Adult: As dry powder inhaler: Persistent mild to moderate asthma: Initially, 400 mcg once daily in the evening. Maintenance: 200 mcg 1-2 times daily. Severe asthma: Initially, 400 mcg bid. Dose must be individualised and titrated to the lowest effective dose once asthma is controlled. Dosage recommendations and expression of dosage units may vary between countries (expressed as either the amount of drug released for each actuation or amount delivered from mouthpiece). Refer to specific product guidelines. Child: 4-11 years 100 mcg once daily in the evening; ≥12 years Same as adult dose. Treatment recommendations may vary among countries and individual products. Refer to specific product guidelines.
Nasal Nasal polyps
Adult: As 50 mcg/actuation nasal spray: Initially, 2 actuations (100 mcg) in each nostril once daily (total dose: 200 mcg), may be increased after 5-6 weeks to 2 actuations (100 mcg) in each nostril bid (total dose: 400 mcg daily) if symptoms are inadequately controlled. Titrate to the lowest effective dose. If there is no improvement after 5-6 weeks of bid administration, re-evaluate patient and reconsider treatment strategy.
Adult: As 50 mcg/actuation nasal spray: Prophylaxis and treatment: 2 actuations (100 mcg) in each nostril once daily (total dose: 200 mcg). Reduce dose to 1 actuation in each nostril (total dose: 100 mcg) once symptoms are controlled. If symptoms are not controlled, may increase to a Max of 4 actuations in each nostril once daily (total dose: 400 mcg). For prophylaxis of seasonal allergic rhinitis in patients with history of moderate to severe symptoms, treatment may be initiated 2-4 weeks before the expected start of pollen season. Child: 3-11 years As 50 mcg/actuation nasal spray: Usual dose: 1 actuation (50 mcg) in each nostril once daily (total dose: 100 mcg); ≥12 years Same as adult dose.
Adult: As 0.1% w/w cream or ointment: Apply a thin film onto the affected areas once daily until lesion heals or for a duration of 3 weeks (whichever is sooner). As 0.1% w/w lotion: Apply a few drops onto the affected areas (including scalp area) once daily, then massage lightly and thoroughly until the lotion disappears. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines). Child: As 0.1% w/w cream or ointment: ≥2 years Apply a thin film onto the affected areas once daily for no more than 3 weeks. As 0.1% w/w lotion: ≥12 years Same as adult dose. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Chống chỉ định
Inhalation: Status asthmaticus or other acute asthma episodes requiring intensive measures. Nasal: Presence of untreated localised infection involving the nasal mucosa (e.g. herpes simplex) or severe nasal infection (particularly candidiasis); recent nasal surgery or trauma (unless healing has occurred); haemorrhagic diathesis, history of recurrent nasal bleeding. Topical: Rosacea, acne vulgaris, perioral dermatitis, diaper dermatitis; untreated bacterial, viral, parasitical, and fungal skin infections; ulcerative skin conditions or wounds.
Thận trọng
Patient with active or quiescent tuberculous infections, untreated fungal, bacterial, viral, or parasitic infection, or ocular herpes simplex (nasal and inhalation use); cataract and/or glaucoma; major risk factors for decreased bone mineral count (e.g. prolonged immobilisation and family history of osteoporosis). Immunocompromised patients. Avoid exposure to chickenpox or measles. Caution is needed when switching from systemic corticosteroid therapy to inhalation or nasal corticosteroid therapy. Avoid abrupt withdrawal. Avoid prolonged topical use, particularly on the face. Hepatic impairment. Children. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, hyperglycaemia, glycosuria, growth retardation in children and adolescents, decreased BMD, cataracts, glaucoma, increased intraocular pressure (particularly during prolonged use); visual disturbances (e.g. blurred vision), immunosuppression; hypersensitivity reactions (e.g. anaphylaxis, angioedema, pruritus, rash, urticaria, wheezing); local nasal effects such as nasal septum perforation, epistaxis, nasal irritation, and infection of the nose and/or pharynx (nasal); oropharyngeal candidiasis (inhalation); allergic contact dermatitis (topical). Gastrointestinal disorders: Dyspepsia (inhalation); throat irritation, disturbance of taste (nasal). General disorders and administration site conditions: Application site pain or reactions (topical). Musculoskeletal and connective tissue disorders: Musculoskeletal pain, back pain (inhalation). Nervous system disorders: Headache. Psychiatric disorders: Anxiety, sleep disorders, depression, aggression, psychomotor hyperactivity (inhalation). Reproductive system and breast disorders: Dysmenorrhoea (inhalation). Respiratory, thoracic and mediastinal disorders: Pharyngitis, dysphonia, sinusitis; disturbance of smell, cough (nasal). Skin and subcutaneous tissue disorders: Skin hypopigmentation, striae, miliaria, dermatitis acneiform, hypertrichosis, skin atrophy, folliculitis (topical). Potentially Fatal: Paradoxical bronchospasm (inhalation).
