Dosing & Uses
Dosage Forms & Strengths
sinus implant
- 370mcg, 23mm nominal length (Propel)
- 370mcg, 16mm nominal length (Propel Mini)
- 370mcg, 8mm nominal length (Propel Contour)
Postoperative intervention for chronic sinusitis surgery
Bioabsorbable implant indicated for adults (aged ≥18 yr) following sinus surgery to maintain sinus patency; prevents sinus obstruction from adhesions, reduces inflammation, and reduces the need for postoperative intervention (eg, adhesion lysis, oral corticosteroids)
Ethmoid sinus: Use Propel
Ethmoid and frontal sinuses: Use Propel mini
Frontal and maxillary sinuses: Use Propel Contour
See Administration
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Frequency Not Defined
Premature displacement of implant or implant fragments
Swallowing implant or implant fragments
Pain
Pressure
Headache
Foreign body response
Warnings
Contraindications
Suspected or confirmed intolerance to mometasone furoate
Hypersensitivity to lactide, glycolide, or caprolactone copolymers
Cautions
Special care should be taken to avoid bending, twisting or damaging the implant
Placement should be under endoscopic visualization; avoid modifications to implant; not intended to be compressed or loaded into delivery system ≥2 times
Confirm no antimicrobial properties are present; possible foreign body reaction may occur
Reports of sinus surgery-associated physiochemical condition, with or without sinus implants and packing
Risk of toxic shock syndrome
Pregnancy & Lactation
Pregnancy Categories
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Corticosteroids have been shown to have a wide range of effects on multiple cell types (eg mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (eg, histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation
The mechanism for anti-inflammatory properties for eluted mometasone furoate is unknown
Administration
Sinus Implant Preparation
Place funnel onto delivery system tip
Remove implant holder top; avoid grasping or dislodging implant
Gently grasp and compress implant between fingers
Insert compressed implant into delivery system tip
Carefully remove funnel without dislodging implant
If implant withdraws from tip, replace funnel and gently squeeze delivery system tip
Sinus Implant Administration
Ethmoid sinus
- Orient delivery system so distal tip curves superiorly toward the posterior roof of sinus cavity
- Align green plunger distal tip with middle turbinate anterior edge
- Insert implant via depressing the plunger while removing delivery system
- Confirm proximal loops of implant align with middle turbinate anterior edge; confirm implant is well applied to tissue for maximum drug delivery
Frontal sinus
- Orient delivery system so distal tip curves superiorly toward the frontal sinus
- Advance distal tip of delivery system to frontal sinus
- Insert implant via depressing the plunger while removing delivery system
- Confirm implant loops support frontal sinus opening align; confirm implant is well applied to tissue for maximum drug delivery
Sinus ostium
- Orient delivery system so distal tip curves superiorly toward the sinus ostium
- Depress plunger until coiled pusher aligns with green to clear transition; implant halfway deployed
- Slightly withdraw delivery system to visualize implant waist; align waist with sinus ostium; continue to withdraw delivery system via depressing the plunger and implant waist alignment
- Confirm waist aligns with sinus ostium
Postoperative Care
Frequently spray, rinse, or irrigate nasal cavity maintaining the implant remains moist; routine debridement
Proper surgical instruments should be use when removing implant
Storage
Store at room temperature, 59-86°C (15-30°C)
Images
Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
