mometasone topical (Rx)

Frequency Not Defined

Burning

Itching

Pruritus

Rosacea

Postmarketing Reports

Irritation

Dryness

Folliculitis

Hypertrichosis

Acneiform eruptions

Hypopigmentation

Perioral dermatitis

Allergic contact dermatitis

Secondary infection

Skin atrophy

Striae

Miliaria

Blurred vision

Cataracts

Glaucoma

Increased intraocular pressure

Central serous chorioretinopathy

Contraindications

Hypersensitivity

Cautions

Safety/efficacy in children use for longer than 3 wk not established; pediatric patients may be more susceptible to systemic toxicity

Do not use with occlusive dressings

Not for acne, rosacea, perioral dermatitis, diaper dermatitis

If concomitant skin infections are present or develop, use appropriate antifungal or antibacterial agent; if favorable response does not occur promptly, therapy should be discontinued until infection has been adequately controlled

If irritation develops, discontinue therapy and institute appropriate therapy; allergic contact dermatitis with corticosteroids is usually diagnosed by observing failure to heal rather than noting a clinical exacerbation; corroborate observation with appropriate diagnostic patch testing

Use of topical corticosteroids may increase risk of posterior subcapsular cataracts and glaucoma; cataracts and glaucoma reported in postmarketing experience with therapy; avoid contact with eyes; advise patients to report any visual symptoms and consider referral to ophthalmologist for evaluation

Endocrine system effects

• Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with potential for glucocorticosteroid insufficiency; this may occur during treatment or after withdrawal of treatment
• Manifestations of Cushing's syndrome, hyperglycemia, and glucosuria can be produced in some patients by systemic absorption of topical corticosteroids while on treatment
• Factors that predispose a patient using a topical corticosteroid to HPA axis suppression include use of high potency steroids, large treatment surface areas, prolonged use, use of occlusive dressing, altered skin barrier, liver failure and young age
• Because of potential for systemic absorption, use of topical corticosteroids may require that patients be periodically evaluated for HPA axis suppression; this may be done by using the adrenocorticotropic hormone (ACTH) stimulation test
• If HPA axis suppression documented, attempt to gradually withdraw drug, to reduce frequency of application, or to substitute a less potent corticosteroid; recovery of HPA axis function is generally prompt upon discontinuation of topical corticosteroids; infrequently, signs and symptoms of glucocorticosteroid insufficiency may occur, requiring supplemental systemic corticosteroids
• Pediatric patients may be more susceptible to systemic toxicity from equivalent doses due to their larger skin surface to body mass ratios

Pregnancy Category: C

Lactation: use caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Absorption: 0.4%

Metabolism: hepatic P450 enzyme CYP3A4

Excretion: N/A

Potency

Medium

Relative potency: ointment >cream >lotion >solution

Very-high: clobetasol, diflorasone diacetate ointment 0.05%, halobetasol

High: betamethasone dipropionate 0.05%, amcinonide, fluocinonide, desoximetasone, mometasone, diflorasone emollient 0.05%, halcinonide

Medium: triamcinolone, betamethasone valerate 0.1%, fluticasone, flurandrenolide, fluocinolone 0.025%, hydrocortisone

Mild: hydrocortisone 0.5, 1, 2.5% base, desonide, alclometasone

Mechanism of Action

Anti-inflammatory corticosteroid