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Mometasone
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<h2 id="medical-uses">Medical uses</h2> <p>Mometasone furoate is used in the treatment of inflammatory skin disorders (such as <a href="/facts/Eczema/JwlyQBa2">eczema</a><a class="footnote-ref" id="fnref:20" href="#fn:20"><sup>20</sup></a> and <a href="/facts/Psoriasis/WW1k1LsH">psoriasis</a>) (topical form), <a href="/facts/Allergic_rhinitis/ukE6bkIs">allergic rhinitis</a> (such as <a href="/facts/Hay_fever/ukE6bkIs">hay fever</a>) (topical form), <a href="/facts/Asthma/7GkJvxn3">asthma</a> (inhalation form)<a class="footnote-ref" id="fnref:21" href="#fn:21"><sup>21</sup></a><a class="footnote-ref" id="fnref:22" href="#fn:22"><sup>22</sup></a> for patients unresponsive to less potent <a href="/facts/Corticosteroids/jeL2QeIL">corticosteroids</a>, and penile <a href="/facts/Phimosis/9w24WHUS">phimosis</a>.<a class="footnote-ref" id="fnref:23" href="#fn:23"><sup>23</sup></a> In terms of steroid strength, it is more potent than <a href="/facts/Hydrocortisone/zvRCrYXG">hydrocortisone</a>, and less potent than <a href="/facts/Dexamethasone/rwAhDqls">dexamethasone</a>.<a class="footnote-ref" id="fnref:24" href="#fn:24"><sup>24</sup></a> </p><p>Some low-quality evidence suggests the use of mometasone for symptomatic improvement in children with <a href="/facts/Adenoid_hypertrophy/oFLm03qD">adenoid hypertrophy</a>.<a class="footnote-ref" id="fnref:25" href="#fn:25"><sup>25</sup></a> </p><p>Mometasone is used to alleviate inflammation and itchiness in skin conditions that respond to treatment with glucocorticoids such as psoriasis and atopic dermatitis.<a class="footnote-ref" id="fnref:26" href="#fn:26"><sup>26</sup></a><a class="footnote-ref" id="fnref:27" href="#fn:27"><sup>27</sup></a> </p><p><a href="/facts/Nasal_administration/W0hvb0gd">Nasal</a> 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 <a href="/facts/Nasal_polyps/scc2WAU1">nasal polyps</a>.<a class="footnote-ref" id="fnref:28" href="#fn:28"><sup>28</sup></a> </p><p>It is not useful for the <a href="/facts/Common_cold/fP9A03U9">common cold</a>.<a class="footnote-ref" id="fnref:29" href="#fn:29"><sup>29</sup></a> </p> <h3>Asthma</h3> <p>Mometasone furoate can be used with <a href="/facts/Formoterol/EhK6qGUo">formoterol</a> for the treatment of asthma, due to its anti-inflammatory properties.<a class="footnote-ref" id="fnref:30" href="#fn:30"><sup>30</sup></a><a class="footnote-ref" id="fnref:31" href="#fn:31"><sup>31</sup></a> </p> <h2 id="contraindications">Contraindications</h2> <p>People should not use inhaled mometasone or mometasone <a href="/facts/Nasal_administration/W0hvb0gd">nasal spray</a> if they have: </p> <ul><li>glaucoma or cataracts</li> <li><a href="/facts/Hypersensitivity/j2AWmqCD">hypersensitivity</a>, or are allergic to any ingredient in mometasone</li></ul> <p>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 <a href="/facts/Glaucoma/MWqWVNz3">glaucoma</a> and <a href="/facts/Cataract/RzN7k7K2">cataracts</a> 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. </p><p>People should not use mometasone topical (skin cream) if: </p> <ul><li>hypersensitive or allergic to any ingredient in the skin cream</li></ul> <p>The risks of Mometasone furoate to the baby during pregnancy cannot be ruled out. </p> <h2 id="side-effects">Side effects</h2> <p>The nasal spray form of mometasone may cause the following <a href="/facts/Side_effect/PhuX2haY">side effects</a>: </p> <ul><li>headache</li> <li><a href="/facts/Virus/mf88Bcbl">Viral</a> <a href="/facts/Upper_respiratory_tract_infection/DL59KLz4">upper respiratory infections</a></li> <li>sore