Is Nasonex (mometasone) available over-the-counter (OTC) in Canada?

Nasonex (Mometasone Furoate) is NOT Available Over-the-Counter in Canada

Nasonex (mometasone furoate) is only available by prescription in Canada and is not available over-the-counter (OTC). 1

Evidence from Guidelines

According to the 2015 clinical practice guideline for allergic rhinitis from the American Academy of Otolaryngology-Head and Neck Surgery, mometasone furoate (Nasonex) is classified as a prescription-only medication, while only triamcinolone acetonide (Nasacort Allergy 24HR) is listed as available OTC 1. The guideline clearly presents this information in a comprehensive table of intranasal steroids that specifies their availability status.

The European Position Paper on Rhinosinusitis and Nasal Polyps (2020) further confirms that while some intranasal corticosteroids are available OTC in most developed countries, specifically mentioning that "intranasal medications containing fluticasone are classified as OTC," it does not include mometasone furoate (Nasonex) among those available without prescription 1.

Prescription Status in Canada

In Canada specifically, the regulatory framework maintains Nasonex as a prescription-only medication. This differs from some other intranasal corticosteroids:

• Triamcinolone acetonide (Nasacort Allergy 24HR): Available OTC
• Fluticasone propionate (Flonase): Available OTC in many countries including Canada
• Mometasone furoate (Nasonex): Prescription-only

Clinical Considerations

Mometasone furoate is a potent synthetic corticosteroid that has been extensively studied for the treatment of allergic rhinitis:

• Efficacy: It effectively controls symptoms of both seasonal and perennial allergic rhinitis at a dosage of 200 mcg once daily 2
• Safety profile: Generally well-tolerated with minimal systemic activity and common side effects including headache, pharyngitis, epistaxis, and nasal irritation 2
• Onset of action: Approximately 7 hours in patients with seasonal allergic rhinitis 2

Dosing Information

For patients who do obtain Nasonex by prescription, the recommended dosing is:

• Ages 2-11 years: 1 spray per nostril daily (50 mcg per spray)
• Ages ≥12 years: 2 sprays per nostril daily 1

Alternative OTC Options

For patients seeking OTC nasal corticosteroid options in Canada, alternatives include:

1. Triamcinolone acetonide (Nasacort Allergy 24HR) - the only intranasal steroid explicitly listed as OTC in the clinical practice guidelines 1
2. Fluticasone propionate - available OTC in most developed countries including Canada 1

Practical Implications

Patients seeking relief from allergic rhinitis symptoms without a prescription should be aware that they cannot purchase Nasonex OTC in Canada. They would need to:

1. Consult with a healthcare provider to obtain a prescription for Nasonex
2. Consider available OTC alternatives like Nasacort Allergy 24HR or Flonase
3. Discuss with a pharmacist about appropriate OTC options for their specific symptoms

It's worth noting that while Nasonex requires a prescription, it has been established as an effective treatment with a good safety profile over its 20 years on the market 3.