Nasonex (mometasone furoate monohydrate) Nasal Spray is a prescription corticosteroid medication designed for the management of nasal symptoms associated with seasonal and perennial allergic rhinitis in adults and pediatric patients. It delivers targeted anti-inflammatory action directly to the nasal mucosa, reducing congestion, sneezing, and rhinorrhea. Clinical studies demonstrate its efficacy in improving quality of life measures and nasal airflow with a favorable safety profile.

Features

• Active ingredient: mometasone furoate monohydrate (equivalent to 50 mcg mometasone furoate per spray)
• Delivery system: metered-dose, manual pump spray mechanism
• Formulation: aqueous suspension, alcohol-free
• Container: 17 g (delivering approximately 120 sprays) or 60 g (approximately 420 sprays)
• Preservative: benzalkonium chloride
• pH-balanced for nasal compatibility

Benefits

• Provides significant reduction in nasal inflammation and mucosal edema
• Alleviates primary allergic rhinitis symptoms: nasal congestion, rhinorrhea, sneezing, and pruritus
• Demonstrates onset of action within 12 hours with maximum benefit achieved after several days of regular use
• Minimizes systemic absorption due to low bioavailability (<0.1%)
• Suitable for long-term management of chronic allergic rhinitis symptoms
• FDA-approved for use in patients as young as 2 years old

Common use

Nasonex Nasal Spray is primarily indicated for the treatment of seasonal allergic rhinitis (hay fever) and perennial allergic rhinitis 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 adjunctive treatment of nasal polyposis and non-allergic rhinitis, though these applications require physician supervision.

Dosage and direction

Adults and adolescents (12 years and older): 2 sprays (100 mcg) in each nostril once daily (total dose 200 mcg/day). Once symptoms are controlled, reduction to 1 spray per nostril may be effective for maintenance.

Children (2-11 years): 1 spray (50 mcg) in each nostril once daily (total dose 100 mcg/day).

Administration technique:

1. Shake bottle gently before each use
2. Prime pump by spraying into air until fine mist appears (if new or not used for 14+ days)
3. Gently blow nose to clear nostrils
4. Tilt head slightly forward and insert tip into nostril
5. Direct spray away from nasal septum toward lateral wall
6. Breathe in gently through nose while spraying
7. Repeat for other nostril
8. Avoid blowing nose for 15 minutes after application

Precautions

• Not for ophthalmic, oral, or intravaginal use
• Monitor patients for signs of nasal septal perforation or Candida infection
• Use with caution in patients with recent nasal surgery, trauma, or septal ulcers
• May cause reduced growth velocity in pediatric patients; monitor growth routinely
• Patients with tuberculosis, untreated fungal, bacterial, or viral infections should use only with physician guidance
• Immunocompromised patients may be at increased risk of infection

Contraindications

• Hypersensitivity to mometasone furoate or any component of the formulation
• Untreated localized nasal infections (including fungal, bacterial, or viral)
• Active or quiescent tuberculosis infections of the respiratory tract
• Untreated systemic fungal, bacterial, viral, or parasitic infections
• Ocular herpes simplex

Possible side effects

Common (≥1%):

• Headache (~26%)
• Nasopharyngitis (~9%)
• Epistaxis (~8%)
• Pharyngolaryngeal pain (~4%)

Less common (<1%):

• Nasal burning or irritation
• Nasal ulceration
• Immediate hypersensitivity reactions
• Cataracts or glaucoma (with long-term use)
• Impaired wound healing
• Adrenal suppression (with excessive doses)

Rare:

• Nasal septal perforation
• Anosmia
• Growth suppression in children

Drug interaction

Although systemic absorption is minimal, potential interactions include:

• Strong CYP3A4 inhibitors (ketoconazole, ritonavir) may increase systemic corticosteroid exposure
• Other corticosteroids (oral, inhaled, topical) may increase risk of systemic effects
• Live vaccines should be avoided during treatment due to potential immunosuppression
• Monitor patients on warfarin for potential altered coagulation parameters

Missed dose

If a dose is missed, administer as soon as remembered. If it is near the time of the next dose, skip the missed dose and resume regular dosing schedule. Do not double the dose to make up for a missed administration.

Overdose

Acute overdose is unlikely due to low systemic bioavailability. Single doses up to 20 times the recommended dose have been administered without adverse effects. Chronic excessive use may lead to systemic corticosteroid effects including hypercortisolism and adrenal suppression. Treatment should be symptomatic and supportive. There is no specific antidote.

Storage

Store at controlled room temperature (20-25°C or 68-77°F). Do not freeze. Keep bottle upright and protected from light. Discard after 120 actuations (17 g bottle) or 420 actuations (60 g bottle) even if not empty, as dose delivery may become inconsistent. Keep out of reach of children.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Nasonex Nasal Spray is available by prescription only. Consult a healthcare professional for proper diagnosis and treatment recommendations. Individual results may vary. Full prescribing information is available at www.nasonex.com or by contacting the manufacturer.

Reviews

Clinical trials demonstrate Nasonex’s efficacy with patient-reported outcomes showing significant improvement in nasal symptom scores. In a 12-month safety study, 78% of patients reported “good” or “excellent” symptom control with once-daily dosing. Pediatric studies show similar efficacy profiles with appropriate dose adjustments. Real-world evidence supports maintained effectiveness over multiple allergy seasons with consistent use patterns.