Nasonex Dosing Frequency
Nasonex (mometasone furoate) is administered once daily for most indications, with the exception of nasal polyps in adults, which requires twice-daily dosing.
Standard Dosing by Indication
Allergic Rhinitis (Seasonal and Perennial)
- Adults and children ≥12 years: 2 sprays per nostril once daily (200 μg total daily dose) 1
- Children 2-11 years: 1 spray per nostril once daily (100 μg total daily dose) 1
The once-daily regimen for allergic rhinitis is supported by multiple high-quality trials demonstrating that mometasone furoate 200 μg once daily is as effective as twice-daily beclomethasone and provides optimal symptom control 2, 3, 4. Dose-ranging studies confirmed that 200 μg once daily is the optimal dose for adults, providing superior efficacy to lower doses without additional benefit from higher doses 5.
Nasal Polyps
- Adults ≥18 years: 2 sprays per nostril twice daily (400 μg total daily dose) 1
This is the only indication requiring twice-daily administration. Clinical trials in post-viral rhinosinusitis (which shares pathophysiology with nasal polyps) demonstrated that mometasone furoate 200 μg twice daily produced significantly greater symptom improvements compared to once-daily dosing 6.
Clinical Considerations
Timing and Administration
- Administer in the morning for once-daily dosing 1
- Use regularly rather than as-needed for optimal symptom control 1
- Onset of action is delayed approximately 12 hours, with maximal efficacy reached over days to weeks 1
Pediatric Dosing Optimization
In children 6-11 years, dose-ranging studies showed that 100 μg once daily provided optimal efficacy by day 29, while 25 μg was insufficient and 200 μg provided no additional benefit 7. This supports the guideline recommendation of 100 μg once daily for children 2-11 years 1.
Common Pitfall
Do not confuse the standard once-daily dosing for allergic rhinitis with the twice-daily dosing required for nasal polyps. The higher dose and frequency for polyps reflects the more severe inflammatory burden in this condition 6, 1.