From the Guidelines
Mometasone and fluticasone are both effective intranasal corticosteroids for treating allergic rhinitis, with similar efficacy profiles but some subtle differences, and the choice between them should be based on individual patient response and preference, as well as insurance coverage. When considering the treatment of allergic rhinitis, it is essential to weigh the benefits and risks of each medication.
- Both mometasone and fluticasone have been shown to be effective in reducing symptoms of allergic rhinitis, including nasal congestion, runny nose, and itching 1.
- The onset of action for both medications is relatively quick, with some studies suggesting that mometasone may have a slightly faster onset of action (12-24 hours) compared to fluticasone (12-36 hours) 1.
- Safety profiles for both medications are comparable, with minimal systemic absorption and similar local side effects like nasal irritation, occasional nosebleeds, and headaches 1.
- Dosing for both medications is similar, with mometasone (Nasonex) typically used as 2 sprays per nostril once daily (50 mcg/spray), and fluticasone (Flonase) used as 1-2 sprays per nostril once or twice daily (50 mcg/spray) 1.
- Proper administration technique is essential for optimal results with either medication, including gently clearing the nose first and aiming the spray away from the nasal septum 1.
- It is also important to note that both medications are available as over-the-counter options and prescription formulations, and patient preference, insurance coverage, and individual response often guide selection between these equally effective options 1. In terms of specific differences between the two medications, some studies suggest that mometasone may have a slightly better taste profile with less post-nasal drip sensation 1. However, the overall efficacy and safety profiles of both medications are similar, and the choice between them should be based on individual patient needs and preferences. Ultimately, the decision to use mometasone or fluticasone should be made on a case-by-case basis, taking into account the individual patient's medical history, symptoms, and response to treatment.
From the Research
Efficacy of Mometasone and Fluticasone
- Both mometasone and fluticasone are efficacious in treating seasonal allergic rhinitis and as prophylaxis for perennial allergic rhinitis, relieving nasal congestion and itching, rhinorrhea, and sneezing 2.
- Mometasone furoate nasal spray has been shown to be effective in relieving cough and nasal symptoms associated with allergic rhinitis 3.
- Fluticasone furoate nasal spray has been compared to mometasone furoate nasal spray in a patient preference study, with 56% of patients preferring fluticasone furoate due to its sensory attributes such as less drip down the throat and less run out of the nose 4.
Safety of Mometasone and Fluticasone
- Adverse reactions to intranasal corticosteroids, including mometasone and fluticasone, are usually limited to the nasal mucosa, such as dryness, burning and stinging, and sneezing, together with headache and epistaxis in 5-10% of patients 2.
- Mometasone furoate nasal spray has been shown to be well tolerated in the treatment of daytime cough associated with seasonal allergic rhinitis 3.
- Fluticasone furoate nasal spray has been compared to regular use, with as-needed use resulting in similar improvement in total nasal symptom scores and Rhinoconjunctivitis Quality of Life-36 Questionnaire scores, but with half the exposure to the medication 5.
Comparison of Mometasone and Fluticasone
- A patient preference study found that patients with allergic rhinitis preferred fluticasone furoate nasal spray over mometasone furoate nasal spray due to its sensory attributes 4.
- There is no direct comparison of the efficacy and safety of mometasone and fluticasone in the same study, but both medications have been shown to be effective and well tolerated in the treatment of allergic rhinitis 2, 5, 3.