Mometasone and its derivate mometasone furoate are steroids (specifically, glucocorticoids), medications used to treat certain skin conditions, hay fever, and asthma. Specifically, they are used to prevent, rather than treat, asthma attacks. They can be applied to the skin, inhaled, or used in the nose. Currently only mometasone furoate is used in medical products. Common side effects when used for asthma include headache, sore throat, and thrush. It is therefore recommended to rinse the mouth after use. Long-term use may increase the risk for glaucoma and cataracts. Common side effects when used in the nose include upper respiratory tract infections and nose bleeds. Common side effects when applied on the skin include acne, skin atrophy, and itchiness. It works by decreasing inflammation. Mometasone furoate was patented in 1981 and came into medical use in 1987. It is on the World Health Organization's List of Essential Medicines and is available as a generic medication. In 2023, it was the 272nd most commonly prescribed medication in the United States, with more than 800,000 prescriptions.
Medical uses Mometasone furoate is used in the treatment of inflammatory skin disorders such as eczema and psoriasis (topical form), allergic rhinitis such as hay fever (topical form), asthma (inhalation form) for patients unresponsive to less potent corticosteroids, and penile phimosis. Some low-quality evidence suggests the use of mometasone for symptomatic improvement in children with adenoid hypertrophy. In terms of steroid strength, it is more potent than hydrocortisone, and less potent than dexamethasone. Mometasone is used to alleviate inflammation and itchiness in skin conditions that respond to treatment with glucocorticoids such as psoriasis and atopic dermatitis. Nasal mometasone is used in people over two years of age to diminish the symptoms of hay fever (seasonal allergic rhinitis) and other allergies (perennial rhinitis), including nasal congestion, discharge, pruritus, sneezing, and treat nasal polyps. Mometasone furoate can be used with formoterol for the treatment of asthma, due to its anti-inflammatory properties. It is not useful for the common cold.
Contraindications
People should not use inhaled mometasone or mometasone nasal spray if they have glaucoma, cataracts, hypersensitivity, or are allergic to any ingredient in mometasone. Those who are using mometasone nasal or inhaled for a long period of time (e.g. more than three months) should get regular eye exams to check for glaucoma and cataracts and should take precautions to avoid infections such as taking a vitamin D supplement, staying away from those with an infection (chickenpox, measles, colds or flu, COVID-19), washing foods, hand washing and calling a family doctor at the first sign of a severe infection. People should not use mometasone topical (skin cream) if hypersensitive or allergic to any ingredient in the skin cream. Risks of mometasone furoate to the baby during pregnancy cannot be ruled out.
Side effects
The nasal spray form of mometasone may cause the following side effects:
headache Viral upper respiratory infections sore throat nose bleeds cough muscle and joint pain Serious side effects include: Thrush (fungal infection in the nose or throat), slow wound healing, eye problems such as glaucoma or cataracts, weakened immune system (immunodeficiency) which causes increased susceptibility to infections and adrenal insufficiency. The inhaled form of mometasone for asthma may cause the following side effects:
headache stuffy or runny nose dry throat swelling of nose, throat and sinuses flu-like symptoms painful menstrual periods Serious side effects may include allergic reactions (anaphylaxis), increased risk of osteoporosis, glaucoma and cataracts, thrush in the mouth or throat, growth retardation in children, bronchospasms, adrenal insufficiency and weakened immune system which causes increased susceptibility to infections. The topical (skin cream) version may cause:
burning and itching at the application site acne changes in skin color dryness at the application site skin sores The only serious side effect that is known with mometasone topical is adrenal insufficiency.
Pharmacology
Pharmacodynamics Mometasone furoate reduces inflammation by causing several effects:
Reversing the activation of inflammatory proteins Activating the secretion of anti-inflammatory proteins Stabilizing cell membranes Decreasing the influx of inflammatory cells In addition to the glucocorticoid properties of mometasone furoate, it is a very potent agonist of the progesterone receptor as well as a partial agonist of the mineralocorticoid receptor.
Mechanism of action
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