Nasonex (Mometasone) - Nasal

What Is Mometasone - Nasal?

Mometasone, previously sold under the brand name Nasonex, is a nasal spray used to treat or prevent seasonal allergy symptoms and nasal polyps. Mometasone belongs to the corticosteroid drug class.

It is available in an over-the-counter (OTC) version under the brand name Nasonex 24HR Allergy or by prescription from a healthcare provider.

Allergy symptoms occur when your body reacts to exposure to allergens. Symptoms include a runny nose, sneezing, stuffy nose (congestion), itchy eyes or throat, and cough. Consistent exposure to allergens can cause irritation and inflammation in your nasal passages. Mometasone reduces the swelling in your nose, making it easier to breathe.

Mometasone is administered by spraying it into each nostril. It is also available as a nasal implant for people with nasal polyps under the brand name Sinuva. However, this article will focus on the nasal spray version of the drug.

What Is Mometasone Used For?

The Food and Drug Administration (FDA) approved mometasone to:

• Treat nasal symptoms of allergies (also known as hay fever)
• Treat nasal congestion associated with seasonal allergies
• Prevent seasonal allergies
• Treat nasal polyps

How to Take Mometasone

Mometasone comes in a nasal spray that goes in your nose. Do not take this medication by mouth.

Always follow the directions given to you by your prescribing healthcare provider when taking your medications.

Generally, mometasone is given as two sprays (one in each nostril) once a day.

To prepare the mometasone bottle for use:

• If this is your first bottle or you are starting a new bottle, you need to prime the bottle before you use it.
• To prime the bottle, hold it with your thumb on the bottom of the bottle and your index and middle finger on each side of the nozzle.
• Shake the bottle well before each use.
• Remove the plastic cap on top.
• Press down on the nozzle and release the pump 10 times or until a fine spray appears. Do NOT spray into your eyes.
• The nasal spray is now ready for use.

To administer the medication:

• Gently blow your nose to clear your nostrils.
• Close one nostril with your finger.
• Tilt your head forward slightly and keep the bottle upright. Gently insert the nozzle into the other (open) nostril.
• Support the base of the bottle with your thumb and press firmly down on the sides of the nozzle using your index and middle fingers one time.
• Breathe gently and slowly through your nostril as you spray the bottle. Breathe out through your mouth. Do not spray directly onto the hard part of the walls of your nostril.
• Repeat the steps above for the other nostril.
• When you're done, wipe the top of the nozzle with a clean tissue and replace the plastic cap on the bottle.

You can store the bottle unused for up to one week without having to prime it again. After one week without using it, you will need to prime the bottle again by spraying it two times or until a fine spray appears. 

Storage

Store mometasone in a cool, dry place away from light. Do not store it in areas exposed to heat or humidity like your bathroom. These environments can affect how well medications work. Keep the bottle out of reach of children and pets.

Off-Label Uses

Providers may prescribe mometasone nasal spray for other conditions that it is not approved for by the FDA. This is known as off-label use.

For example, mometasone can be beneficial for treating symptoms of inflammation of the nasal passages and sinus cavities (rhinosinusitis), such as:

• Runny nose
• Post-nasal drip
• Nasal congestion
• Sinus pain or pressure
• Headache
• Loss of smell

What Are the Side Effects of Mometasone?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or pharmacist. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of mometasone nasal spray are listed below:

• Headache
• Viral infection
• Inflammation of the throat (pharynx)
• Nosebleeds
• Coughing

Severe Side Effects

Contact your healthcare provider immediately if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects of mometasone nasal spray and their symptoms can include the following:

• Thrush (oral candidiasis), a fungal infection with symptoms like white coating or patches, redness, or soreness inside the mouth or throat
• Eye problems such as glaucoma or cataracts with symptoms such as changes in vision or blurry vision
• Slow wound healing

Long-Term Side Effects

Using corticosteroids for a long period or at higher doses than recommended can cause:

• Increased susceptibility to infections
• Reduced growth in children
• Hypercorticism (also known as Cushing's syndrome or high cortisol levels in the body) and adrenal suppression
  

However, since this drug is a nasal spray, these side effects are less likely to occur.

