Formulary
Mometasone furoate: Indications, Dosing, Side Effects and Interactions
Mometasone furoate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 6 min read
Mometasone furoate: Indications, Dosing, Side Effects and Interactions
Mometasone furoate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Prophylaxis of asthma**
- **Child** (By Inhalation Of Powder): 12-17 years Initially 400 micrograms once daily, to be inhaled in the evening, alternatively initially 200 micrograms twice daily; reduced to 200 micrograms once daily, to be inhaled in the evening, dose to be reduced if control maintained.
- **Adult** (By Inhalation Of Powder): Initially 400 micrograms once daily, to be inhaled in the evening, alternatively initially 200 micrograms twice daily; reduced to 200 micrograms once daily, to be inhaled in the evening, dose to be reduced if control maintained.
**Prophylaxis of severe asthma**
- **Child** (By Inhalation Of Powder): 12-17 years Initially 400 micrograms twice daily, reduce to the lowest effective dose when control achieved.
- **Adult** (By Inhalation Of Powder): Initially 400 micrograms twice daily, reduce to the lowest effective dose when control achieved.
**Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids,Psoriasis**
- **Child** (To The Skin): 2-17 years Apply once daily, to be applied thinly (to scalp in case of lotion).
- **Adult** (To The Skin): Apply once daily, to be applied thinly (to scalp in case of lotion).
**Prophylaxis of asthma for mometasone furoate**
- **Child 12-17 years** (By inhalation of powder): Initially 400 micrograms once daily, to be inhaled in the evening, alternatively initially 200 micrograms twice daily; reduced to 200 micrograms once daily, to be inhaled in the evening, dose to be reduced if control maintained.
**Prophylaxis of severe asthma for mometasone furoate**
- **Child 12-17 years** (By inhalation of powder): Initially 400 micrograms twice daily, reduce to the lowest effective dose when control achieved.
**Severe inflammatory skin disorders such as eczemas unresponsive to less potent corticosteroids, Psoriasis for mometasone furoate**
- **Child 1 month-1 year** (To the skin): Apply once daily, to be applied thinly (to scalp in case of lotion).
- **Child 2-17 years** (To the skin): Apply once daily, to be applied thinly (to scalp in case of lotion).
**Prophylaxis and treatment of seasonal allergic or perennial rhinitis for mometasone furoate**
- **Child 3-11 years** (By intranasal administration): 50 micrograms once daily, dose to be sprayed into each nostril.
- **Child 12-17 years** (By intranasal administration): 100 micrograms once daily, dose to be sprayed into each nostril, increased if necessary up to 200 micrograms once daily, dose to be sprayed into each nostril; reduced to 50 micrograms once daily, dose to be sprayed into each nostril, dose to be reduced when control achieved.
Cautions
For all corticosteroids (intranasal) Avoid after nasal surgery (until healing has occurred); avoid in pulmonary tuberculosis; avoid in the presence of untreated nasal infections; patients transferred from systemic corticosteroids may experience exacerbation of some symptoms Cautions, further information Systemic absorption Systemic absorption may follow nasal administration particularly if high doses are used or if treatment is prolonged; therefore also consider the cautions and side-effects of systemic corticosteroids. The risk of systemic effects may be greater with nasal drops than with nasal sprays; drops are administered incorrectly more often than sprays. Cautions For all corticosteroids (topical) Avoid prolonged use (particularly on the face); cautions applicable to systemic corticosteroids may also apply if absorption occurs following topical and local use; dermatoses of infancy, including nappy rash (extreme caution required-treatment should be limited to 5-7 days) (in children); infection; keep away from eyes; use potent or very potent topical corticosteroids under specialist supervision (in children); use potent or very potent topical corticosteroids under specialist supervision in psoriasis (can result in rebound relapse, development of generalised pustular psoriasis, and local and systemic toxicity) (in adults)
Contraindications
For all corticosteroids (topical) Acne; perioral dermatitis; potent corticosteroids in widespread plaque psoriasis; rosacea; untreated bacterial, fungal or viral skin lesions
Side effects
For all corticosteroids (inhaled) Common or very common Headache; oral candidiasis; pneumonia (in patients with COPD); taste altered; voice alteration Uncommon Bronchospasm paradoxical; cataract; vision blurred Rare or very rare Adrenal suppression; anxiety; behaviour abnormal; glaucoma; growth retardation (in children); sleep disorder Side-effects, further information Systemic absorption may follow inhaled administration particularly if high doses are used or if treatment is prolonged. Therefore also consider the side-effects of systemic corticosteroids. Candidiasis The risk of oral candidiasis can be reduced by using a spacer device with the corticosteroid inhaler; rinsing the mouth with water after inhalation of a dose may also be helpful. An anti-fungal oral suspension or oral gel can be used to treat oral candidiasis without discontinuing corticosteroid therapy. Paradoxical bronchospasm The potential for paradoxical bronchospasm (calling for discontinuation and alternative therapy) should be borne in mind. Mild bronchospasm may be prevented by inhalation of a short-acting beta2 agonist beforehand (or by transfer from an aerosol inhalation to a dry powder inhalation). Side-effects For all corticosteroids (intranasal) Common or very common Altered smell sensation; epistaxis; headache; nasal complaints; taste altered; throat irritation Rare or very rare Glaucoma; nasal septum perforation (more common following nasal surgery); vision blurred Side-effects, further information Systemic absorption may follow nasal administration particularly if high doses are used or if treatment is prolonged. Therefore also consider the side-effects of systemic corticosteroids. Side-effects For all corticosteroids (topical) Common or very common Skin reactions; telangiectasia Rare or very rare Adrenal suppression; hypertrichosis; skin depigmentation (may be reversible) Frequency not known Local reaction; vasodilation Side-effects, further information Side-effects applicable to systemic corticosteroids may also apply if absorption occurs following topical and local use. In order to minimise the side-effects of a topical corticosteroid, it is important to apply it thinly to affected areas only, no more frequently than twice daily, and to use the least potent formulation which is fully effective. Side-effects For mometasone furoate Common or very common When used by inhalation Candida infection Side-effects, further information Nasal ulceration occurs commonly with preparations containing mometasone furoate.
Interactions
**Severe interactions:**
- Co-administration of inhaled mometasone furoate with the potent CYP3A4 enzyme inhibitor ketoconazole causes small but marginally significant (p= 0.09) decreases in serum cortisol AUC (0-24) and...
**Other interactions (2):**
- However, there may be a potential for increased systemic exposure to mometasone furoate when strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, nelfinavir, ritonavir, cobicistat) are...
- Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side-effects of corticosteroids.
Pregnancy
For all corticosteroids (inhaled) Inhaled drugs for asthma can be taken as normal during pregnancy.
Breast feeding
For all corticosteroids (inhaled) Inhaled corticosteroids for asthma can be taken as normal during breast-feeding.
Medicinal forms
Powder,Spray,Cream,Ointment
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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