New medications update April 2008 (Patanase, Omnaris)

1. Perrigo Pharmaceuticals, a manufacturer of OTC medications, won approval 4/15/08 to manufacture and market generic cetirizine liquid syrup (trade name Zyrtec). I prescribed liquid Zyrtec often for younger patients, so I shall be monitoring this generic product for adverse effects and efficacy.
2. Alcon's hay fever drug, the nasal spray Patanase, was approved as a treatment for seasonal allergic rhinitis in patients 12 and older. The company expects to begin selling Patanase in May. Patanase will compete with Astelin, another prescription antihistamine nasal spray. In my experience, Astelin has a bitter metallic aftertaste, from the spray dripping post-nasally into the throat. This discouraged many patients from using Astelin, despite its proven efficacy. Some patients simply do not like spraying products in their nose. Swallowing pills is quicker and easier. I predict Patanase's market niche will be as a third-line medication to be used when antihistamines, Singulair, and nasal steroid sprays have failed.
3. Sepracor has begun marketing Omnaris, which is a nasal spray containing the new corticosteroid ciclesonide. This is the first new steroid to become available for some time. So with no track record here in the U.S. or in Europe or Asia, physicians and patients world-wide shall be learning about ciclesonide's safety and efficacy. As with all new products, Omnaris will start off as Tier 3 in all drug formularies, meaning there will be a high co-pay. If you use Omnaris, remember to use the rebate coupons. My product review is that Omnaris' spray bottle is ergonomically average compared to other sprays. There is no flowery odor. There are no comparative efficacy studies available yet. So I can not recommend Omnaris first-line at this time. Eventually, as our comfort level with Omnaris rises, there is better formulary coverage, and more marketing, I predict Omnaris' sales will increase. The field is crowded. There are at least 6 other products already available (generic Flonase, Nasacort AQ, Nasarel, Nasonex, Rhinocort AQ, Veramyst).