Intranasal corticosteroid
ATC code: R01AD09 (Mometasone (nasal))
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.
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 2–11 years: 1 spray per nostril once daily.
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.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
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.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
T1 use is acceptable when symptomatic measures are insufficient. Budesonide has more pregnancy data and may be preferred for allergic rhinitis in pregnancy.
Systemic bioavailability is low; milk transfer is minimal. Compatible with breastfeeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
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.
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.
FDA category C. T1 use is acceptable when symptomatic measures are insufficient. Budesonide has more pregnancy data and may be preferred for allergic rhinitis in pregnancy.
Systemic bioavailability is low; milk transfer is minimal. Compatible with breastfeeding.
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.