Mometasone

NASONEX

What it isGlucocorticoid-receptor agonist used for asthma, allergic rhinitis, and inflammatory dermatoses.

Why this oneHigh first-pass metabolism gives strong local effect with little systemic exposure, which suits long-term intranasal use.

What limits itOral candidiasis when inhaled; epistaxis intranasally. Topical use carries the usual atrophy risk.

FDA-approved for

FDA dosing	Population	Start	Target	Max
Nasal allergy symptoms	≥12 yr	2 sprays/nostril QD
Nasal allergy symptoms	2–11 yr	1 spray/nostril QD

Renal Undefined

Hepatic Undefined

Prime the bottle before first use; shake well before each use.
Use only once a day; do not use more than directed.
Children 2–11: use under adult supervision, for the shortest time needed; consult a doctor if used more than two months a year.
Do not use in children under 2 years.

Pregnancy Undefined

Lactation Undefined

NO BOXED WARNINGS

Principal riskOral candidiasis when inhaled

Cost, est. cash$30–$500/month

Generic entry2002

Therapeutic safety burden0 / 4

Overdose danger0 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryC

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.