Mometasone Furoate Nasal Spray (mometasone furoate (intranasal))
Also sold as: Nasonex, Momez, Momeflux, Nasamet, Momate nasal
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Nasal spray 50 mcg/actuation (140-dose bottle) +1
Indications
- Seasonal allergic rhinitis (SAR)
- Perennial allergic rhinitis (PAR)
- Nasal polyposis (treatment and prevention of recurrence)
- Prophylaxis of seasonal allergic rhinitis (pre-season use)
- Non-allergic rhinitis (off-label)
Adult Dosing
Allergic rhinitis (treatment)
2 sprays (100 mcg) in each nostril once daily (total 200 mcg/day)
Once daily (OD); onset of action 1–2 days, full effect in 1–2 weeks
Reduce to 1 spray per nostril OD (100 mcg/day) when well controlled (maintenance).
Nasal polyposis
2 sprays (100 mcg) in each nostril twice daily (total 400 mcg/day)
Twice daily (BD) for 5–6 weeks; reassess
Long-term use may be needed. Monitor for any signs of HPA axis suppression.
Prophylaxis of seasonal allergic rhinitis
2 sprays in each nostril OD (200 mcg/day)
Start 2–4 weeks before the expected start of allergy season
Most effective when started before symptom onset.
Pediatric Dosing
Children ≥ 12 years: same as adult dose. For children 3–11 years: 1 spray per nostril OD. Approved for seasonal allergic rhinitis in children ≥ 3 years.
Pregnancy & Lactation
Pregnancy: Category C
Systemic absorption is very low (<0.1%) with intranasal use. Despite Category C classification, mometasone intranasal is often preferred over oral antihistamines for allergic rhinitis in pregnancy due to minimal systemic exposure. Use with caution, particularly in 1st trimester.
Lactation: Caution
Systemic absorption is negligible (<0.1%). Minimal to no drug expected in breast milk at standard intranasal doses. Use with caution; generally considered low risk.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Systemic CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) | May increase systemic mometasone exposure — monitor for signs of adrenal suppression with prolonged combined use | Moderate |
| Oral corticosteroids | Additive adrenal suppression risk with concurrent systemic steroids | Moderate |
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Side Effects
Common
- Epistaxis (nosebleed) — most common (5–8%)
- Nasal burning or irritation
- Pharyngitis
- Headache
- Sneezing immediately after use
- Nasal dryness
Serious / Discontinue If
- Nasal septal perforation (with prolonged use or improper technique — direct spray at septum)
- HPA axis suppression (rare at recommended intranasal doses; risk with very high doses or combined corticosteroid therapy)
- Growth retardation in children with high-dose chronic use
- Candida infection of nasal mucosa (rare)
- Glaucoma / raised IOP (very rare; risk with ophthalmic use of nasal spray if sprayed toward eyes)
Contraindications
- Hypersensitivity to mometasone furoate
- Untreated localized nasal fungal or bacterial infection
- Recent nasal surgery or nasal trauma — until healing is complete
- Nasal tuberculosis
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Nasonex 50 mcg Nasal Spray | MSD (Merck) | ₹385/140 doses |
| Momez Nasal Spray 50 mcg | Sun Pharma | ₹245/140 doses |
| Momeflux Nasal Spray 50 mcg | Cipla | ₹265/140 doses |
| Nasamet 50 mcg Nasal Spray | Glenmark | ₹228/140 doses |
Monitoring Required
- Symptom control — VAS/TNSS score at 2–4 weeks
- Nasal mucosa inspection — for dryness, epistaxis, or perforation at follow-up
- Growth velocity — in children on long-term therapy (annual height measurement)
- Signs of HPA suppression — with very high doses or combined corticosteroid use (fatigue, weight loss)
- Intraocular pressure — in patients with personal or family history of glaucoma
Patient Counseling Points
- Shake the bottle gently before each use. Prime the pump by spraying 10 times into the air before first use, or 2 times if unused for >1 week.
- Blow your nose gently before using the spray.
- Tilt head slightly forward (not back). Insert tip into one nostril, aiming toward the outer wall of the nose (away from the nasal septum in the middle) — this reduces risk of septal perforation and nosebleeds.
- Press the pump once while inhaling gently through the nostril. Breathe out through the mouth.
- Avoid sneezing or blowing nose for several minutes after use.
- Use every day at the same time, even when feeling better — mometasone works best with regular use. It is not a decongestant and will not give immediate relief.
- Full effect may take 1–2 weeks — do not discontinue prematurely.
- Starting 2–4 weeks before allergy season gives the best preventive effect.
- Wipe the nozzle with a clean tissue after each use to prevent clogging. Do not rinse the nozzle in water.
- Report any nosebleeds that are heavy or persistent, vision changes, or significant nasal pain.
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Clinically reviewed by: Dr. Ananya Pillai, MD (Pharmacology), Clinical Pharmacist Consultant
Last reviewed: 2026-04-01
References
- Meltzer EO, et al. Mometasone furoate nasal spray: a review of safety and systemic effects. Drug Saf. 2000;23(4):309–322.
- ARIA Guidelines (Allergic Rhinitis and its Impact on Asthma). 2020 update.
- MSD India. Nasonex prescribing information. 2023.
- British National Formulary. Mometasone furoate (intranasal). 2025.