Intranasal Corticosteroid Pregnancy: Compatible — negligible systemic absorption

Mometasone Nasal Spray

Brand names: Nasonex, Clarinaze (with loratadine)

Adult dose

Dose: Allergic rhinitis: 200 mcg (2 sprays per nostril) OD or 100 mcg (1 spray per nostril) OD. Nasal polyps: 200 mcg per nostril BD.

Route: Intranasal

Frequency: OD (rhinitis) or BD (polyps)

Max: 400 mcg/day (rhinitis); 800 mcg/day (polyps)

Low systemic bioavailability (<1%). Not for children <2 years. Can reduce use once symptoms controlled. Takes 1–2 weeks for full effect.

Route: Intranasal

Frequency: OD

Max: 100 mcg OD (2–11 years); 200 mcg OD (≥12 years)

Concentration: 50 mcg/spray mcg/ml

Children 2–11 years: 50 mcg (1 spray) per nostril OD only. ≥12 years: adult dosing. Not for children <2 years.

Renal

N/A

Hepatic

N/A

Among lowest systemic bioavailability of intranasal steroids (<1%) — good safety profile for long-term use
Nasal polyps: NICE recommends 3-month trial of intranasal steroid before considering surgery or oral steroids
Epistaxis management: apply Vaseline to nasal septum; check correct spray technique (direct spray to lateral nasal wall, away from septum)
Licensed OTC (Nasonex) — advise proper technique

CYP3A4 inhibitors — theoretical increase in systemic exposure (minimal at intranasal doses)

Reference: BNFc; BNF; NICE NG174; BNF for Children. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

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