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Rhinocort Aqua pregnancy rating upgraded to Category B for allergic rhinitis treatment

WILMINGTON, DEL., August 26, 2004 -- AstraZeneca announced that the FDA has approved revised labeling for its anti-inflammatory corticosteroid nasal spray Rhinocort Aqua (budesonide). The new labeling upgrades Rhinocort Aqua's pregnancy rating to Category B for the treatment of allergic rhinitis ("hay fever").

Achievement of a Category B rating indicates that adequate studies in women of child-bearing years have demonstrated that treatment with Rhinocort Aqua does not increase the risk of congenital malformations to the fetus during the first trimester of pregnancy and in later trimesters. This may give physicians greater confidence in prescribing a particular medication for women of child-bearing age or during pregnancy.

The FDA's pregnancy category rating system provides guidance to help physicians who prescribe medications to pregnant women. Rhinocort Aqua is the first and only intranasal corticosteroid product for the treatment of allergic rhinitis in the United States to receive a Category B rating. All other intranasal corticosteroids approved by the FDA for the treatment of allergic rhinitis are rated Pregnancy Category C.

The agency based its pregnancy category label change for Rhinocort Aqua on a review of data from three Swedish birth registries. These registries covered over 2,000 births from 1995-2001 (Swedish Medical Birth Registry, Registry of Congenital Malformations, and Child Cardiology Registry). The data indicate no increased risk for overall congenital malformation (birth defects) from the use of intranasal budesonide during early pregnancy.

Early pregnancy is the period during which most major organ malformations can occur. This evidence demonstrates that intranasal and inhaled budesonide, the active compound in Rhinocort Aqua, does not increase the risk of abnormalities when administered during pregnancy.

"Pregnant women suffering from significant symptoms of allergic rhinitis should be appropriately treated with medications that offer potential benefit and minimal risk," said Joan C. Gluck, MD, Partner, Florida Center for Allergy and Asthma Care, Miami, FL. "The change in pregnancy rating for Rhinocort Aqua means that the medical community now has evidence of what to expect when pregnant women use this drug. Other drugs in this class have Category C ratings and they lack this evidence."

Experience in pregnant women has not shown that Rhinocort Aqua increases the risk of fetal abnormalities when administered during pregnancy. Despite adverse effects in animal reproductive studies, it would appear that the possibility of fetal harm is remote (see PRECAUTIONS in full Prescribing Information). Nevertheless, because studies in humans cannot rule out the possibility of harm, Rhinocort Aqua should be used in pregnancy only if clearly indicated.

It is not known whether budesonide is excreted in human milk. Because other corticosteroids are excreted in human milk, caution should be exercised when Rhinocort Aqua Nasal Spray is administered to nursing women.

Allergic Rhinitis

Commonly known as "hay fever", allergic rhinitis is a respiratory allergy that causes an inflammation or irritation of the mucous membranes lining the nose. It is caused by allergens such as pollen, dust mites, mold, or animal dander and may produce sneezing, congestion, runny nose, and other related symptoms.(2) According to the American Academy of Allergy, Asthma and Immunology, nearly 36 million people in the United States suffer from allergic rhinitis. The disorder leads to more than 16.7 million patient visits to physicians each year, with estimated costs in the United States exceeding $6 billion.

According to the National Center for Health Statistics, more than 6 million women of childbearing ages suffer from allergic rhinitis.

Rhinocort Aqua

Rhinocort Aqua is for the treatment of seasonal (outdoor) and year-round (indoor) nasal allergy symptoms in adults and children 6 years and older. Side effects are generally mild and may include nosebleed, sore throat, nasal irritation, and cough. Maximum relief may take up to 2 weeks to achieve.

The recommended starting dosage for Rhinocort Aqua is one spray per nostril once daily. However, health care providers may recommend a higher dosage. For best results, Rhinocort Aqua should be taken exactly as prescribed.

More information about nasal allergies and Rhinocort Aqua is available at

Source: AstraZeneca

Posted: August 2004