What are the uses and dosages of Mometasone (mometasone furoate)?

Mometasone Furoate: Uses and Dosages

Mometasone furoate is a medium-potency synthetic corticosteroid available in multiple formulations for treating various inflammatory conditions, with specific dosages and indications depending on the formulation and condition being treated. 1, 2

Topical Formulations

Indications

• Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses 1
• Effective for treating:
  • Atopic dermatitis 2
  • Seborrheic dermatitis 2
  • Psoriasis vulgaris 2
  • Scalp psoriasis 2

Dosage and Administration

• Topical solution/lotion (0.1%): Apply a few drops to affected areas once daily and massage lightly until it disappears 1
• For most effective use, hold nozzle close to affected area and gently squeeze 1
• Treatment duration: Discontinue when control is achieved; reassess diagnosis if no improvement after 2 weeks 1
• Not recommended for pediatric patients under 12 years of age 1

Special Considerations

• Should not be used with occlusive dressings unless directed by physician 1
• Avoid application in diaper area if patient requires diapers or plastic pants (may constitute occlusive dressing) 1
• Can be used in combination with other agents:
  • Addition of salicylic acid to mometasone is safe for treating moderate to severe psoriasis (BSA ≤20%) 3
  • Combination with emollients can help reduce itching, desquamation, and total body surface area involvement in psoriasis 3

Intranasal Formulation

Indications

• Seasonal and perennial allergic rhinitis 3, 4
• Nasal polyps (age ≥18 years) 3

Dosage and Administration

• Nasal spray (50 μg per spray):
  • Ages 2-11 years: 1 spray per nostril once daily 3
  • Ages ≥12 years: 2 sprays per nostril once daily 3
  • Adults with nasal polyps: 2 sprays per nostril twice daily 3

Efficacy

• Onset of action approximately 7 hours in seasonal allergic rhinitis 4
• As effective as twice-daily beclomethasone dipropionate or once-daily fluticasone propionate in perennial allergic rhinitis 4
• More effective than placebo in controlling symptoms of moderate to severe seasonal or perennial allergic rhinitis 4

Inhaled Formulation for Asthma

Indications

• Control of mild to severe persistent asthma in adults and adolescents 5

Dosage and Administration

• Dry powder inhaler (200 μg per inhalation):
  • Dosage varies based on asthma severity 3
  • Once-daily administration of 400 μg appears as effective as twice-daily administration of 200 μg 5

Efficacy

• Improves lung function, asthma symptom scores, and reduces rescue medication use 5
• Can reduce requirements for oral corticosteroids in patients with oral corticosteroid-dependent asthma 5

Advantages and Safety Profile

Advantages

• Once-daily application for topical formulations (versus multiple daily applications for many other corticosteroids) 2, 6
• Low potential for causing primary sensitization and cross-reactions with other topical glucocorticoids 2
• Minimal systemic activity when used as directed 2, 4
• Low atrophogenic potential compared to other glucocorticoids in its class 2

Common Side Effects

• Topical: Transient mild to moderate local effects such as burning, stinging, folliculitis, dryness, acneiform eruptions 2
• Intranasal: Headache, pharyngitis, epistaxis, nasal irritation/burning 3, 4
• Inhaled: Oral candidiasis, headache, pharyngitis, dysphonia 5

Special Populations

Pregnancy and Lactation

• Moisturizers (which can be used with mometasone) are considered safe during pregnancy and lactation 3

Pediatric Use

• Not recommended for topical use in children under 12 years 1
• Intranasal formulation approved for children as young as 2 years 3
• Salicylic acid (sometimes combined with mometasone) should be avoided in children due to greater risk of systemic absorption and toxicity 3

Clinical Pearls

• For pruritus treatment, topical mometasone furoate 0.1% ointment or betamethasone valerate 0.1% ointment can be considered for moderate to high-potency steroid needs 3
• For psoriasis, combination therapy of mometasone with tazarotene may provide synergistic effects, increasing efficacy during therapy and duration of therapeutic effect 3
• In allergic rhinitis, patient preference between oral antihistamines and nasal steroids like mometasone should be considered to promote better adherence to therapy 3