mometasone, intranasal (Rx, OTC)

Brand and Other Names:Nasonex 24HR Allergy
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray suspension

  • 50mcg/spray (generic [Rx]; Nasonex 24HR Allergy [OTC])

Allergic Rhinitis

Nasal symptoms of allergic rhinitis

2 sprays (100 mcg) in each nostril qDay

Seasonal Allergic Rhinitis

Nasal congestion associated with seasonal allergic rhinitis; also indicated for prophylaxis of seasonal allergic rhinitis

Treatment: 2 sprays (100 mcg) in each nostril qDay

Prophylaxis: 2 sprays (100 mcg) in each nostril qDay; initiate 2-4 weeks prior to pollen season

Nasal Polyps

2 sprays (100 mcg) in each nostril q12hr; qDay dosing may be effective in some patients

Dosage Forms & Strengths

nasal spray suspension

  • 50mcg/spray (generic [Rx]; Nasonex 24HR Allergy [OTC])

Allergic Rhinitis

Nasal symptoms of allergic rhinitis

<2 years: Safety and efficacy not established

2-12 years: 1 spray (50 mcg) in each nostril qDay

≥12 years: 2 sprays (100 mcg) in each nostril qDay

Seasonal Allergic Rhinitis

Nasal congestion associated with seasonal allergic rhinitis; also indicated for prophylaxis of seasonal allergic rhinitis

Treatment

  • <2 years: Safety and efficacy not established
  • 2-12 years: 1 spray (50 mcg) in each nostril qDay
  • >12 years: 2 sprays (100 mcg) in each nostril qDay

Prophylaxis

  • <12 years: Safety and efficacy not established
  • >12 years: 2 sprays (100 mcg) in each nostril qDay; initiate 2-4 weeks prior to allergy season

Nasal Polyps

Safety and efficacy not established

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Interactions

Interaction Checker

and mometasone, intranasal

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (1)

            • desmopressin

              mometasone, intranasal increases toxicity of desmopressin by Other (see comment). Contraindicated. Comment: Increases risk of severe hyponatremia.

            Serious - Use Alternative (0)

              Monitor Closely (20)

              • atazanavir

                atazanavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ceritinib

                mometasone, intranasal increases toxicity of ceritinib by Other (see comment). Modify Therapy/Monitor Closely. Comment: May increase risk of hyperglycemia.

              • clarithromycin

                clarithromycin will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • cobicistat

                cobicistat will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • darunavir

                darunavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • idelalisib

                idelalisib will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • indinavir

                indinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • itraconazole

                itraconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ketoconazole

                ketoconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • levoketoconazole

                levoketoconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lopinavir

                lopinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • mifepristone

                mifepristone will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • nefazodone

                nefazodone will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • nelfinavir

                nelfinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)

                ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • posaconazole

                posaconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ritonavir

                ritonavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • saquinavir

                saquinavir will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • voriconazole

                voriconazole will increase the level or effect of mometasone, intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              Minor (0)

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                Adverse Effects

                >10%

                Headache

                Pharyngitis

                Cough

                Viral infection

                Epistaxis

                1-10%

                Diarrhea

                Dyspnea

                Vomiting

                Dysmenorrhea

                Musculoskeletal pain

                Myalgia

                Conjunctivitis

                Otitis media

                Flu-like syndrome

                <1%

                Anaphylaxis

                Angioedema

                Growth suppression

                Nasal candidiasis

                Taste disturbance

                Nasal septal perforation

                Nasal burning and irritation

                Postmarketing Reports

                Hypercortism and adrenal suppression

                Immunosuppression and risk of infections

                Ulcerations, Candida albicans Infection, impaired wound healing

                Glaucoma and cataracts

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                Warnings

                Contraindications

                Hypersensitivity

                Recent nasal surgery, nasal trauma, nasal septum ulcers (until healing has occurred)

                Cautions

                Monitor for vision change or, with history of increased IOP, glaucoma, or for cataracts; glaucoma and cataracts reported with systemic and topical (including nasal, inhaled and ophthalmic) corticosteroid use; consider referral to ophthalmologist in patients who develop ocular symptoms or receive therapy long term

                Respiratory tract fungal or bacterial infections, viral/parasitic infections, or ocular herpes simplex may occur

                Potential worsening of existing tuberculosis; fungal, bacterial, viral, or parasitic infections; or ocular herpes simplex

                Epistaxis observed more frequently in patients with allergic rhinitis and patients with chronic rhinosinusitis with nasal polyps who received therapy than those who received placebo

                In clinical studies, the development of localized infections of the nose and pharynx with Candida albicans reported; when infection develops, use should be discontinued and appropriate local or systemic therapy instituted, if needed

