Mometasone (Nasonex) Interactions
Mometasone (Nasonex) Interactions
No drug interactions with intranasal or topical mometasone have been reported. In clinical studies, the concurrent administration of mometasone inhalation and other drugs commonly used in the treatment of asthma was not associated with any unusual adverse events. However, systemic ketoconazole, a potent inhibitor of CYP3A4, may increase plasma levels of mometasone furoate during concomitant dosing. An inhaled dose of mometasone furoate 440 mcg twice daily was given to 24 healthy subjects for 9 days and ketoconazole (200 mg PO twice daily) was given concomitantly on days 4 - 9. Mometasone furoate plasma concentrations were < 150 pcg/ml on day 3 prior to coadministration of ketoconazole or placebo. Following concomitant administration of ketoconazole, 4 (out of 12) subjects in the ketoconazole treatment group had peak plasma concentrations of mometasone furoate >200 pcg/ml on day 9 (211 to 324 pcg/ml). Since mometasone furoate plasma levels appear to increase and plasma cortisol levels appear to decrease upon concomitant administration of ketoconazole, caution should be exercised in the coadministration of these drugs.[7974]
Additional monitoring may be required when coadministering systemic or inhaled corticosteroids with mecasermin, recombinant, rh-IGF-1. In animal studies, corticosteroids impair the growth-stimulating effects of growth hormone (GH) through interference with the physiological stimulation of epiphyseal chondrocyte proliferation exerted by GH and IGF-1. Dexamethasone administration on long bone tissue in vitro resulted in a decrease of local synthesis of IGF-1.[8314] Similar counteractive effects are expected in humans. If systemic glucocorticoid therapy is required, the steroid dose should be carefully adjusted and growth rate monitored.[8315]
[ Last revised: 11/7/2005 2:06:00 PM ]
References
. Asmanex Twisthaler® (mometasone) package insert. Kenilworth NJ: Schering Corporation; 2005 Mar.
. Jux C, Leiber K, Hugel U, et al. Dexamethasone impairs growth hormone (GH)-stimulated growth by suppression of local insulin-like growth factor (IGF)-1 production and expression of GH- and IGF-1 receptor in cultured rat chondrocytes. Endocrinology 1998;139:3296 - 305.
. Allen DB. Inhaled corticosteroid therapy for asthma in preschool children: growth issues. Pediatrics 2002;109:373 - 80.
Related entries
Monthly Archives
Syndicate
|
Allergies
