Mometasone dosing

Beclomethasone dipropionate, triamcinolone acetonide, budesonide, flunisolide, and mometasone furoate are available as nasal sprays for the topical treatment of allergic rhinitis. They are effective at doses (one or two sprays one, two, or three times daily) that in most patients result in plasma levels that are too low to influence adrenal function or have any other systemic effects. 

Nasonex nasal spray, 50 meg is a metered-dose, manual-pump spray unit containing an aqueous suspension of mometasone furoate monohydrate equivalent to 0.05% w/w mometasone furoate, calculated on the anhydrous basis, in an aqueous medium containing glycerin, micro-... 

The effect of increasing doses of mometasone furoate and fluticasone propionate by dry powder inhaler on adrenal function was studied by using overnight urinary cortisol in 21 patients with asthma (55). Patients were randomized in a crossover fashion to receive 2-weekly consecutive doubling doses of either fluticasone propionate (500, 1000, and 2000 micrograms/day) or mometasone furoate (400, 800, and 1600 micrograms/day). Both treatments were... 

S. Affrime, M. Marino, M. Regional lung deposition of a technetium 99m-labeled formulation of mometasone furcate administration by hydrofluoroalkane 227 metered-dose Inhaler. Clin. Then 2000, 22 (12), 1483-1493. 

NASONEX Schering-Plough (UK) Mometasone furoate 50 p,g glucocorticosteroid BKC, MCC, CCS, glycerol, NaCit cit, Tw80, PE-OH White HD PE bottle and metered-dose pump... 

Following IV suspension or inhalation administration, mometasone furoate was detected in the plasma for up to 8 hours, with a half-life of 4 to 6 hours (Table 33.5) and an oral bioavailability of less than 1%. It is extensively metabolized with less than 10% of the administered dose recovered in the urine unchanged (108). Among the polar metabolites ( 80%) and their conjugates (42%) that were recovered were 6(3-hydroxymometasone furoate and its 21-hydroxy metabolite. In contrast, following intranasal administration, its plasma concentrations were below the limit of quantification, and the systemic bioavailability by this route was estimated to be less than 1 %. The majority of the intranasal dose for mometasone furoate is deposited in the nasal mucosa and swallowed without absorption in the Gl tract until eliminated in the feces (approximately 50-90% of the intranasal dose is recovered in the feces). That portion of the intranasal dose that was absorbed was extensively metabolized. These results indicate that inhaled mometasone furoate has negligible systemic bioavailability and is extensively metabolized, with reduced risk for causing systemic adrenal suppression effects. 

Mometasone furoate nasal suspension is supplied as an aqueous suspension with an atomizing pump that dispenses 50 pg per metered spray. The total daily dose for mometasone furoate is 200 pg. 

Affrime MB, Cuss F, Padhi D, et al. Bioavailability and metabolism of mometasone furoate following administration by metered-dose and dry-powder inhalers in healthy human volunteers. J Clin Pharmacol 2000 40 1227-1236. 

Tashkin DP, Doherty DE, Kerwin E, Matiz-Bueno CE, Knorr B, Shekar T, et al. Efficacy and safety of a fixed-dose combination of mometasone furcate and formoterol fumarate in subjects with moderate to very severe COPD results from a 52-week phase III trial. Int J Chron Obstruct Pulmon Dis 2012 7 43-55. 

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