Nasonex (mometasone furoate monohydrate) nasal spray is a prescription corticosteroid medication designed for the management of nasal symptoms associated with allergic rhinitis in adults and pediatric patients. It works locally in the nasal passages to reduce inflammation, providing targeted relief from congestion, sneezing, and runny nose. Clinical studies demonstrate its efficacy in improving nasal airflow and quality of life for allergy sufferers, with onset of action often within hours and maximal benefit achieved after several days of consistent use.

Features

• Active ingredient: mometasone furoate monohydrate (50 mcg per spray)
• Delivery system: metered-dose, manual pump spray bottle
• Preservative: benzalkonium chloride
• Available in 17g (60 sprays) and 17g x3 (180 sprays) sizes
• pH-balanced formulation for nasal comfort
• Prescription-only status ensures professional oversight

Benefits

• Reduces nasal inflammation at the source, not just masking symptoms
• Provides 24-hour relief from allergic rhinitis symptoms with once-daily dosing
• Minimizes systemic absorption due to local action
• Suitable for long-term management of perennial and seasonal allergies
• Improves nasal airflow and reduces need for rescue medications
• FDA-approved for use in patients as young as 2 years old

Common use

Nasonex is primarily indicated for the treatment of seasonal and perennial allergic rhinitis symptoms in adults and children ages 2 years and older. It is also approved for the prophylaxis of seasonal allergic rhinitis when initiated 2-4 weeks prior to anticipated pollen exposure. Off-label uses may include treatment of non-allergic rhinitis and adjunctive management of nasal polyps, though these applications require specific medical supervision.

Dosage and direction

For allergic rhinitis in adults and children 12 years and older: 2 sprays in each nostril once daily (total 200 mcg/day). For children 2-11 years: 1 spray in each nostril once daily (total 100 mcg/day). Shake well before use. Prime the pump before first use by pressing down several times until a fine mist appears. Gently blow nose to clear nostrils before administration. Tilt head slightly forward and insert nozzle into nostril, pointing toward the outer wall of the nose. Breathe in gently while spraying, then breathe out through the mouth. Avoid spraying directly toward the nasal septum.

Precautions

Regular nasal examinations are recommended during prolonged treatment due to potential for nasal septum perforation. Use with caution in patients with recent nasal surgery, nasal trauma, or nasal ulcers. Monitor for signs of fungal or bacterial infections. Not recommended for treatment of non-allergic rhinitis without medical supervision. Patients with tuberculosis, untreated fungal, bacterial, or viral infections should use only under direct medical care. Ophthalmic evaluations may be warranted with long-term use due to potential for increased intraocular pressure or cataract formation.

Contraindications

Hypersensitivity to mometasone furoate or any component of the formulation. Contraindicated in patients with untreated localized nasal infections. Not recommended for patients with active or quiescent tuberculosis infections of the respiratory tract. Avoid use in patients with untreated systemic fungal, bacterial, viral, or parasitic infections. Should not replace systemic corticosteroids in medically unstable asthmatic patients.

Possible side effects

Common (≥1%): headache, viral infection, pharyngitis, epistaxis, coughing. Less common: nasal burning/irritation, nasal ulceration, sinusitis. Rare but serious: nasal septum perforation, increased intraocular pressure, glaucoma, cataracts, impaired adrenal function, hypersensitivity reactions including anaphylaxis. Pediatric patients may experience slowed growth velocity with prolonged use, requiring regular monitoring.

Drug interaction

Concomitant use with strong CYP3A4 inhibitors (ketoconazole, ritonavir) may increase systemic exposure to mometasone. Potential additive effects with other systemic corticosteroids. No clinically significant interactions identified with commonly prescribed antihistamines or decongestants. Caution advised when using with other nasally administered medications due to potential for increased local adverse effects.

Missed dose

If a dose is missed, administer as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain regular dosing schedule once daily, preferably at the same time each day for consistent symptom control.

Overdose

Acute overdose is unlikely due to limited systemic absorption. Single doses up to 20 times the recommended dose have been administered without significant adverse effects. Chronic overdose may suppress hypothalamic-pituitary-adrenal function. Treatment should be symptomatic and supportive. No specific antidote exists. Monitor adrenal function in cases of significant chronic overdose.

Storage

Store at room temperature (15-30°C/59-86°F). Do not freeze. Keep bottle tightly closed and protected from light. Discard 120 days after opening, even if medication remains. Keep out of reach of children. Do not store in bathroom where moisture could affect stability. Do not puncture or incinerate container.

Disclaimer

This information does not replace professional medical advice. Consult a healthcare provider for proper diagnosis and treatment recommendations. Individual response to medication may vary. Use only as prescribed by a qualified healthcare professional. Report any unusual symptoms or side effects to your physician promptly.

Reviews

Clinical trials demonstrate significant improvement in nasal symptom scores compared to placebo (p<0.001). 78% of patients reported satisfaction with allergy symptom control in post-marketing surveys. Real-world evidence supports maintained efficacy over multiple allergy seasons with consistent use. Pediatric studies show appropriate symptom control with favorable safety profile when used as directed under medical supervision.