Mometasone furoate (nasal)

Intranasal corticosteroid

ATC code: R01AD09(Mometasone (nasal))

Updated 17 Jul 2026 · Methodology

Indications

Allergic rhinitis

First line

First-line for moderate-to-severe allergic rhinitis under ARIA 2020. Intranasal corticosteroids beat antihistamines on all nasal symptoms, particularly congestion. Adults and adolescents from 12 years: 2 sprays (100 mcg) per nostril once daily; children 3–11 years: 1 spray per nostril once daily.

Sources

AEMPS: Ficha técnica de Furoato de mometasona (nasal) (2024)
EAACI: ARIA guideline 2019 update on allergic rhinitis (2020)
Otolaryngol Head Neck Surg: Clinical practice guideline: Allergic rhinitis. (2015)
BMJ: Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. (1998)

ICD-10: J30.9 · ICD-11: CA08.0

Chronic rhinosinusitis

First line

First-line for chronic rhinosinusitis with or without nasal polyps under EPOS 2020. Reduces polyp size, nasal congestion, and restores olfaction. Polyp dose: 2 sprays per nostril twice daily. Long-term use is the rule – often many months.

Sources

ICD-10: J32.9 · ICD-11: CA0A

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Immune support and respiratory infection care

Not recommended

Nasal mometasone furoate is used for cold prevention and as nasal mucosal protection outside an allergic rhinitis or nasal polyps indication ( 2024, AEMPS Ficha Técnica). No clinical studies of prophylactic use for colds exist. The drug can cause nosebleeds, nasal septum perforation on long-term use, hoarseness, and allergic reactions. If nasal mometasone furoate was prescribed for cold prevention, consider seeking a second opinion.

Sources

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

A synthetic corticosteroid with high glucocorticoid receptor affinity and low systemic bioavailability via the nasal route (under 0.5%). Suppresses release of inflammatory mediators, cytokine synthesis, and migration of inflammatory cells into the nasal mucosa. Onset within 12 hours of the first dose; peak effect after 1–2 weeks of regular use.

Safety

Contraindications

Mometasone hypersensitivity
Untreated nasal mucosal infection (bacterial, fungal, herpetic)
Recent nasal trauma or surgery (until healing)

Serious adverse effects

Nasal septum perforation (rare, with poor spray technique)
Nasal or pharyngeal candidiasis
Raised intraocular pressure and cataract with very long-term high-dose use

Common adverse effects

Epistaxis (5–10%)
Nasal mucosa irritation
Headache
Pharyngeal dryness

Pregnancy: can you take Mometasone furoate (nasal)?

T1 use is acceptable when symptomatic measures are insufficient. Budesonide has more pregnancy data and may be preferred for allergic rhinitis in pregnancy.

Breastfeeding: can you take Mometasone furoate (nasal)?

Systemic bioavailability is low; milk transfer is minimal. Compatible with breastfeeding.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Practical notes

Timing and administration

Before first use, shake the bottle and prime with 10 sprays into the air until a uniform mist forms. Blow the nose before each spray. Tilt the head slightly forward and aim away from the septum toward the lateral nasal wall – this reduces mucosal irritation and epistaxis. The effect builds gradually: in seasonal rhinitis, start 1–2 weeks before pollen season.

Common myths

Myth: «steroid nasal sprays get absorbed and affect hormone levels like oral prednisolone.» Fact: systemic bioavailability of intranasal mometasone is under 0.5%. Adrenal suppression and other systemic effects at standard doses are not reported, unlike with tablets. Long-term use in children does not slow growth when used per label.

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Frequently asked

What is Mometasone furoate (nasal) used for?

Mometasone furoate (nasal) is evaluated for the following indications with varying evidence strength: Chronic rhinosinusitis (evidence tier A), Allergic rhinitis (evidence tier A), Immune support and respiratory infection care (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Mometasone furoate (nasal)?

Common side effects of Mometasone furoate (nasal) (≥ 1 in 100): Epistaxis (5–10%), Nasal mucosa irritation, Headache, Pharyngeal dryness. See the Safety section for uncommon and serious reactions.

Is Mometasone furoate (nasal) safe during pregnancy?

T1 use is acceptable when symptomatic measures are insufficient. Budesonide has more pregnancy data and may be preferred for allergic rhinitis in pregnancy.

Is Mometasone furoate (nasal) compatible with breastfeeding?

Systemic bioavailability is low; milk transfer is minimal. Compatible with breastfeeding.

Who should not take Mometasone furoate (nasal)?

Mometasone furoate (nasal) is contraindicated in: Mometasone hypersensitivity; Untreated nasal mucosal infection (bacterial, fungal, herpetic); Recent nasal trauma or surgery (until healing). Full list in the Safety section.

Other drugs in this group

Fluticasone furoate (nasal), Interferon alpha-2b (nasal formulations), Oxymetazoline, Pseudoephedrine, Xylometazoline