Inhalation: Rinse the mouth with water and spit out contents without swallowing after every administration.
Chỉ số theo dõi
Monitor growth (in children and adolescents) and signs and symptoms of adrenal insufficiency. Assess for ocular changes. Inhalation: Obtain forced expiratory volume in the 1st second (FEV1), peak flow, and/or other pulmonary function tests. Monitor BMD and signs and symptoms of oral candidiasis (during prolonged use) and asthma.
Quá liều
Symptoms: Suppression of pituitary-adrenal function resulting in secondary adrenal insufficiency. Management: Symptomatic treatment. If electrolyte imbalance occurs, treat it as necessary. For chronic toxicity, slowly withdraw corticosteroid use.
Tương tác
Strong CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, cobicistat-containing products) may increase the systemic exposure of mometasone, potentially increasing the risk for systemic corticosteroid adverse effects.
Tác dụng
Description: Mechanism of Action: Mometasone is a synthetic corticosteroid that has local anti-inflammatory, antipruritic, and vasoconstrictive properties. It may inhibit the formation, release, and activity of endogenous chemical mediators of inflammation (kinins, liposomal enzymes, histamine, prostaglandins) by inducing phospholipase A2 inhibitory proteins and sequential blocking of arachidonic acid release. Furthermore, it inhibits the margination and subsequent cell migration to the injury site; it reverses vascular dilatation and increases vessel permeability, resulting in reduced access of cells to the areas of injury. Onset: Nasal: Improvement in allergic rhinitis symptoms: Within 12 hours (Max effect: Within 1-2 weeks). Pharmacokinetics: Absorption: Poorly absorbed following inhalation, nasal use, and topical application. Bioavailability: <1%. Time to peak plasma concentration: 0.5-2.5 hours (inhalation). Distribution: Plasma protein binding: 98-99%. Metabolism: Extensively metabolised in the liver mainly by the CYP3A4 isoenzyme to multiple metabolites. Excretion: Mainly via faeces (approx 74%); urine (approx 8%). Elimination half-life: Approx 5 hours.
Đặc tính
Mometasone Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 441335, Mometasone. https://pubchem.ncbi.nlm.nih.gov/compound/Mometasone. Accessed Dec. 20, 2023.
Bảo quản
Store between 15-30°C. Protect from light (nasal spray). Storage recommendations may vary between products. Refer to specific product guidelines.
D07AC13 - mometasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases. R01AD09 - mometasone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis. R03BA07 - mometasone ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.
Tài liệu tham khảo
Anon. Mometasone (Nasal). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/10/2022.Anon. Mometasone (Oral Inhalation). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/10/2022.Anon. Mometasone (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/10/2022.Asmanex HFA Aerosol (Organon LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/10/2022.Asmanex Inhalant (Organon LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/10/2022.Asmanex Twisthaler 200 micrograms Inhalation Powder (Merck Sharp & Dohme Limited). MHRA. https://products.mhra.gov.uk. Accessed 05/10/2022.Buckingham R (ed). Mometasone Furoate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/10/2022.Elocon 0.1% w/w Cream (Organon Pharma [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 05/10/2022.Elocon 0.1% w/w Scalp Lotion (Organon Pharma [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 05/10/2022.Elomet Cream and Ointment 0.1% (Organon Malaysia Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 05/10/2022.Elomet Lotion 0.1% (Organon Malaysia Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 05/10/2022.Joint Formulary Committee. Mometasone Furoate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/10/2022.Mometasone Furoate 0.1% w/w Ointment (Glenmark Pharmaceuticals Europe Ltd). MHRA. https://products.mhra.gov.uk. Accessed 05/10/2022.Mometasone Furoate 50 micrograms/actuation Nasal Spray, Suspension (Cipla [EU] Limited). MHRA. https://products.mhra.gov.uk. Accessed 05/10/2022.Mometasone Furoate Cream (Cosette Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/10/2022.Mometasone Furoate Ointment (Cosette Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/10/2022.Mometasone Furoate Solution (Taro Pharmaceuticals U.S.A., Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/10/2022.Mometasone Furoate Spray, Metered (Apotex Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/10/2022.Nasonex Aqueous Nasal Spray (Organon Malaysia Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 05/10/2022.Organon (New Zealand) Limited. Elocon Alcohol Free Topical Cream, 0.1% w/w; Elocon Topical Ointment, 0.1% w/w; Elocon Lotion, 0.1% w/w data sheet 20 January 2022. Medsafe. http://www.medsafe.govt.nz. Accessed 07/10/2022.Organon New Zealand Limited. Nasonex Aqueous Nasal Spray data sheet 1 December 2020. Medsafe. http://www.medsafe.govt.nz. Accessed 07/10/2022.
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