                Instances of nasal septum perforation reported following nasal application of corticosteroids; as with any long-term topical treatment of nasal cavity, patients receiving therapy over several months or longer should be examined periodically for possible changes in nasal mucosa

                Because of inhibitory effect of corticosteroids on wound healing, patients who have experienced recent nasal septum ulcers, nasal surgery, or nasal trauma should not use nasal corticosteroid until healing has occurred

                Hypersensitivity reactions including instances of wheezing may occur after nasal administration of mometasone furoate monohydrate; discontinue therapy if such reactions occur

                When nasal steroids are used at higher than recommended dosages or in susceptible individuals at recommended dosages, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear; if this occurs, slowly discontinue dosage of drug, consistent with accepted procedures for discontinuing oral corticosteroid therapy

                Effect on growth

                • Controlled clinical studies have shown nasal corticosteroids may cause a reduction in growth velocity in pediatric patients; this effect has been observed in absence of laboratory evidence of hypothalamic-pituitary-adrenal (HPA) axis suppression, suggesting that growth velocity is a more sensitive indicator of systemic corticosteroid exposure in pediatric patients than some commonly used tests of HPA axis function
                • The growth of pediatric patients receiving nasal corticosteroids, should be monitored routinely (eg, via stadiometry); the potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and availability of safe and effective noncorticosteroid treatment alternatives; to minimize systemic effects of nasal corticosteroids each patient should be titrated to his/her lowest effective dose

                Immunosuppression and risk of infections

                • Persons who are on drugs which suppress the immune system are susceptible to infections; chickenpox and measles, for example, can have a more serious or even fatal course in nonimmune children or adults on corticosteroids
                • In children or adults who have not had these diseases, should take care to avoid exposure; how dose, route, and duration of corticosteroid administration affect risk of developing a disseminated infection not known
                • If exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated; if exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated; if chickenpox develops, treatment with antiviral agents may be considered
                • Corticosteroids should be used with caution, if at all, in patients with active or quiescent tuberculous infection of respiratory tract, or in untreated fungal, bacterial, systemic viral infections, or ocular herpes simplex because of potential for worsening of these infections

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                Pregnancy & Lactation

                Pregnancy

                There are no adequate and well-controlled clinical studies in pregnant women

                Animal data

                • In animal reproduction studies with pregnant mice, rats, or rabbits, mometasone furoate caused increased fetal malformations and decreased fetal survival and growth following administration of doses that produced exposures approximately 1/3 to 8 times maximum recommended human dose (MRHD) on a mcg/m2 or AUC basis; however, experience with oral corticosteroids suggests that rodents are more prone to teratogenic effects from corticosteroid exposure than humans
                • The drug is minimally absorbed systemically following nasal use, and maternal use is not expected to result in fetal exposure to the drug; available data from observational studies of mometasone use in pregnant women are insufficient to evaluate for a drug-associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes

                Lactation

                There are no available data on presence of drug in human milk, effects on breastfed child, or on milk production; other corticosteroids are excreted in human milk, however, mometasone is minimally absorbed systemically by mother following nasal use, and breastfeeding is not expected to result in exposure of infant to mometasone

                The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition

                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.

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                Pharmacology

                Mechanism of Action

                Corticosteroid with potent anti-inflammatory properties; elicits effects on various cells, including mast cells and eosinophils; also elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)

                Absorption

                Bioavailability: <1%

                Minimal systemic absorption occurs, mostly by small amount swallowed during nasal administration

                Distribution

                Protein bound: 98-99%

                Metabolism

                Metabolism: CYP3A4

                Elimination

                Half-life: 5.8 hr

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                Administration

                Intranasal Preparation

                Initial priming: Before initial use, prime pump by actuating 10 times or until fine spray appears; may store unused for up to 1 week without repriming

                Repriming (as needed): If unused for >1 week, reprime by actuating 2 times or until fine spray appears

                Intranasal Administration

                For intranasal use only

                Shake well before each use

                Gently blow nose to clear nostrils

                Close 1 nostril and tilt head forward slightly, keep the bottle upright, carefully insert nasal applicator into the other nostril

                Do Not spray directly onto nasal septum (the wall between the 2 nostrils)

                Missed dose

                • If dose missed, take as soon as remembered; do not take more than the prescribed dose

                Storage

                Store at 25ºC (77F); excursions permitted to 15-30ºC (59-86F)

                Protect from light

                When removed from cardboard container, avoid prolonged exposure of product to direct light

