Mometasone Nasal Spray

How it works

Mometasone is a potent topical glucocorticoid that acts on nasal mucosal cells to suppress inflammatory mediator release and reduce mucosal oedema, easing congestion, rhinorrhoea and sneezing.

Prescribing in practice

• Correct technique — aiming the spray away from the nasal septum — reduces the risk of epistaxis, nasal irritation and, rarely, septal perforation with prolonged use.
• Full benefit develops over days of regular use, so it should be taken continuously rather than as required during the relevant season.
• Long-term use, particularly alongside inhaled or other corticosteroids, warrants awareness of cumulative steroid load and, in children, periodic height monitoring.

Monitoring

Periodically check inhalation/intranasal technique and inspect for nasal irritation or bleeding, and monitor growth in children on prolonged treatment.

Counselling the patient

• Use it every day as prescribed; it may take several days to work fully.
• Aim the nozzle slightly outward, away from the middle wall of the nose, to reduce nosebleeds.
• Tell your clinician about persistent nosebleeds, crusting or a whistling sound when breathing.

Evidence & guidelines

Intranasal mometasone is a guideline-recommended first-line treatment for moderate-to-severe allergic rhinitis and is established in nasal polyp care, supported by NICE and the SPC.