Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Tilade (Fisons)
metered dose aerosol delivering 2 mg/dose
Indication: asthma prophylaxis
The airways of asthmatic patients are hyper responsive to a variety of stimuli and increased reactivity is related to an inflammatory response. Nedocromil acts by inhibiting the release of inflammatory mediators e.g. histamine. It has a stabilising effect on mast cells and so resembles sodium cromoglycate.
Like sodium cromoglycate, the dose is two inhalations 4 times a day. Both drugs can have beneficial effects on asthma symptoms, but data on their relative efficacies are inconclusive.1
Nedocromil has also been compared to inhaled steroids in small numbers of patients. While both treatments improve lung function, inhaled steroids may give better control. It would be unwise to substitute nedocromil abruptly in a patient stabilised on inhaled steroids. Nedocromil has no role in the management of acute asthma.
The drug can be used in adults and children over 12 years old as prophylactic therapy for mild to moderate asthma. It is also approved for the prevention of acute bronchospasm caused by recognised trigger factors. Two inhalations can give several hours' protection against bronchospasm if taken a few minutes before exercise or exposure to cold air or allergens.
About 5% of the inhaled dose is absorbed and some is also swallowed. A bitter taste is patients' most common complaint. Upper gastrointestinal symptoms and headache can also occur during treatment.
