Indication

Allergic rhinitis, Nasal polyps, Asthma prophylaxis

Adult Dose

Nasal\r\nAllergic rhinitis\r\nAdult: Nasal Treatment and prophylaxis of allergic rhinitis Adults: 100 mcg (2 sprays) in each nostril once daily, increased to 200 mcg into each nostril once daily if needed. Maintenance: 50 mcg in each nostril daily. \r\n\r\nIn patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis, prophylaxis with Mometasone Nasal Spray is recommended 2 to 4 weeks prior to the anticipated start of the pollen season. \r\n\r\nNasal polyps:\r\n100 mcg (2 sprays) in each nostril once daily; may increase to bid after 5-6 wk if needed. \r\n\r\nInhalation\r\nAsthma prophylaxis: \r\nMild to moderate: Initially, 400 mcg once daily in the evening. Maintenance: 200 mcg once to bid. \r\nSevere: Initially, 400 mcg bid, then titrated to lowest effective dose once controlled. \r\n\r\nChild: Mild to moderate: Initially, 400 mcg once daily. Maintenance: 200 mcg once to bid. Severe: Initially, 400 mcg bid, then titrated to lowest effective dose once controlled.

Child Dose

Nasal\r\nAllergic rhinitis\r\nChild: 2-11 yr: 50 mcg (1 spray) in each nostril daily; Child: >12 yr: 100 mcg in each nostril daily. \r\n\r\nInhalation\r\nAsthma prophylaxis: \r\nChild: Mild to moderate: Initially, 400 mcg once daily. Maintenance: 200 mcg once to bid. \r\nSevere: Initially, 400 mcg bid, then titrated to lowest effective dose once controlled.

Contraindication

Hypersensitivity, Immunosuppressed patients, Tuberculosis, Status asthmaticus or other acute asthma episode necessitating intensive measures, Known hypersensitivity to milk proteins or any other ingredients

Mode of Action

Mometasone depresses the formation, release and activity of endogenous inflammatory chemical mediators (e.g. kinins, histamine, liposomal enzymes and prostaglandin). It inhibits the margination and subsequent cell migration to the injury site, reverses vascular dilatation and permeability, resulting in decreased access of cells to the area of injury.

Precaution

Respiratory tract tuberculosis, untreated fungal or bacterial infections, viral or parasitic infections, ocular herpes simplex\r\nNasal septum perforation, epistaxis, wheezing\r\nCataracts, glaucoma, increased intraocular pressure\r\nRisk of more serious or fatal course of chickenpox and measles in susceptible individuals; avoid use in unvaccinated or immunologically unexposed children or adults\r\nDeaths from adrenal insufficiency have occurred after abrupt withdrawal of oral steroids; taper withdrawal gradually\r\nMay retard growth in children\r\nImmunocompromised patients\r\nInfections of nose and pharynx, including Candida albicans\r\nExcessive use may suppress hypothalamic-pituitary-adrenal function\r\nDuring periods of stress or severe status asthmaticus, patient may require supplementary systemic corticosteroids immediately; carry warning card to that effect\r\nLong-term administration reduces bone mineral density

Side Effect

>10%\r\nHeadache (26%),Viral infection (14%),Pharyngitis (12%),Epistaxis (11%)\r\n\r\n1-10%\r\nCough (7%),Upper respiratory tract infection (6%),Dysmenorrhea (5%)\r\n\r\nFrequency Not Defined\r\nLoss of taste,Muscle soreness

Interaction

Increased risk of hypokalaemia with amphotericin B, potassium-wasting diuretics. Decreases hypoglycaemic effects of antidiabetic drugs. Increased serum levels with antifungals (imidazole). Increased risk of tendinopathies with fluoroquinolones.