Dosage: How Much Mometasone Should I Take?

Modifications

There are no special changes that would need to be made based on your age or whether you are pregnant or nursing. Mometasone is generally dosed the same for people in these situations.

Missed Dose

If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take more than one dose at a time.

Missing one dose of this medication is not harmful, but it is important to take it daily to control your allergy symptoms.

Overdose: What Happens If I Take Too Much Mometasone?

Research has not identified a specific dose or amount of sprays that would be an overdose of mometasone.

Nasal sprays are unlikely to be absorbed into the bloodstream. This is known as having low systemic bioavailability, which is a measure of how much of a given drug enters the bloodstream. A drug that has a higher systemic bioavailability may have a greater effect during overdoses.

Mometasone is a corticosteroid and could carry a risk for Cushing’s syndrome. However, the risk is considered theoretical because of how the medication is taken. A nasal spray is not likely to be absorbed into your bloodstream. For the risk to be more likely to happen, you would need to take a much higher dose of the medication than is recommended and take it for a long time.

Even though it would be hard to overdose on this medication, you can still accidentally use too many sprays. Taking too much mometasone on a given day may cause a headache or sore throat.

Precautions

What Are Reasons I Shouldn’t Take Mometasone?

You should not take or be prescribed mometasone if you have experienced an allergic reaction to the drug or any of the ingredients.

A drug allergy can cause these symptoms:

• Skin rash
• Fever
• Hives
• Swelling

What Other Medications Interact With Mometasone?

No clinical studies have been done to look at mometasone's interactions with other drugs. However, there are a few drug-drug interactions that are considered theoretically possible.

Mometasone is broken down in the body by a group of proteins in your liver called cytochrome P450 (CYP450) enzymes. The CYP450 enzymes are a large group of proteins and there are many subclasses of them. Each one has different functions. A specific CYP450 enzyme, CYP3A4, breaks down mometasone. Other drugs can affect the ability of these enzymes to do their jobs.

Theoretically, taking medications that block the CYP3A4 enzyme (such as ketoconazole) could affect how well mometasone works.

Before you start treatment with mometasone, tell your provider about all the medications you take, including prescription and over-the-counter (OTC) products, vitamins, and herbal supplements. It's also important to tell your healthcare provider that you are using mometasone when they prescribe new medications for you.

What Medications Are Similar?

Mometasone is a corticosteroid administered by a nasal spray. It is approved by the FDA to treat symptoms associated with allergies, such as nasal congestion.

Listed below are medications that can be taken for similar purposes:

• Fluticasone: Fluticasone is a nasal corticosteroid available in both prescription and OTC forms. It is used to treat symptoms of nonallergic rhinitis, seasonal allergies, or nasal polyps.
• Dymista (azelastine and fluticasone): Dymista is a prescription nasal medication used to relieve seasonal allergy symptoms.
• Nasacort Allergy 24HR (triamcinolone): Nasacort Allergy 24HR is an OTC nasal corticosteroid used for allergy symptoms. It is also available in generic forms.

This is a list of medications that can also be used for allergy symptoms. It is NOT a list of drugs that are recommended to take with mometasone. In fact, taking these drugs together can increase the risk of side effects. Talk to your pharmacist or healthcare provider if you have any questions about your medications.

How Can I Stay Healthy While Taking Mometasone?

To stay healthy while you are using mometasone, take it exactly as directed by your healthcare provider. Using it consistently will help control or prevent your allergy symptoms.

In addition to taking medication, there are other ways to find relief during allergy season. Non-pharmacologic tips for managing allergy symptoms include:

• Controlling exposure to allergens, such as pet dander or house dust mites, that trigger your symptoms.
• Using an air purifier to remove allergens from the air in your home.
• Closing the windows and doors in your home as much as possible to prevent allergens from coming in from outside.
• Checking pollen counts to prepare for high-pollen days.
• Vacuuming frequently to rid your home of potential allergens, such as dust, dander, and other substances.