Adult: As dry powd inhaler: Mild to moderate: Initially, 400 mcg once daily in the evening. Maintenance dose: 200 mcg 1-2 times daily. Severe: Initially, 400 mcg bid, titrated to the lowest effective dose once symptoms are controlled. Child: ≥12 yr Same as adult dose.
Nasal Allergic rhinitis
Adult: As 0.05% susp: 100 mcg into each nostril once daily, increased to 200 mcg into each nostril daily if needed. Child: 3-11 yr 50 mcg into each nostril once daily; ≥12 yr Same as adult dose.
Nasal Nasal polyps
Adult: 100 mcg into each nostril once daily, increased to bid after 5-6 wk if needed.
Adult: As 0.1% cream/oint: Apply a thin film to affected area once daily. As 0.1% lotion: Apply a few drops to affected area once daily, massage lightly until it disappears. Child: ≥2 yr As 0.1% cream/oint: Apply a thin film to affected area once daily for not more than 3 wk. ≥12 yr As 0.1% lotion: Same as adult dose.
Special Precautions
Patient w/ heart failure, DM, GI disorders, myasthenia gravis, acute MI, cataracts/glaucoma, thyroid disease; history of seizure disorders; untreated localised infection of the nasal mucosa (e.g. herpes simplex), recent nasal surgery/trauma; patient w/ or at risk of osteoporosis. Patient w/ facial rosacea, acne vulgaris, skin atrophy, perioral dermatitis, perianal/genital pruritis, napkin eruptions; bacterial, viral, parasitical and fungal infections; varicella, syphilis or post-vaccine reactions. Avoid abrupt withdrawal when switching from systemic to oral or orally inhaled corticosteroid. Hepatic and renal impairment. Pregnancy and lactation.
Monitor pulmonary function, signs/symptoms of candidiasis, ocular effects.
Overdosage
Symptoms: Suppression of hypothalamic-pituitary-adrenal (HPA) function resulting in secondary adrenal insufficiency. Management: Gradually reduce dose.
Drug Interactions
Strong CYP3A4 inhibitors (e.g. ketoconazole) may increase systemic exposure of mometasone.
Action
Description: Mometasone depresses the formation, release and activity of endogenous inflammatory chemical mediators (e.g. kinins, histamine, liposomal enzymes and prostaglandin). It inhibits the margination and subsequent cell migration to the injury site, reverses vascular dilatation and permeability, resulting in decreased access of cells to the area of injury. Onset: Inhalation: ≥1-2 wk. Pharmacokinetics: Absorption: Poorly absorbed (<1%) after inhalation, intranasal use and topical application. Time to peak plasma concentration: 0.5-2.5 hr (inhalation). Distribution: Volume of distribution: 152 L. Plasma protein binding: 98-99%. Metabolism: Undergoes hepatic metabolism by CYP3A4 isoenzyme. Excretion: Via faeces and urine (lesser extent). Terminal elimination half-life: Approx 5 hr.
Chemical Structure
Mometasone Source: National Center for Biotechnology Information. PubChem Database. Mometasone, CID=441335, https://pubchem.ncbi.nlm.nih.gov/compound/Mometasone (accessed on Jan. 23, 2020)
Storage
Dry powd for inhaler: Store between 20-25°C. Protect from heat or open flame. Nasal susp: Store at 25°C. Protect from light. Cream/Oint/Lotion: Store between 2-30°C.
Anon. Mometasone (EENT). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 13/07/2015.Anon. Mometasone (Nasal). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/07/2015.Anon. Mometasone (Oral Inhalation). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/07/2015.Anon. Mometasone (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/07/2015.Buckingham R (ed). Mometasone Furoate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/07/2015.McEvoy GK, Snow EK, Miller J et al (eds). Mometasone Furoate (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 13/07/2015.McEvoy GK, Snow EK, Miller J et al (eds). Mometasone Furoate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 13/07/2015.Mometasone Furoate Ointment (G & W Laboratories, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 09/07/2015.Mometasone Furoate Solution (E. Fougera & Co.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 09/07/2015.
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