Mometasone Nasal Spray

SCOPE: this dose is for allergic rhinitis, the page's primary indication. The same SPC also covers NASAL POLYPOSIS: 'The usual recommended starting dose for polyposis is two actuations (50 micrograms/actuation) in each nostril once daily (total daily dose of 200 micrograms). If after 5 to 6 weeks symptoms are inadequately controlled, the dose may be increased to a daily dose of two sprays in each nostril twice daily (total daily dose of 400 micrograms). The dose should be titrated to the lowest dose at which effective control of symptoms is maintained. If no improvement in symptoms is seen after 5 to 6 weeks of twice daily administration, the patient should be re-evaluated and treatment strategy reconsidered.' Efficacy and safety studies in nasal polyposis were four months in duration. VERBATIM RHINITIS POSOLOGY: 'Adults (including older patients) and children 12 years of age and older: The usual recommended dose is two actuations (50 micrograms/actuation) in each nostril once daily (total dose 200 micrograms). Once symptoms are controlled, dose reduction to one actuation in each nostril (total dose 100 micrograms) may be effective for maintenance. If symptoms are inadequately controlled, the dose may be increased to a maximum daily dose of four actuations in each nostril once daily (total dose 400 micrograms). Dose reduction is recommended following control of symptoms.' ONSET: 'a clinically significant onset of action within 12 hours after the first dose in some patients with seasonal allergic rhinitis; however, full benefit of treatment may not be achieved in the first 48 hours. Therefore, the patient should continue regular use to achieve full therapeutic benefit.' Treatment may need to start some days before the expected start of the pollen season in patients with a history of moderate to severe seasonal symptoms. DEVICE PRIMING: 'Prior to administration of the first dose, shake container well and actuate the pump 10 times (until a uniform spray is obtained). If the pump is not used for 14 days or longer, reprime the pump with 2 actuations until a uniform spray is observed, before next use. Shake container well before each use. The bottle should be discarded after the labelled number of actuations or within 2 months of first use.' EACH ACTUATION 'delivers approximately 100 mg of mometasone furoate suspension, containing mometasone furoate monohydrate equivalent to 50 micrograms mometasone furoate'. NOT COVERED BY THIS SOURCE: the mometasone-with-loratadine combination spray (Clarinaze) listed among this page's brands has its own licence and is not described by this SPC. Some sections of the product information we used were incomplete — check the full SPC.

NOT A PER-KG DOSE — dosePerKg is deliberately null; this is a fixed actuation count, not a weight-based dose. VERBATIM SPC 4.2: 'Children between the ages of 3 and 11 years: The usual recommended dose is one actuation (50 micrograms/actuation) in each nostril once daily (total dose 100 micrograms).' AGE LIMITS, verbatim: 'Seasonal Allergic Rhinitis and Perennial Rhinitis — The safety and efficacy of NASONEX Nasal Spray in children under 3 years of age have not been established. Nasal Polyposis — The safety and efficacy of NASONEX Nasal Spray in children and adolescents under 18 years of age have not been established.' So there is NO paediatric polyposis dose in this label. Section 4.4 warns that potential systemic effects of nasal corticosteroids include growth retardation in children and adolescents, and psychological or behavioural effects particularly in children. Verify paediatric use against a children's formulary.