (nosebleeds).
Nasal congestion or swelling.
Throat irritation or dryness.
Allergic reactions such as rash, itching, or swelling.

Serious Adverse Events:

Very rare reports of hypersensitivity reactions including anaphylaxis.
No significant systemic effects noted due to low absorption.

Warnings and Precautions

Avoid use if hypersensitive to olopatadine or any components of the formulation.
Use caution in patients with nasal ulcers, trauma, or recent nasal surgery.
Safety and efficacy have not been established in children under 6 years of age.
Avoid spraying into the eyes; if contact occurs, rinse thoroughly with water.
Pregnant and breastfeeding women should consult their healthcare provider before use.
Patients should not exceed recommended dosing to avoid increased side effects.

Drug Interactions

No significant drug interactions have been identified due to minimal systemic absorption.
Concomitant use with other nasal products should be discussed with a healthcare provider to avoid local irritation.
Use caution when combined with other systemic antihistamines or sedatives.

Use in Special Populations

Pregnancy: Category B (Animal studies show no risk, but adequate human studies are lacking). Use only if clearly needed.
Lactation: Unknown if olopatadine is excreted in breast milk; consult healthcare provider.
Pediatrics: Safety and effectiveness in children under 6 years not established.
Geriatrics: No dosage adjustment generally needed but monitor for side effects.

Patient Counseling Information

Demonstrate correct nasal spray technique for effective delivery.
Inform patients that relief may begin quickly but consistent use is required for maximum benefit.
Advise not to share nasal spray to prevent infections.
Discuss potential side effects and importance of reporting severe adverse reactions.
Encourage regular follow-up for assessment and therapy adjustment.

FAQs

Q1: How soon will Patanase start to work?
A: Many patients experience relief within 30 minutes of the first dose.

Q2: Can I use Patanase all year round?
A: It is primarily for seasonal allergies; for perennial allergies, consult your healthcare provider.

Q3: Is Patanase sedating like oral antihistamines?
A: No, it has minimal systemic absorption and does not typically cause sedation.

Q4: What if I miss a dose?
A: Use as soon as you remember; do not double doses to catch up.

Q5: Can children under 6 use Patanase?
A: Patanase is not approved for children under 6; speak with your pediatrician.

Summary

Patanase nasal spray offers a targeted, effective, and well-tolerated treatment for seasonal allergic rhinitis. Its dual action as an antihistamine and mast cell stabilizer provides rapid and sustained relief of nasal allergy symptoms with minimal systemic exposure. Proper patient education, adherence to dosing, and regular monitoring optimize therapeutic outcomes.

References

FDA Patanase Label. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021843s000lbl.pdf
Meltzer EO, et al. Efficacy and Safety of Olopatadine Nasal Spray in Seasonal Allergic Rhinitis. J Allergy Clin Immunol. 2003;112(3): 589–594.
American Academy of Allergy, Asthma & Immunology. Intranasal antihistamines for allergic rhinitis. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/intranasal-antihistamines
MedlinePlus. Olopatadine Nasal. https://medlineplus.gov/druginfo/meds/a604011.html
Mayo Clinic. Seasonal Allergies Treatment Options. https://www.mayoclinic.org/diseases-conditions/hay-fever/diagnosis-treatment/drc-20373039