throat</li> <li>nose bleeds</li> <li>cough</li> <li>muscle and joint pain</li></ul> <p>Serious side effects include: <a href="/facts/Candidiasis/gklGEfuq">Thrush</a> (fungal infection in the nose or throat), slow wound healing, eye problems such as glaucoma or cataracts, weakened immune system (<a href="/facts/Immunodeficiency/CIEujXmc">immunodeficiency</a>) which causes increased susceptibility to infections and <a href="/facts/Adrenal_insufficiency/7oxdJtF4">adrenal insufficiency</a>. </p><p>The inhaled form of mometasone for asthma may cause the following side effects: </p> <ul><li>headache</li> <li>stuffy or runny nose</li> <li>dry throat</li> <li>swelling of nose, throat and sinuses</li> <li><a href="/facts/Influenza-like_illness/4GsM3d6r">flu-like symptoms</a></li> <li>painful menstrual periods</li></ul> <p>Serious side effects may include allergic reactions (<a href="/facts/Anaphylaxis/F9IDQxeL">anaphylaxis</a>), increased risk of <a href="/facts/Osteoporosis/xa1W00Tj">osteoporosis</a>, glaucoma and cataracts, thrush in the mouth or throat, growth retardation in children, <a href="/facts/Bronchospasm/E61Q1mGD">bronchospasms</a>, adrenal insufficiency and weakened immune system which causes increased susceptibility to infections. </p><p>The topical (skin cream) version may cause: </p> <ul><li>burning and itching at the application site</li> <li><a href="/facts/Acne/TKJxhHSd">acne</a></li> <li>changes in skin color</li> <li>dryness at the application site</li> <li>skin sores</li></ul> <p>The only serious side effect that is known with mometasone topical is <a href="/facts/Adrenal_insufficiency/7oxdJtF4">adrenal insufficiency</a>. </p> <h2 id="pharmacology">Pharmacology</h2> <h3>Pharmacodynamics</h3> <p>Mometasone furoate reduces inflammation by causing several effects:<a class="footnote-ref" id="fnref:32" href="#fn:32"><sup>32</sup></a><a class="footnote-ref" id="fnref:33" href="#fn:33"><sup>33</sup></a><a class="footnote-ref" id="fnref:34" href="#fn:34"><sup>34</sup></a> </p> <ul><li>Reversing the activation of inflammatory proteins</li> <li>Activating the secretion of anti-inflammatory proteins</li> <li>Stabilizing cell membranes</li> <li>Decreasing the influx of inflammatory cells</li></ul> <p>In addition to the <a href="/facts/Glucocorticoid/2P91Aj3S">glucocorticoid</a> properties of mometasone furoate, it is a very potent <a href="/facts/Agonist/nz8U5NNp">agonist</a> of the <a href="/facts/Progesterone_receptor/B8W2o28f">progesterone receptor</a> as well as a <a href="/facts/Partial_agonist/VLm2vmgU">partial agonist</a> of the <a href="/facts/Mineralocorticoid_receptor/kwNhKIyC">mineralocorticoid receptor</a>.<a class="footnote-ref" id="fnref:35" href="#fn:35"><sup>35</sup></a> </p> <h4>Mechanism of action</h4> <p>Mometasone, like other corticosteroids, possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. For allergies, corticosteroids reduce the allergic reactions in various types of cells (mastocytes and eosinophils) that are responsible for allergic reactions. Mometasone and other corticosteroids circulate in the blood easily, crossing cellular membranes and binding with cytoplasmic receptors, resulting in the transcription and synthesis of proteins. It also inhibits the actions of the enzyme <a href="/facts/CYP2C8/bHQbSR5u">cytochrome P450 2C8</a> which participates in the activity of monooxygenase.