Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Elocon
Active ingredient: Mometasone
Available dosage forms: 5 g
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Active – active substance / start: mometasone
Asmaneks (Asmaneks Tvistheyler); Momat; mometasone; Mometasone furoate; Nasonex; Uniderm; Elokim.
mometasone – a highly synthetic glucocorticosteroid for local and external use. It has anti-inflammatory, anti-allergic, anti-itching effect. It does not cause systemic effects. Nasal Spray is used for the treatment and prophylaxis of seasonal and perennial allergic rhinitis, nasal polyposis, sinusitis. Cream, ointment and lotion is used to reduce the symptoms of inflammation and itching at dermatoses such as: eczema, atopic dermatitis, atopic dermatitis, contact dermatitis, seborrheic dermatitis, fotodermatit (solar dermatitis), psoriasis, .
Active – active substance:
mometasone / mometasone furoate / Mometasone.
nasal aerosol (spray).
Properties / Action:
Mometasone is a highly active, not containing fluorine synthetic glucocorticosteroid for local and external use. It has anti-inflammatory, anti-allergic, anti-pruritic properties. His local action appears at doses that do not cause systemic effects.
mometasone inhibits the release of inflammatory mediators lipomodulina increases the production, an inhibitor of phospholipase A, which causes the decrease of arachidonic acid release and, accordingly, suppression of the synthesis of the arachidonic acid metabolism products – cyclic endoperekisey, prostaglandins. It reduces the inflammatory exudation and production of lymphokines inhibits the migration of macrophages, reduces the processes of infiltration and granulation. Reduces inflammation by reducing the formation of chemotactic factors (late phase allergic reaction), inhibits the development of “immediate” allergic reactions.
In studies with provocative tests when applied to allergens nasal mucosa was demonstrated high anti-inflammatory activity of mometasone in early and late stage in the allergic response.
mometasone peculiar negligible bioavailability (0.1%) when administered by inhalation, and topically. Mometasone hardly detected in the blood plasma. In this regard, there is no pharmacokinetic data. Mometasone is very poorly absorbed from the gastrointestinal tract, so that a small amount, which can get into the gastrointestinal tract after inhalation into the nasal cavity, exposed to the active primary metabolism.
cream, ointment and lotion:
In order to reduce the symptoms of inflammation and itching at dermatoses sensitive to corticosteroid therapy, such as:
lotion for the treatment of skin lesions of the scalp.
Dosage and administration:
It is used as a nasal inhalation. Inhalation carried out by a special dispensing nozzle. Prior to starting the nasal spray is necessary to “calibrate” the spray gun (the first 6 – 7 clicks). Next, a drug supply stereotyped in which each is ejected by pressing about 100 mg of the slurry in an amount equivalent to 50 g of chemically pure mometasone furoate. If the drug has not been used for 14 days or more, before another application is needed to re “calibrate”.
Before each use, it is necessary to shake the container vigorously aerosol.
For adults (including elderly patients) and children 12 years and older the recommended preventive and therapeutic dose is usually two inhalations (50 micrograms each) in each nostril once a day (daily dose of 200 mcg). Upon reaching therapeutic effect for maintenance therapy may be sufficient one inhalation in each nostril (100 mg daily dose).
If the effect of the drug is inadequate, the dose may be increased to four inhalations in each nostril (400 mg daily dose). After the disappearance of symptoms is recommended to decrease the dose.
The clinical effect is usually observed within the first 12 hours after drug administration.
Children 2 – 11 years: the recommended therapeutic dose – 1 inhalation (50 micrograms) in each nostril once daily (total daily dose of 100 mcg).
Auxiliary treatment of exacerbations of sinusitis:
Adults (including the elderly) and adolescents from 12 years of age: The recommended therapeutic dose is 2 inhalations (50 micrograms) in each nostril 2 times daily (total daily dose of 400 mcg). If no reduction of symptoms was achieved using the drug at the recommended therapeutic dose, the daily dose may be increased to 4 inhalations in each nostril two times a day (total daily dose 800 mg). After reducing the symptoms of the disease it is recommended to decrease the dose.
cream, ointment and lotion:
ointment or cream is applied thinly to the affected skin 1 time per day.
A few drops of lotion applied to the affected areas of the scalp 1 times a day and rub soft motion until completely absorbed.
Because of the low (less than 0.1%) systemic bioavailability is unlikely that the accidental or intentional overdose require the adoption kakah – any measures other than observation of patients with subsequent continuation of treatment at the recommended dose.
Excessive and prolonged use of corticosteroids for local and external use can cause suppression of the pituitary – adrenal function, which leads to secondary adrenal insufficiency. It is also possible manifestation of Cushing, including Cushing’s disease. Displaying an appropriate symptomatic treatment. Giperkortikoidnye Acute symptoms are usually reversible. If necessary, a correction of electrolyte imbalance. In the case of chronic toxic recommended the phasing out of the corticosteroid.
