mometasone, intranasal (Rx, OTC)

Brand and Other Names:Nasonex 24HR Allergy
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray suspension

  • 50mcg/spray (generic [Rx]; Nasonex 24HR Allergy [OTC])

Allergic Rhinitis

Nasal symptoms of allergic rhinitis

2 sprays (100 mcg) in each nostril qDay

Seasonal Allergic Rhinitis

Nasal congestion associated with seasonal allergic rhinitis; also indicated for prophylaxis of 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

Nasal Polyps

2 sprays (100 mcg) in each nostril q12hr; qDay dosing may be effective in some patients

Dosage Forms & Strengths

nasal spray suspension

  • 50mcg/spray (generic [Rx]; Nasonex 24HR Allergy [OTC])

Allergic Rhinitis

Nasal symptoms of 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

Seasonal Allergic Rhinitis

Nasal congestion associated with seasonal allergic rhinitis; also indicated for prophylaxis of seasonal allergic rhinitis

Treatment

  • <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

Prophylaxis

  • <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

Nasal Polyps

Safety and efficacy not established

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Interactions

Interaction Checker

and mometasone, intranasal

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (1)

            • desmopressin

              mometasone, intranasal increases toxicity of desmopressin by Other (see comment). Contraindicated. Comment: Increases risk of severe hyponatremia.

            Serious - Use Alternative (0)

              Monitor Closely (20)

              • atazanavir

                atazanavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ceritinib

                mometasone, intranasal increases toxicity of ceritinib by Other (see comment). Modify Therapy/Monitor Closely. Comment: May increase risk of hyperglycemia.

              • clarithromycin

                clarithromycin will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • cobicistat

                cobicistat will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • darunavir

                darunavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • idelalisib

                idelalisib will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • indinavir

                indinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • itraconazole

                itraconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ketoconazole

                ketoconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • levoketoconazole

                levoketoconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lopinavir

                lopinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • mifepristone

                mifepristone will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • nefazodone

                nefazodone will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • nelfinavir

                nelfinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)

                ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • posaconazole

                posaconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ritonavir

                ritonavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • saquinavir

                saquinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • voriconazole

                voriconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              Minor (0)

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                Adverse Effects

                >10%

                Headache

                Pharyngitis

                Cough

                Viral infection

                Epistaxis

                1-10%

                Diarrhea

                Dyspnea

                Vomiting

                Dysmenorrhea

                Musculoskeletal pain

                Myalgia

                Conjunctivitis

                Otitis media

                Flu-like syndrome

                <1%

                Anaphylaxis

                Angioedema

                Growth suppression

                Nasal candidiasis

                Taste disturbance

                Nasal septal perforation

                Nasal burning and irritation

                Postmarketing Reports

                Hypercortism and adrenal suppression

                Immunosuppression and risk of infections

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                Warnings

                Contraindications

                Hypersensitivity

                Recent nasal surgery, nasal trauma, nasal septum ulcers (until healing has occurred)

                Cautions

                Monitor for vision change or, with history of increased IOP, glaucoma, or for cataracts; glaucoma and cataracts reported with systemic and topical (including nasal, inhaled and ophthalmic) corticosteroid use; consider referral to ophthalmologist in patients who develop ocular symptoms or receive therapy long term

                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

                Epistaxis observed more frequently in patients with allergic rhinitis with drug than those who received placebo

                In clinical studies, the development of localized infections of the nose and pharynx with Candida albicans reported; when infection develops, use should be discontinued and appropriate local or systemic therapy instituted, if needed

                Instances of nasal septum perforation reported following nasal application of corticosteroids; as with any long-term topical treatment of nasal cavity, patients receiving therapy over several months or longer should be examined periodically for possible changes in nasal mucosa

                Because of inhibitory effect of corticosteroids on wound healing, patients who have experienced recent nasal septum ulcers, nasal surgery, or nasal trauma should not use nasal corticosteroid until healing has occurred

                Hypersensitivity reactions including instances of wheezing may occur after nasal administration of mometasone furoate monohydrate; discontinue therapy if such reactions occur

                When nasal steroids are used at higher than recommended dosages or in susceptible individuals at recommended dosages, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear; if this occurs, slowly discontinue dosage of drug, consistent with accepted procedures for discontinuing oral corticosteroid therapy

                Corticosteroids may cause a reduction in growth velocity when administered to pediatric patients; monitor growth routinely of pediatric patients receiving therapy to minimize systemic effects of therapy, titrate each patient’s dose to lowest dosage that effectively controls his/her symptoms

                Immunosuppression and risk of infections

                • Persons who are on drugs which suppress the immune system are susceptible to infections; chickenpox and measles, for example, can have a more serious or even fatal course in nonimmune children or adults on corticosteroids
                • In children or adults who have not had these diseases, should take care to avoid exposure; how dose, route, and duration of corticosteroid administration affect risk of developing a disseminated infection not known
                • If exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated; if exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated; if chickenpox develops, treatment with antiviral agents may be considered
                • Corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculous infection of respiratory tract, or in untreated fungal, bacterial, systemic viral infections, or ocular herpes simplex because of potential for worsening of these infections

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                Pregnancy & Lactation

                Pregnancy

                There are no adequate and well-controlled clinical studies in pregnant women

                Animal data

                • In animal reproduction studies with pregnant mice, rats, or rabbits, mometasone furoate caused increased fetal malformations and decreased fetal survival and growth following administration of doses that produced exposures approximately 1/3 to 8 times maximum recommended human dose (MRHD) on a mcg/m2 or AUC basis; however, experience with oral corticosteroids suggests that rodents are more prone to teratogenic effects from corticosteroid exposure than humans

                Lactation

                There are no available data on presence of drug in human milk, effects on breastfed child, or on milk production; other corticosteroids are excreted in human milk

                The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition

                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.

