From the Guidelines
Mometasone is a potent synthetic corticosteroid that should be used at the lowest effective dose for the shortest duration necessary to control symptoms, due to its potential for systemic side effects and impact on quality of life.
Uses and Dosing Recommendations
Mometasone is used to treat various conditions, including:
- Allergic rhinitis: The standard dose is 2 sprays (50 mcg/spray) in each nostril once daily, which can be reduced to 1 spray per nostril once symptoms improve 1.
- Asthma management: Mometasone is available as an inhaler (Asmanex) with typical dosing of 220-440 mcg once daily in the evening for adults, while children typically use 110 mcg once daily.
- Inflammatory skin conditions: Apply the cream or ointment (0.1%) thinly to affected areas once daily.
Mechanism of Action and Side Effects
Mometasone works by reducing inflammation through suppression of inflammatory mediators and immune cell activity, with a glucocorticoid anti-inflammatory effect that has minimal systemic activity 1. When using the nasal spray or inhaler, it is essential to rinse the mouth afterward to prevent thrush, and with skin applications, avoid covering treated areas with occlusive dressings unless directed by a doctor, as this increases absorption and risk of side effects. Local side effects of intranasal corticosteroids such as nasal irritation, bleeding, and nasal septal perforation are rare and can be avoided with proper administration technique 1.
Key Considerations
- Treatment duration should be limited to the shortest effective period, especially for skin applications, to minimize side effects.
- Intranasal corticosteroids, including mometasone, are not generally associated with clinically significant systemic side effects when given in recommended doses 1.
- Growth effect may be a better indicator of systemic effect than HPA axis suppression in children, and studies with intranasal mometasone furoate have shown no effect on growth at recommended doses compared with placebo 1.
From the FDA Drug Label
The efficacy of ASMANEX TWISTHALER in patients with asthma 12 years and older was evaluated in ten 8- to 12-week, randomized, double-blind, placebo-controlled, parallel-group clinical trials Patients received ASMANEX TWISTHALER 110 mcg twice daily (n=133), 220 mcg once daily in the morning (n=209), 220 mcg once daily in the evening (n=232), 220 mcg twice daily (n=433), 440 mcg once daily in the morning (n=419), 440 mcg once daily in the evening (n=250), or 440 mcg twice daily (n=74)
The uses of Mometasone include the treatment of asthma in patients 12 years and older. The dosing recommendations for Mometasone are as follows:
- 110 mcg twice daily
- 220 mcg once daily in the morning
- 220 mcg once daily in the evening
- 220 mcg twice daily
- 440 mcg once daily in the morning
- 440 mcg once daily in the evening
- 440 mcg twice daily 2
From the Research
Uses of Mometasone
- Mometasone is used to treat various inflammatory dermatological disorders, including atopic dermatitis, seborrhoeic dermatitis, scalp psoriasis, and psoriasis vulgaris 3
- It is also used to treat allergic rhinitis, including seasonal and perennial allergic rhinitis, and has been shown to be effective in reducing nasal symptoms and improving quality of life 4, 5, 6, 7
- Mometasone furoate nasal spray has been used to treat patients with adenoidal hypertrophy and otitis media, and has been shown to be effective in reducing symptoms and improving outcomes 4, 5
Dosing Recommendations
- For dermatological disorders, mometasone is typically applied once daily, with a recommended dose of 0.1% cream, ointment, or lotion 3
- For allergic rhinitis, mometasone furoate nasal spray is typically administered once daily, with a recommended dose of 100-200 micrograms 4, 5, 6, 7
- The dosage and duration of treatment may vary depending on the specific condition being treated and the individual patient's response to therapy 3, 4, 5, 6, 7
Safety and Efficacy
- Mometasone has been shown to be safe and effective in the treatment of various inflammatory dermatological disorders and allergic rhinitis, with a low risk of adverse effects and no significant systemic effects 3, 4, 5, 6, 7
- Mometasone furoate nasal spray has been shown to be well-tolerated and effective in the treatment of allergic rhinitis, with a low risk of adverse effects and no significant systemic effects 4, 5, 6, 7