Mometasone (Nasonex) Indications and Dosage
- allergic rhinitis
- alopecia
- asthma
- atopic dermatitis
- contact dermatitis
- dermatitis
- discoid lupus erythematosus
- eczema
- exfoliative dermatitis
- granuloma annulare
- keloids
- lichen planus
- lichen simplex
- lichen striatus
- necrobiosis lipoidica diabeticorum
- pemphigus
- pityriasis rosea
- polymorphous light eruption
- pruritus
- psoriasis
- Rhus dermatitis
- sarcoidosis
- seborrheic dermatitis
- xerosis
Mometasone (Nasonex) Indications and Dosage
General Comparative Topical Corticosteroid Potency:
NOTE: The following is a general representation. Check specific product formulations prior to making potency decisions.
Very High Potency
Betamethasone dipropionate (augmented)
Clobetasol
Diflorasone diacetate ointment
Halobetasol
High Potency
Amcinonide
Betamethasone dipropionate
Desoximetasone gel or ointment, or cream >= 0.25%
Diflorasone diacetate cream
Fluocinolone cream >= 0.2%
Fluocinonide
Halcinonide
Triamcinolone >= 0.5%
Medium Potency
Beclomethasone
Betamethasone benzoate
Betamethasone valerate
Clobetasone
Desoximetasone cream < 0.25%
Diflucortolone
Fluocinolone ointment or topical solution or cream < 0.2%
Flurandrenolide >= 0.025%
Fluticasone
Hydrocortisone butyrate
Hydrocortisone valerate
Mometasone
Triamcinolone < 0.5%
Low Potency
Alclometasone
Clocortolone
Desonide
Dexamethasone
Flumethasone
Flurandrenolide < 0.025%
Hydrocortisone base
Hydrocortisone acetate
For the treatment of pruritus and topical inflammation associated with moderate to severe corticosteroid-responsive dermatoses including alopecia areata, atopic dermatitis, contact dermatitis, dermatitis, discoid lupus erythematosus, eczema, exfoliative dermatitis, granuloma annulare, keloids, lichen planus, lichen simplex, lichen striatus, necrobiosis lipoidica diabeticorum, pemphigus, pityriasis rosea, polymorphous light eruption, pruritus, psoriasis, severe Rhus dermatitis due to plants like poison ivy, sarcoidosis, seborrheic dermatitis, urticaria, and xerosis:
NOTE: Occlusive dressings may be required for chronic or severe cases of lichen simplex chronicus, psoriasis, eczema, atopic dermatitis, or chronic hand eczema. More potent topical corticosteroids and/or occlusive dressings may be necessary for the treatment of discoid lupus erythematosus, lichen planus, granuloma annulare, psoriatic plaques, and psoriasis of the palms, soles, elbows, or knees.
Topical dosage (cream or ointment):
Adults: Apply a thin film to the affected areas once daily.
Adolescents and children >= 2 years: Apply a thin film to the affected areas once daily. Safety and efficacy of treatment for more than 3 weeks has not been established.
Children < 2 years: Safe and effective use has not been established.
Topical dosage (lotion):
Adults: Apply a few drops to the affected areas once daily.
Children <= 12 years: Safe and effective use has not been established.
For maintenance treatment of asthma as prophylactic therapy:
NOTE: Mometasone is not indicated for the treatment of acute bronchospasm.
- in patients previously receiving bronchodilators alone:
Oral inhalation dosage (Asmanex Twisthaler® inhalation powder):
Adults, adolescents and children >= 12 years: Initially, 220 mcg (1 puff) once daily in the evening (PM) by oral inhalation. The maximum recommended dose is 440 mcg/day, given as either 220 mcg twice daily or 440 mcg once daily in the PM. Titrate to the lowest effective dose once asthma stability is achieved.
Children < 12 years: Safe and effective use not established.
- in patients previously receiving inhaled corticosteroids:
Oral inhalation dosage (Asmanex Twisthaler® inhalation powder):
Adults, adolescents and children >= 12 years: Initially, 220 mcg (1 puff) once daily in the evening (PM) by oral inhalation. The maximum recommended dose is 440 mcg/day, given as either 220 mcg twice daily or 440 mcg once daily in the PM. Titrate to the lowest effective dose once asthma stability is achieved.
Children < 12 years: Safe and effective use not established.
- in patients previously receiving oral corticosteroids:
Oral inhalation dosage (Asmanex Twisthaler® inhalation powder):
Adults, adolescents and children >= 12 years: 440 mcg (2 puffs) twice daily by oral inhalation. The maximum recommended dose is 880 mcg/day. For Patients Currently Receiving Chronic Oral Corticosteroid Therapy: The oral corticosteroid should be reduced no faster than 2.5 mg/day of prednisone or equivalent on a weekly basis, beginning after at least 1 week of mometasone inhaled therapy. Patients should be carefully monitored for signs of asthma instability, including serial objective measures of airflow, and for signs of adrenal insufficiency. Once oral corticosteroid reduction is complete, titrate to the lowest effective mometasone dose.
Children < 12 years: Safe and effective use not established.
For the prophylaxis and treatment of the nasal symptoms of seasonal allergic rhinitis or for the treatment of the nasal symptoms of perennial allergic rhinitis:
NOTE: In patients with a known seasonal allergen that precipitates nasal symptoms of seasonal allergic rhinitis, prophylaxis with Nasonex® is recommended 2 - 4 weeks prior to the anticipated start of the pollen season.
Intranasal dosage:
Adults and adolescents: 2 sprays (50 mcg/spray) in each nostril once daily (total daily dose of 200 mcg). Total daily intranasal doses up to 800 mcg/day have been studied in clinical trials, with the most effective dose for the population found to be 200 mcg/day.
Children 2 - 11 years: 1 spray (50 mcg/spray) in each nostril once daily (total daily dose of 100 mcg). Total daily intranasal doses up to 200 mcg/day have been studied in clinical trials, with the most effective dose for the population found to be 100 mcg/day.
Children < 2 years: Safe and effective use has not been established.
- for the treatment of nasal polyps:
Intranasal dosage:
Adults: 2 sprays (50 mcg/spray) in each nostril twice daily (total daily dose of 400 mcg). A dose of 2 sprays (50 mcg/spray) in each nostril once daily is effective in some patients.
Elderly: 2 sprays (50 mcg/spray) in each nostril twice daily (total daily dose of 400 mcg). A dose of 2 sprays (50 mcg/spray) in each nostril once daily is effective in some patients.
Adolescents: Safe and effective use have not been established.
Children: Safe and effective use have not been established.
Maximum Dosage Limits:
In general, corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, route and product of administration, and on patient age and response. For some products maximum dosage limits have not been specified.
- Adults: 800 mcg/day intranasally; 880 mcg/day inhalation.
- Elderly: 800 mcg/day intranasally; 880 mcg/day inhalation.
- Adolescents >= 12 years: 800 mcg/day intranasally; 880 mcg/day inhalation.
- Children 2 - 11 years: 200 mcg/day intranasally; use of topical cream or ointment should not exceed 3 weeks duration; safe and effective use of topical lotion has not been established.
- Children < 2 years: Not recommended.
Patients with hepatic impairment:
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
[ Last revised: 4/13/2005 3:50:00 PM ]
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