mometasone, intranasal (Rx)

Brand and Other Names:Nasonex
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

nasal spray suspension

  • 50mcg/spray

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

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 (19)

              • 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.

              • 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

                ombitasvir/paritaprevir/ritonavir & dasabuvir 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

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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 with drug 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

                Corticosteroids may cause a reduction in growth velocity when administered to pediatric patients; monitor growth routinely of pediatric patients receiving therapy to minimize systemic effects of therapy, titrate each patient’s dose to lowest dosage that effectively controls his/her symptoms

                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

                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

                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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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % ointment
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % cream
                mometasone topical
                -
                0.1 % solution
                mometasone topical
                -
                0.1 % solution
                Sinuva sinus
                -
                1,350 mcg implant
                Nasonex nasal
                -
                50 mcg/actuation aerosol
                mometasone nasal
                -
                50 mcg/actuation aerosol
                mometasone nasal
                -
                50 mcg/actuation aerosol
                mometasone nasal
                -
                50 mcg/actuation aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (14) aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (60) aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (120) aerosol
                Asmanex Twisthaler inhalation
                -
                110 mcg/ actuation (30) aerosol
                Asmanex Twisthaler inhalation
                -
                220 mcg/ actuation (30) aerosol
                Asmanex HFA inhalation
                -
                100 mcg/actuation aerosol
                Asmanex HFA inhalation
                -
                200 mcg/actuation aerosol
                Asmanex HFA inhalation
                -
                50 mcg/actuation aerosol

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Select a drug:
                Patient Education
                mometasone inhalation

                MOMETASONE HFA INHALER - ORAL INHALATION

                (moe-MET-a-sone)

                COMMON BRAND NAME(S): Asmanex HFA

                USES: Mometasone is used to control and prevent symptoms (such as wheezing and shortness of breath) caused by asthma. Controlling symptoms of asthma helps you maintain your normal activities and decreases time lost from work or school. Mometasone belongs to a class of drugs known as corticosteroids. It works by reducing swelling (inflammation) of the airways in the lungs to make breathing easier.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.

                HOW TO USE: Read the Patient Information Leaflet and the product instructions provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Follow the instructions for priming the inhaler if you are using it for the first time or if you have not used it for more than 5 days. When priming the inhaler, make sure to spray away from your face so that you do not get the medication into your eyes.Shake the inhaler well before each use. Inhale this medication by mouth as directed by your doctor, usually twice a day (morning and evening). The dosage is based on your medical condition 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 and rinse your mouth with water after each use. Do not swallow the rinse water.Clean the mouthpiece once a week with a dry tissue. Do not wet the inhaler. Do not take the inhaler apart.Use this medication regularly 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 times each day. Do not increase your dose, use this drug more often, or stop using it without first consulting your doctor.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 section.Dry/irritated throat, hoarseness, or coughing may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell 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 you have any serious side effects, including: white patches in your mouth or on your tongue, signs of infection (such as fever, chills, persistent sore throat), mental/mood changes (such as depression, mood swings, agitation), vision problems, increased thirst/urination, easy bruising/bleeding, bone pain.Rarely, this medication may cause sudden severe wheezing/trouble breathing immediately after you use it. If this occurs, use your quick-relief inhaler and 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, 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).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.Laboratory and/or medical tests (such as cortisol levels, lung function, eye exams, bone density tests) should be performed periodically to monitor your progress or check for side effects.Learn to use a peak flow meter, use it daily, and promptly report worsening breathing problems (such as readings in the yellow/red range or increased use of quick-relief inhalers).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 help promote healthy bones include increasing weight-bearing exercise, stopping smoking, limiting alcohol, and eating well-balanced meals that contain adequate calcium and vitamin D. You may also need to take calcium and vitamin D supplements. Consult your doctor for specific advice. 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 at room temperature. Do not puncture or expose this medication to high heat or open flame. 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.

                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 September 2021. Copyright(c) 2021 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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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
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                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
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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.