Pregnancy and lactation:
The safety of local corticosteroids in pregnant women has not been established, the purpose of this group of drugs in pregnancy is justified only if the potential benefit outweighs the potential risk to the fetus. During pregnancy, this group of drugs should not be used in high doses or for a long time.
After intranasal application to the maximum therapeutic dose of mometasone not determined even in the minimum concentration in plasma; therefore, it can be expected that its effect on the fetus will be negligible, and potential toxicity to reproductive function – very low.
Newborns whose mothers during pregnancy were used steroids, should be carefully examined to identify possible hypoadrenalism.
So far not clear, whether as a result of systemic absorption of topical corticosteroids cause the appearance of their mother’s milk. Therefore, you should decide whether to terminate breast-feeding or terminating the application of the drug, taking into account, as far as is necessary to its purpose.
Use in pediatric patients:
In the appointment of glucocorticosteroids topically in children more often than adults there are signs of depression of the hypothalamic – pituitary – adrenal axis of the – of the larger children the relationship to the body surface area weight.
Manifestations of adrenal suppression in children: low cortisol levels in plasma and the lack of response to ACTH stimulation, increased intracranial pressure manifested bulging fontanelle, headaches, bilateral edema of the optic nerve.
These phenomena are typical when using any nasal spray containing corticosteroids.
Very rarely of use with intranasal corticosteroids have been cases of nasal septum perforation or increased intraocular pressure.
cream, ointment and lotion:
Rare effects occurring and the application of other topical corticosteroids are irritation, hypertrichosis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, striae, miliaria.
Special instructions and precautions:
Patients with a history of seasonal allergic rhinitis, moderate and severe, it is recommended preventive use of the drug for two – four weeks before the expected onset of the seasonal exacerbation.
As with any long-term treatment, patients who use nasal spray for several months or longer should be inspected periodically for possible changes in the nasal mucosa.
Not recommended for nasal inhalation after a recent surgery or nasal trauma (until complete wound healing).
Be wary appoint the active or latent form of tuberculosis, untreated fungal, bacterial or viral infection, Herpes simplex c eye failure.
In the case of a local fungal infection of the nose or throat, or you need to stop the drug or to carry out special treatment.
The continuing for a long time irritation of the mucous membranes of the nose or throat can also be an indication for the abolition of the drug.
The treatment of children is carried out under strict indications and under medical supervision, as may develop systemic side effects. In a placebo – controlled clinical trials in children when applied nasal spray in a daily dose of 100 mg for one year, growth retardation in children were noted.
In the long-term treatment nasal spray suppression signs of hypothalamic function – pituitary – adrenal system was observed.
After the 12 – month treatment with mometasone nasal spray did not arise signs of atrophy of the nasal mucosa; In addition, mometasone tended to promote the normalization of histology of biopsy samples in studies of the nasal mucosa.
Patients who switch to treatment with mometasone nasal spray corticosteroids after prolonged therapy with systemic action, require special attention. Cancel corticosteroids systemic effects in such patients may result in adrenal insufficiency, which may require the adoption of appropriate measures. During the transition from the treatment of glucocorticoid systemic effects to treatment with mometasone nasal spray, some patients may experience withdrawal symptoms glucocorticosteroids, for example, pain in the joints and / or muscles, fatigue, depression; despite a decrease in the severity of symptoms associated with lesions of the nasal mucosa; such patients should be especially convincing in the desirability of the continuation of treatment with mometasone nasal spray. Change of therapy may also reveal previously develop allergic diseases such as allergic conjunctivitis, eczema, previously disguised therapy corticosteroids systemic effects.
patients treated with corticosteroids, have potentially reduced immune reactivity, they should be warned of the increased risk of infection in the event of contact with sick infectious diseases (varicella, measles), as well as the need of medical advice, if such contact occurs.
cream, ointment and lotion:
If you check skin irritation or hypersensitivity symptoms in connection with the use of drug treatment should be discontinued and the patient to choose the appropriate therapy.
In the presence of infection should be appointed, respectively, antifungal or antibacterial agents. If the desired effect does not appear quickly, use of corticosteroids should be discontinued until, until signs of infection will be eliminated.
Any side effects that occur with the use of corticosteroids systemically, including the suppression of the adrenal cortex can occur and when they are applied topically, especially in children. It should regularly monitor adrenal function (in order not to miss the symptoms of Cushing).
Systemic absorption of corticosteroids applied topically to be higher when used for a long time in the treatment of large surfaces of the body, or when using occlusive dressings, and also for children.
cream, ointment, lotion is not intended for use in ophthalmology.
mometasone nasal spray can be administered simultaneously with loratadine th without any – any effect on the concentration of loratadine or its major metabolite (a desloratadine) in the plasma. When this is not detected in the plasma of mometasone furoate in the presence of even a minimal concentration. Combined therapy was well tolerated.
List B. The temperature 2 – 25 ° C
The expiration date on the package.
Terms of pharmacy holiday – prescription.