Mometasone

Listed in Dosage.

Adult : Inhalation Asthma prophylaxis As dry powd inhaler: Mild to moderate: Initial: 400 mcg once daily in the evening. Maintenance: 200 mcg 1-2 times/day. Severe: Initial: 400 mcg bid, titrated to the lowest effective dose once symptoms are controlled. Nasal Allergic rhinitis As 0.05% susp: 100 mcg into each nostril once daily, up to 200 mcg into each nostril daily if needed. Nasal polyps 100 mcg into each nostril once daily, increased to bid after 5-6 wk if needed. Topical Corticosteroid-responsive dermatoses As 0.1% cream/oint: Apply thinly to affected area once daily. As 0.1% lotion: Apply a few drops to affected area once daily.

Inhalation/Respiratory
Asthma prophylaxis

Nasal
Allergic rhinitis

Nasal
Nasal polyps

Topical/Cutaneous
Corticosteroid-responsive dermatoses

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.

Hypothalmic-pituitary-adrenal (HPA) axis suppression, immunosuppression, Kaposi sarcoma, oral candidiasis, psychiatric disturbances, headache, allergic rhinitis, pharyngitis, upper resp tract infection, sinusitis, dysmenorrhoea, musculoskeletal pain, back pain, dyspepsia, myalgia, abdominal pain, nausea.
Potentially Fatal: Paradoxical bronchospasm, anaphylaxis.

Inhalation/Respiratory/Nasal/Topical: C

Monitor pulmonary function, signs/symptoms of candidiasis, ocular effects.

Symptoms: Suppression of hypothalamic-pituitary-adrenal (HPA) function resulting in secondary adrenal insufficiency. Management: Gradually reduce dose.

Strong CYP3A4 inhibitors (e.g. ketoconazole) may increase systemic exposure of mometasone.

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.

Source: National Center for Biotechnology Information. PubChem Database. Mometasone, CID=441335, https://pubchem.ncbi.nlm.nih.gov/compound/Mometasone (accessed on Jan. 23, 2020)

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.

Topical Corticosteroids / Antiasthmatic & COPD Preparations / Nasal Decongestants & Other Nasal Preparations

D07AC13 - mometasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
R01AD09 - mometasone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
D07XC03 - mometasone ; Belongs to the class of potent (group III) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
R03BA07 - mometasone ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.

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.