Drug information of nasal Mometasone
Mometasone is a medium-potency synthetic corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties.
Mechanism of effect
Unbound corticosteroids cross cell membranes and bind with high affinity to specific cytoplasmic receptors. Inflammation is decreased by diminishing the release of leukocytic acid hydrolases, prevention of macrophage accumulation at inflamed sites, interference with leukocyte adhesion to the capillary wall, reduction of capillary membrane permeability, reduction of complement components, inhibition of histamine and kinin release, and interference with the formation of scar tissue.
The anti inflammatory actions of corticosteroids are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.
Maximum improvement in symptoms following inhaled administration of mometasone furoate may not be achieved for 1 to 2 weeks or longer after starting treatment. When glucocorticoids are discontinued, asthma stability may persist for several days or longer. It has anti-inflammatory, antipruritic, and vasoconstrictive properties.
Absorption: Nasal spray is virtually undetectable in plasma
Bioavailability: <1% . Minimal systemic absorption occurs, mostly by small amount swallowed during nasal administration
Metabolism : Hepatic. CYP3A4
Protein bound: 98-99%
Half-life: 5.8 hr
2 sprays (100 mcg) in each nostril qDay
Seasonal Allergic Rhinitis
Treatment: 2 sprays (100 mcg) in each nostril qDay
Prophylaxis: 2 sprays (100 mcg) in each nostril qDay; initiate 2-4 weeks prior to pollen season
2 sprays (100 mcg) in each nostril q12hr; qDay dosing may be effective in some patients
<2 years: Safety and efficacy not established
2-12 years: 1 spray (50 mcg) in each nostril qDay
≥12 years: 2 sprays (100 mcg) in each nostril qDay
Seasonal Allergic Rhinitis
- <2 years: Safety and efficacy not established
- 2-12 years: 1 spray (50 mcg) in each nostril qDay
- >12 years: 2 sprays (100 mcg) in each nostril qDay
- <12 years: Safety and efficacy not established
- >12 years: 2 sprays (100 mcg) in each nostril qDay; initiate 2-4 weeks prior to allergy season
Safety and efficacy not established
Side effectsDiarrhea , Nosebleeds , Headache , vomiting , myalgia , Flu-like symptoms , shortness of breath , Irregular periods
InteractionsItraconazole , Posaconazole , Voriconazole , Ketoconazole , Clarithromycin , Atazanavir , cobicistat , Delavirdine , Telithromycin , boceprevir , Indinavir , Idelalisib , Telaprevir , Mibefradil , Darunavir , Nefazodone , ritonavir , saquinavir , nelfinavir , Amprenavir
Monitor for vision change or, with history of increased IOP, glaucoma, or for cataracts
Respiratory tract fungal or bacterial infections, viral/parasitic infections, or ocular herpes simplex may occur
Potential worsening of existing tuberculosis; fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex
More serious or fatal course of chickenpox or measles in susceptible patients
Risk for hypercorticism and adrenal suppression with higher-than-normal doses
Potential reduction of growth velocity in children
Points of recommendation
- It may take 2 weeks to see the full effect.
- Long-term use may raise the chance of cataracts or glaucoma. Talk with the doctor.
- You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
- Chickenpox and measles can be very bad or even deadly in some people taking steroid drugs like mometasone (nasal). Avoid being near anyone with chickenpox or measles if you have not had these health problems before. If you have been exposed to chickenpox or measles, talk with your doctor.
- Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using mometasone (nasal) while you are pregnant.
- Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
- Use as you have been told, even if your signs get better.
- To gain the most benefit, do not miss doses.
- Shake well before use.
- Prime pump before first use by spraying it 10 times or until you see a fine mist or if not used for more than 1 week by spraying 2 times or until you see a fine mist.
- Blow your nose before use.
- Spray up the nose only. Do not spray onto the wall joining the two nostrils.
- Check your spray use with your doctor at each visit. Read and follow the facts on how to use the spray. Make sure you use the spray the right way.
- Use a missed dose as soon as you think about it.
- If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
- Do not use 2 doses at the same time or extra doses.