Dosing and uses of Nasonex (mometasone intranasal)
Adult dosage forms and strengths
nasal spray suspension
- 50mcg/spray
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
Pediatric dosage forms and strengths
nasal spray suspension
- 50mcg/spray
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
Nasonex (mometasone intranasal) adverse (side) 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
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
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
Pregnancy and lactation
Pregnancy category: C
Lactation: Unknown whether distributed in breast milk
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.
Pharmacology of Nasonex (mometasone intranasal)
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
