This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Mometasone furoate nasal

Updated 2 Feb 2023 | Nasal allergy


Nasal spray suspension containing mometasone furoate (as the monohydrate).

Drugs List

  • mometasone 50microgram nasal spray
  • NASONEX 50microgram nasal spray
  • Therapeutic Indications


    Perennial allergic rhinitis - prevention and treatment
    Seasonal allergic rhinitis - prophylaxis and treatment
    Treatment of nasal polyps



    Seasonal or Perennial Allergic Rhinitis
    2 sprays (50micrograms per spray) into each nostril once daily (total dose 200micrograms). Once symptoms are controlled, dose reduction to 1 spray into each nostril daily (total dose 100micrograms daily) may be effective for maintenance.

    If symptoms are inadequately controlled the dose may be increased to a maximum daily dose of 4 sprays into each nostril once daily (total dose 400micrograms daily). Reduce once symptoms are controlled.

    A clinically significant onset of action within 12 hours after the first dose may be observed in some patients with seasonal allergic rhinitis. The full benefit of treatment may not be achieved in the first 48 hours. Patients should continue regular use to achieve full therapeutic benefit.

    Nasal Polyposis
    2 sprays (50micrograms per spray) in each nostril once daily (total daily dose of 200micrograms). If after 5 to 6 weeks symptoms are inadequately controlled, the dose may be increased to a daily dose of 2 sprays in each nostril twice daily (total daily dose of 400micrograms). The dose should be reduced following control of symptoms. If no improvement in symptoms is seen after 5 to 6 weeks of twice daily administration, alternative therapies should be considered.


    Seasonal or Perennial Allergic Rhinitis

    Children and adolescents over 12 years
    See Dosage; Adult

    Children aged 3 - 11 years
    1 spray (50micrograms per spray) into each nostril once daily (total dose 100micrograms).


    Children under 3 years
    Uncontrolled nasal infection
    Recent nasal surgery
    Recent nasal trauma

    Precautions and Warnings

    Children aged 3 to 18 years
    Transfer from other steroid therapy
    Uncontrolled systemic infection
    Tuberculosis of respiratory tract

    Corticosteroid cover required in adrenal insufficiency
    May mask symptoms or signs of infections
    Systemic corticosteroids may be needed during elective surgery
    Systemic corticosteroids may be needed during periods of stress
    Concomitant treatment may be necessary for allergy eye symptoms
    Contains benzalkonium chloride
    Advise patient to avoid spraying this preparation into or near the eyes
    If growth in children is slowed, consider referral to a paediatrician
    If visual disturbances occur, perform ophthalmic evaluation
    Inspect nasal mucosa regularly in patients on long term treatment
    Monitor regularly the height of children receiving prolonged treatment
    Prolonged or high dose may lead to adrenal suppression
    Unilateral polyps unusual/irregular/ulcerating/bleeding to be investigated
    Corticosteroids may cause growth retardation in children under 18 years
    During transfer from oral steroids allergic conditions may be unmasked
    Systemic effects possible with any inhaled corticosteroid
    Discontinue if localised infection occurs
    Maintain treatment at the lowest effective dose
    Not licensed for all indications in all age groups
    Advise patient to seek medical advice if treatment is ineffective
    Advise patients to avoid chickenpox, measles etc - see doctor if exposed
    Use regularly to maintain freedom from symptoms

    Pregnancy and Lactation


    Use mometasone with caution in pregnancy.

    The manufacturer notes that mometasone furoate should not be used during pregnancy unless the potential benefit to the mother justifies the potential risk to the mother or foetus.

    Briggs (2015) notes that it is not known if mometasone crosses the animal or human placenta. The molecular weight (about 513) is low enough for passage but the very low systemic bioavailability suggests that little, if any, drug will reach the embryo of foetus. No reports describing the use of mometasone in human pregnancy have been located. The animal data suggests risk but the observed developmental toxicity is similar to that observed after systemic exposure to other corticosteroids. The animal reproduction studies were not conducted with the nasal spray formulation of mometasone.

    Infants born to mothers who received corticosteroids during pregnancy should be observed carefully for hypoadrenalism.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Use mometasone with caution in breastfeeding.

    The manufacturer notes that mometasone furoate should not be used during breastfeeding unless the potential benefit to the mother justifies the potential risk to the mother or infant.

    Briggs (2015) notes that no reports describing the use of mometasone during human lactation have been located. Other corticosteroids are excreted into breast milk in low concentrations. The molecular weight (about 513) suggests that the drug, if it reached the plasma, would be excreted into breast milk. However, the very low systemic concentrations obtained after use of the nasal spray formulation suggest that any excretion into milk will be clinically insignificant.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Adrenal suppression
    Anaphylactic reaction
    Behavioural disturbances
    Blurred vision
    Cushing's syndrome
    Cushingoid facies
    Growth retardation (children)
    Hypersensitivity reactions
    Increased intra-ocular pressure
    Nasal burning
    Nasal irritation
    Nasal ulceration
    Perforation of nasal septum
    Psychological changes
    Psychomotor hyperactivity
    Sleep disturbances
    Smelling disturbances
    Systemic effects
    Taste disturbances
    Throat irritation
    Upper respiratory tract infection


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: September 2018

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Medications and Mothers' Milk, Sixteenth Edition (2014) Hale, T and Rowe, H, Hale Publishing, Plano, Texas.

    Summary of Product Characteristics: Nasonex 50micrograms/actuation Nasal Spray. Merck Sharp & Dohme Limited. Revised December 2017.

    NICE Evidence Services Available at: Last accessed: 5 September 2018

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.