<a class="footnote-ref" id="fnref:36" href="#fn:36"><sup>36</sup></a> </p><p>The inflammation is reduced by decreasing the liberation of <a href="/facts/Hydrolase/XW89JvNF">hydrolase</a> acids of <a href="/facts/White_blood_cell/vsDunUK0">leukocytes</a>, the prevention of the accumulation of <a href="/facts/Macrophage/z7hkQu3o">macrophages</a> in the sites of inflammation, the interference with the adhesion of leukocytes to <a href="/facts/Capillary/4BIzKJAe">capillary</a> walls, the reduction of the permeability of the capillary membranes and consequently <a href="/facts/Edema/Q6MI3KdH">edema</a>, the reduction of complementary components, inhibition of histamine and <a href="/facts/Kinin/tbfhc25v">kinin</a> liberation, and interference with scar tissue formation.<a class="footnote-ref" id="fnref:37" href="#fn:37"><sup>37</sup></a> The proliferation of fibroblasts and collagen deposits is also reduced. It is believed that the action of corticosteroid anti-inflammatory agents is bound to inhibitive proteins of <a href="/facts/Phospholipase_A2/ubWX9kQq">phospholipase A2</a>, collectively called lipocortins. The lipocortins, in turn, control the biosynthesis of potent mediators of inflammation as the <a href="/facts/Prostaglandin/kIKw0gDj">prostaglandins</a> and <a href="/facts/Leukotriene/PxNEg3IS">leukotrienes</a>, inhibiting the liberation of the molecular precursors of <a href="/facts/Arachidonic_acid/7fMTra6z">arachidonic acid</a>. Intranasal mometasone alleviates symptoms such as <a href="/facts/Rhinorrhea/DJxxlKqs">rhinorrhea</a> aquosa, <a href="/facts/Nasal_congestion/xClWzxrg">nasal congestion</a>, nasal drip, sneezing, and pharyngeal itching. Topical administration applied to the skin reduces the inflammation associated with chronic or acute dermatosis. </p><p>Although mometasone furoate does not have significant systemic immunomodulatory effects, it can be considered a local immunosuppressive drug because clinical studies have shown reductions (vs. baseline ) in neutrophils (a white blood cell) in the nasal mucosa. It could be also considered an antihistamine along with its glucocorticoid effects because it significantly reduces histamine and eosinophil cationic protein levels. </p> <h3>Pharmacokinetics</h3> <h4>Metabolism</h4> <p>Extensive metabolic hepatic metabolism of mometasone furoate to multiple metabolites occurs. No principal metabolites are detectable in plasma. After <i>in vitro</i> incubation, one of the minor metabolites formed is furoate 6β-hydroxymometasone. In human hepatic microsomes, the formation of these metabolites is regulated by <a href="/facts/CYP3A4/MqD09gEj">CYP3A4</a>.<a class="footnote-ref" id="fnref:38" href="#fn:38"><sup>38</sup></a> </p> <h3>Mometasone</h3> <p>Mometasone by itself is a <a href="/facts/Synthetic_compound/gqCNaN45">synthetic</a>, <a href="/facts/Steroid/4AhMbgXt">steroidal</a> <a href="/facts/Glucocorticoid/2P91Aj3S">glucocorticoid</a> or <a href="/facts/Corticosteroid/jeL2QeIL">corticosteroid</a> that was never marketed.<a class="footnote-ref" id="fnref:39" href="#fn:39"><sup>39</sup></a><a class="footnote-ref" id="fnref:40" href="#fn:40"><sup>40</sup></a><a class="footnote-ref" id="fnref:41" href="#fn:41"><sup>41</sup></a> The C17α <a href="/facts/Furoate/Lz9f7FGY">furoate</a> <a href="/facts/Ester/FoUAIIw4">ester</a> of mometasone, is the marketed medication.<a class="footnote-ref" id="fnref:42" href="#fn:42"><sup>42</sup></a><a class="footnote-ref" id="fnref:43" href="#fn:43"><sup>43</sup></a><a class="footnote-ref" id="fnref:44" href="#fn:44"><sup>44</sup></a> Mometasone furoate acts as a <a href="/facts/Prodrug/cg0GNhH0">prodrug</a> of mometasone.<a class="footnote-ref" id="fnref:45" href="#fn:45"><sup>45</sup></a> In addition to its glucocorticoid activity, mometasone also has very potent <a href="/facts/Progestogen/kodep35t">progestogenic</a> activity and acts as a <a href="/facts/Partial_agonist/VLm2vmgU">partial agonist</a> of the <a href="/facts/Mineralocorticoid_receptor/kwNhKIyC">mineralocorticoid receptor</a>.