                Brief exposure to light, as with normal use, is acceptable

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
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                0.1 % ointment
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                -
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                0.1 % solution
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                -
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                mometasone nasal
                -
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                -
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                mometasone nasal
                -
                50 mcg/actuation aerosol

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Select a drug:
                Patient Education
                mometasone inhalation

                MOMETASONE POWDER - ORAL INHALATION

                (mow-MET-uh-sown)

                COMMON BRAND NAME(S): Asmanex

                USES: Mometasone is used to control and prevent symptoms (wheezing and shortness of breath) caused by asthma. This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden asthma attacks. If an asthma attack occurs, use your quick-relief inhaler (such as albuterol, also called salbutamol in some countries) as prescribed.Mometasone belongs to a class of drugs known as corticosteroids. It works by reducing the irritation and swelling of the airways. Controlling symptoms of breathing problems can decrease time lost from work or school.

                HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. Follow the illustrated directions for the proper use of this medication and proper cleaning of the mouthpiece. If you have any questions, consult your doctor or pharmacist.Inhale this medication by mouth as directed by your doctor, usually once or twice a day. Do not breathe out (exhale) into the inhaler. The dosage is based on your medical condition, age, and response to treatment.If two inhalations/puffs are prescribed, wait at least one minute between them. If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication, and use this drug (the corticosteroid) last.To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. Do not swallow the rinse water.Use this medication regularly in order to get the most benefit from it. This medication works best if used at evenly spaced intervals. To help you remember, use it at the same time(s) each day. Do not increase your dose, use this medication more frequently, or stop using it without first consulting your doctor.Always have your quick-relief inhaler with you. Keep track of the number of inhalations you use. The inhaler should be discarded when every inhalation has been used (when the dose indicator reads ''00'') or if it has been 45 or 60 days (depending on your brand) after removal from its foil overwrap pouch, whichever comes first.If you are regularly taking a different corticosteroid by mouth (such as prednisone), you should not stop taking it unless directed by your doctor. Some conditions (such as asthma, allergies) may become worse when the drug is suddenly stopped. If you suddenly stop taking the drug, you may also have withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness). To help prevent withdrawal, your doctor may slowly lower the dose of your old medication after you begin using mometasone. Tell your doctor or pharmacist right away if you have withdrawal. See also Precautions section.It may take 1-2 weeks before you get the full benefit of this drug. Tell your doctor if your symptoms do not improve or if they worsen.Learn which of your inhalers you should use every day (controller drugs) and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, worsening peak flow meter readings, waking up at night with trouble breathing, if you use your quick-relief inhaler more often (more than 2 days a week), or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.

                SIDE EFFECTS: See also Precautions.Dry or irritated throat, hoarseness or coughing may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: white patches on tongue/in mouth, signs of infection (such as sore throat that doesn't go away, fever), mental/mood changes (such as depression, trouble sleeping), vision problems (such as blurred vision), increased thirst/urination.Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma (paradoxical bronchospasm). If you experience sudden wheezing, get medical help right away.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using mometasone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as lactose, milk proteins), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: current/past infections (such as tuberculosis, herpes), bone loss (osteoporosis), eye problems (such as cataracts, glaucoma), diabetes, decreased adrenal gland function.If you have switched from a corticosteroid taken by mouth (such as prednisone tablets) to this inhaler within the past 12 months, or if you have been using this product in higher-than-usual doses for a long time, it may be more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used a corticosteroid taken by mouth within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. Carry a warning card or medical ID bracelet that says you use (or have used) corticosteroid medications.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may mask signs of infection. It can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.This medication may temporarily slow down a child's growth if used for a long time. However, poorly controlled asthma can also slow down growth. See the doctor regularly so your child's height can be checked.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Do not share this medication with others.Learn to use a peak flow meter and use it daily. Promptly report worsening asthma (such as readings in the yellow or red range, or increased use of quick-relief inhalers) to your doctor.Laboratory and/or medical tests (such as lung function tests, morning cortisol levels, eye exam, bone density tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Avoid allergens/irritants such as smoke, pollen, pet dander, dust, or molds that may worsen breathing problems. Because the flu virus can also worsen breathing problems, ask your doctor or pharmacist if you should have a flu shot every year.In adults, this medication can increase the risk of bone loss (osteoporosis) if used for a long time. Talk with your doctor about your risk, and about available treatments for osteoporosis. Lifestyle changes that reduce the risk of bone loss include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. To help prevent osteoporosis later in life, encourage children to exercise and eat a healthy diet (including calcium).

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store with the cap securely on at room temperature away from light, heat, and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

                Information last revised January 2022. Copyright(c) 2022 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

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                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.