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                Pharmacology

                Mechanism of Action

                Corticosteroid with potent anti-inflammatory properties; elicits effects on various cells, including mast cells and eosinophils; also elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)

                Absorption

                Bioavailability: <1%

                Minimal systemic absorption occurs, mostly by small amount swallowed during nasal administration

                Distribution

                Protein bound: 98-99%

                Metabolism

                Metabolism: CYP3A4

                Elimination

                Half-life: 5.8 hr

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                Administration

                Intranasal Preparation

                Initial priming: Before initial use, prime pump by actuating 10 times or until fine spray appears; may store unused for up to 1 week without repriming

                Repriming (as needed): If unused for >1 week, reprime by actuating 2 times or until fine spray appears

                Intranasal Administration

                For intranasal use only

                Shake well before each use

                Gently blow nose to clear nostrils

                Close 1 nostril and tilt head forward slightly, keep the bottle upright, carefully insert nasal applicator into the other nostril

                Do Not spray directly onto nasal septum (the wall between the 2 nostrils)

                Missed dose

                • If dose missed, take as soon as remembered; do not take more than the prescribed dose

                Storage

                Store at 25ºC (77F); excursions permitted to 15-30ºC (59-86F)

                Protect from light

                When removed from cardboard container, avoid prolonged exposure of product to direct light

                Brief exposure to light, as with normal use, is acceptable

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                Sinuva sinus
                -
                1,350 mcg implant
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (14) aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (60) aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (120) aerosol
                Asmanex Twisthaler inhalation
                -
                110 mcg/ actuation (30) aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (30) aerosol
                mometasone nasal
                -
                50 mcg/actuation aerosol
                mometasone nasal
                -
                50 mcg/actuation aerosol
                mometasone nasal
                -
                50 mcg/actuation aerosol
                Asmanex HFA inhalation
                -
                200 mcg/actuation aerosol
                Asmanex HFA inhalation
                -
                50 mcg/actuation aerosol
                Asmanex HFA inhalation
                -
                100 mcg/actuation aerosol

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

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                Patient Education
                mometasone topical

                MOMETASONE - TOPICAL

                (mow-MET-uh-sown)

                COMMON BRAND NAME(S): Elocon

                USES: This medication is used to treat skin conditions such as eczema, psoriasis, allergies, and rash. Mometasone decreases swelling (inflammation), itching, and redness. Mometasone is a medium-strength corticosteroid. This medication is available in several forms including cream, ointment, and lotion (solution). Your doctor will choose the type of product based on the skin condition/area of the body being treated.

                HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.This medication is for use only on certain areas of skin: do not use it on the face, groin, or underarms, or for diaper rash, unless directed to do so by your doctor.Wash and dry your hands before using. Clean and dry the affected area. Apply as directed by your doctor, usually a thin film of medication to the affected area once daily. Gently rub in. Do not cover the treated area with bandages or other dressings unless instructed to do so by your doctor.Do not wash or rinse the medication off immediately after applying it. Wash your hands with soap and water after each use unless you are using this medication to treat the hands. Avoid getting this medication in your eyes, nose, or mouth. If this occurs, rinse thoroughly with water and call your doctor if irritation lasts.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. Do not apply large amounts of this medication, use it more often, or use it for longer than prescribed. Your condition will not improve any faster, and your risk of side effects may increase.Tell your doctor if your condition does not improve after 2 weeks of treatment or if it worsens.

                SIDE EFFECTS: Burning, itching, or stinging may occur when you apply this medication, but usually only lasts a short time. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: stretch marks, skin thinning/discoloration, acne, hair bumps (folliculitis).Rarely, it is possible this medication will be absorbed from the skin into the bloodstream. This can lead to side effects of too much corticosteroid. These side effects are more likely in children, and in people who use this medication for a long time or over large areas of the skin. Tell your doctor right away if any of the following side effects occur: unusual/extreme tiredness, weight loss, headache, swelling ankles/feet, increased thirst/urination, vision problems.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using mometasone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: poor blood circulation, diabetes, immune system problems.Corticosteroids can make skin infections worse and more difficult to treat. Tell your doctor if you have a skin infection so it can be treated. Tell your doctor promptly if your condition does not improve or if you have worsening skin symptoms.Rarely, using corticosteroid medications for a long time or over large areas of skin can make it more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past few months.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Though it is unlikely, this medication may temporarily slow down a child's growth if used for a long time. See the doctor regularly so your child's height can be checked.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

                OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for other skin problems unless told to do so by your doctor. A different medication may be necessary in those cases.Laboratory and/or medical tests (such as adrenal gland function tests) may be performed periodically to monitor your progress or check for side effects, especially if you use this drug for an extended period of time or apply it over large areas of the body. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised January 2022. Copyright(c) 2022 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.