<a class="footnote-ref" id="fnref:46" href="#fn:46"><sup>46</sup></a> </p> <h2 id="society-and-culture">Society and culture</h2> <h3>Availability</h3> <p>As of 2016, mometasone furoate is available worldwide in formulations for nasal, oral inhalation, and topical administration, for human and veterinary use, either as a single active agent or in combination with other medications, under many brand names.<a class="footnote-ref" id="fnref:47" href="#fn:47"><sup>47</sup></a> </p> <h3>Combinations</h3> <p>The following combination medications are available as of 2022:<a class="footnote-ref" id="fnref:48" href="#fn:48"><sup>48</sup></a> </p> <table><tbody><tr><th>Combination</th><th>Commercial Name</th><th>Notes</th></tr><tr><td><a href="/facts/Azelastine/jDKlUb4D">azelastine</a></td><td>Nasaflex</td><td></td></tr><tr><td><a href="/facts/Clotrimazole/SRY1jAW9">clotrimazole</a> and <a href="/facts/Gentamicin/QXlbQH79">gentamicin</a></td><td>Mometamax, Mometavet</td><td>Veterinary use</td></tr><tr><td><a href="/facts/Clotrimazole/SRY1jAW9">clotrimazole</a> and <a href="/facts/Mupirocin/6NUJQups">mupirocin</a></td><td>Derma Q</td><td></td></tr><tr><td><a href="/facts/Florfenicol/Cy6Vsk02">florfenicol</a> and <a href="/facts/Terbinafine/7qBCjoYW">terbinafine</a></td><td>Claro</td><td>Veterinary use</td></tr><tr><td><a href="/facts/Formoterol/EhK6qGUo">formoterol</a></td><td>Dulera, Hexaler Bronquial Duo, Zenhale</td><td></td></tr><tr><td><a href="/facts/Fusidic_acid/6fht8IQt">fusidic acid</a></td><td>Bactirest-M, Dermotil Fusid, Momate-F</td><td></td></tr><tr><td><a href="/facts/Gentamicin/QXlbQH79">gentamicin</a> and <a href="/facts/Posaconazole/6vFoI0tH">posaconazole</a></td><td>Mometamax Ultra</td><td>Veterinary use</td></tr><tr><td><a href="/facts/Hydroquinone/QQ5EfwCF">hydroquinone</a> and <a href="/facts/Tretinoin/DjthvC01">tretinoin</a></td><td>Acnezac-MH</td><td></td></tr><tr><td><a href="/facts/Miconazole/PjA5UgFB">miconazole</a></td><td>Elica M, Elica-M, and Sensicort-F</td><td></td></tr><tr><td><a href="/facts/Mupirocin/6NUJQups">mupirocin</a></td><td>Sensicort-B</td><td></td></tr><tr><td><a href="/facts/Orbifloxacin/DTRwXXMn">orbifloxacin</a> and <a href="/facts/Posaconazole/6vFoI0tH">posaconazole</a></td><td>Posatex, Posatex voor honden, Posatex für Hunde</td><td>Veterinary use</td></tr><tr><td><a href="/facts/Salicylic_acid/qz7RRQCR">salicylic acid</a></td><td>Cortimax-S, Elicasal, Elocom Plus, Elosalic, Mezo-S, Momate-S, Momesalic,<p>Momtas-S, Monsalic, Sensicort-S</p></td><td></td></tr><tr><td><a href="/facts/Terbinafine/7qBCjoYW">terbinafine</a></td><td>Cutizone-T, Mezo-T, MomelomTerbi-Humanity</td><td></td></tr><tr><td><a href="/facts/Tiotropium/YutRwYQW">tiotropium</a></td><td>Tiomom</td></tr></tbody></table> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>"Mometasone Furoate Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 7 October 2016. Retrieved 11 March 2019. <a href="https://www.drugs.com/monograph/mometasone-furoate.html" target="_blank">https://www.drugs.com/monograph/mometasone-furoate.html</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>"Mometasone Furoate topical Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 5 August 2020. Retrieved 11 March 2019. <a href="https://www.drugs.com/monograph/mometasone-furoate-topical.html" target="_blank">https://www.drugs.com/monograph/mometasone-furoate-topical.html</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li> <li id="fn:3"><p>"Mometasone Furoate eent Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 30 April 2016. 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