mometasone furoate (Asmanex, Nasonex)

Introduction

Tradename: Inhaled glucocorticoid (Asmanex).

Indications

• maintenance prophylactic treatment of asthma in patients 12 years or older
• chronic obstructive pulmonary disease
• allergic rhinitis
• atopy
• inflammatory dermatoses
  • atopic dermatitis
  • seborrheic dermatitis
  • contact dermatitis
  • discoid lupus
  • granuloma annulare
  • psoriasis
  • anal pruritus
  • rash
  • lichen simplex chronicus
  • cutaneous T-cell lymphoma

Contraindications

• acute episodes of asthma, including status asthmaticus

pregnancy category = c

safety in lactation = ?

Dosage

• start 220 ug (1 inhalation) QHS
  • 440 ug (2 inhalations) BID if on oral glucocorticoid
• maximum 440 ug QD
  • 880 ug QD if on oral glucocorticoid
• topical: apply 0.1% ointment/cream/lotion TID/QID.

'Twisthaler' device (dry powder inhaler) contains 30, 60 or 120 inhalations delivers 200 ug of mometasone furoate from the mouthpiece

Nasonex nasal spray 1-2 whiffs QD (generic FDA-approved March 2016)

Pharmacokinetics

• maximum benefit may take 2 weeks or longer

Adverse effects

• generally mild to moderate in severity
• pharyngitis (8-13% vs 7% with placebo)
• upper respiratory tract infections (8-5% vs 7% with placebo)
• oral candidiasis (4-6% vs 2% with placebo)
• growth suppression & decreased bone mineral density has been reported

• drug adverse effects of glucocorticoids
• drug adverse effects of immunosuppressive agents

Drug interactions

• no significant drug interactions in clinical trials

• drug interaction(s) of methotrexate with biological response modifier
• drug interaction(s) of glucocorticoids with warfarin
• drug interaction(s) of NSAIDs with glucocorticoid

Mechanism of action

• inhaled glucocorticoid The average wholesale price is $155.75/120 inhalations. (2005)

More general terms

• glucocorticoid
• antipruritic agent

More specific terms

• Mometasone Topical

Component of

• mometasone/orbifloxacin/posaconazole
• mometasone/olopatadine
• florfenicol/mometasone/terbinafine
• formoterol/fumarate/mometasone
• ammonium lactate/mometasone
• ammonium lactate/lactate/mometasone
• formoterol/mometasone (Dulera)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=123620
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441335
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441336
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=55188
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=4240