Class: Intranasal Corticosteroid
Dosage Forms. Nasal Spray: 50 mcg/actuation
Common FDA Label Indication, Dosing, and Titration.
1. Seasonal and perennial allergic rhinitis: Children 2-11 y of age, 1 spray/nostril daily (100 mcg/d); Children 12 y and older and Adults, 2 sprays/nostril daily (200 mcg/d)
2. Nasal polyp: 2 sprays/nostril (50 mcg/spray) bid (400 mcg/d), reduce dose to 2 sprays/nostril daily if possible
Off-Label Uses. None
MOA. Mometasone has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Drug Characteristics: Mometasone Nasal Inhaler
Medication Safety Issues: Mometasone Nasal Inhaler
Drug Interactions: Mometasone Nasal Inhaler. None known
Adverse Reactions: Mometasone Nasal Inhaler
Efficacy Monitoring Parameters. Control of rhinitis signs and symptoms.
Toxicity Monitoring Parameters. While only small amounts of mometasone reach systemic circulation, bone mineral density and growth and development in children should be monitored. Routine ophthalmologic examinations should be performed. Monitor for signs and symptoms of adrenal suppression or infection.
Key Patient Counseling Points. Advise patients on the proper administration technique for this product. Instruct patients to monitor for signs of toxicity, especially adrenal insufficiency.
Clinical Pearls. Oral inhalation and topical dosage forms of mometasone are also available for treatment of other allergic disorders. While oral antihistamines (either over the counter or prescription) remain the mainstay for treatment of rhinitis, nasal steroids are a recommended option if symptoms are severe, unresolved with oral antihistamines, or if oral antihistamines cause undesirable adverse effects. May begin treatment for seasonal allergic rhinitis 1-2 wk before the expected start of allergy season at the dose approved for the treatment of allergic rhinitis.