Mometasone

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Mometasone furoate
)

Mometasone
Clinical data
Trade namesNasonex, Asmanex, Elocon, others[1]
Other namesLAS-41002, 9α,21-Dichloro-11β,17α-dihydroxy-16α-methylpregna-1,4-diene-3,20-dione 17α-(2-furoate)
AHFS/Drugs.comMonograph
License data
Pregnancy
category
Routes of
administration		Topical, inhalation (nasal spray)
Drug classCorticosteroid; Glucocorticoid
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityNasal spray is virtually undetectable in plasma; but systemic availability is comparable to fluticasone[7]
Protein binding98% to 99%
MetabolismLiver
Elimination half-life5.8 hours
Identifiers
  • (9R,10S,11S,13S,14S,16R,17R)-9-chloro-17-(2-chloroacetyl)-11-hydroxy-10,13,16-trimethyl-3-oxo-6,7,8,9,10,11,12,13,14,15,16,17-dodecahydro-3H-cyclopenta[a]phenanthren-17-yl furan-2-carboxylate
JSmol)
  • CC1CC2C3CCC4=CC(=O)C=CC4(C3(C(CC2(C1(C(=O)CCl)O)C)O)Cl)C

  • as furoate: CC1CC2C3CCC4=CC(=O)C=CC4(C3(C(CC2(C1(C(=O)CCl)OC(=O)C5=CC=CO5)C)O)Cl)C
  • InChI=1S/C22H28Cl2O4/c1-12-8-16-15-5-4-13-9-14(25)6-7-19(13,2)21(15,24)17(26)10-20(16,3)22(12,28)18(27)11-23/h6-7,9,12,15-17,26,28H,4-5,8,10-11H2,1-3H3/t12-,15+,16+,17+,19+,20+,21+,22+/m1/s1 checkY
  • Key:QLIIKPVHVRXHRI-CXSFZGCWSA-N checkY

  • as furoate: InChI=1S/C27H30Cl2O6/c1-15-11-19-18-7-6-16-12-17(30)8-9-24(16,2)26(18,29)21(31)13-25(19,3)27(15,22(32)14-28)35-23(33)20-5-4-10-34-20/h4-5,8-10,12,15,18-19,21,31H,6-7,11,13-14H2,1-3H3/t15-,18+,19+,21+,24+,25+,26+,27+/m1/s1
  • Key:WOFMFGQZHJDGCX-ZULDAHANSA-N
 ☒NcheckY (what is this?)  (verify)

Mometasone, also known as mometasone y 3 s, is a

furoate, not mometasone, is used in medical products.[11]

Common side effects when used for asthma include asthma and

skin atrophy, and itchiness.[9] It works by decreasing inflammation.[8]

Mometasone furoate was patented in 1981 and came into medical use in 1987.

generic medication.[14][15] In 2021, it was the 266th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[16][17]

Medical uses

Mometasone furoate is used in the treatment of inflammatory skin disorders (such as

corticosteroids, and penile phimosis.[21] In terms of steroid strength, it is more potent than hydrocortisone, and less potent than dexamethasone.[22]

Some low-quality evidence suggests the use of mometasone for symptomatic improvement in children with adenoid hypertrophy.[23]

Mometasone is used to alleviate inflammation and itchiness in skin conditions that respond to treatment with glucocorticoids such as psoriasis and atopic dermatitis.[24][25]

nasal polyps.[4]

It is not useful for the common cold.[26]

Asthma

Mometasone furoate can be used with formoterol for the treatment of asthma, due to its anti-inflammatory properties.[23][20]

Contraindications

People should not use inhaled mometasone or mometasone nasal spray if they have:

  • glaucoma or cataracts
  • hypersensitivity, or are allergic to any ingredient in mometasone

Those who are using mometasone nasal or inhaled for a long period of time (e.g. more than three months) should get regular eye exams to check for glaucoma and cataracts and should take precautions to avoid infections such as taking a vitamin D supplement, staying away from those with an infection (chickenpox, measles, colds or flu, COVID-19), washing foods, hand washing and calling a family doctor at the first sign of a severe infection.

People should not use mometasone topical (skin cream) if:

  • hypersensitive or allergic to any ingredient in the skin cream

The risks of Mometasone furoate to the baby during pregnancy cannot be ruled out.

Side effects

The nasal spray form of mometasone may cause the following side effects:

Serious side effects include: Thrush (fungal infection in the nose or throat), slow wound healing, eye problems such as glaucoma or cataracts, weakened immune system (immunodeficiency) which causes an increased susceptibility to infections and adrenal insufficiency.

The inhaled form of mometasone for asthma may cause the following side effects:

  • headache
  • stuffy or runny nose
  • dry throat
  • swelling of nose, throat and sinuses
  • flu-like symptoms
  • painful menstrual periods

Serious side effects may include: allergic reactions (anaphylaxis), increased risk of osteoporosis, glaucoma and cataracts, thrush in the mouth or throat, growth retardation in children, bronchospasms, adrenal insufficiency and weakened immune system which causes an increased susceptibility to infections.

The topical (skin cream) version may cause:

  • burning and itching at the application site
  • acne
  • changes in skin color
  • dryness at application site
  • skin sores

The only serious side effect that is known with mometasone topical is adrenal insufficiency.

Pharmacology

Pharmacodynamics

Mometasone furoate reduces inflammation by causing several effects:[4][27][28]

  • Reversing the activation of inflammatory proteins
  • Activating the secretion of anti-inflammatory proteins
  • Stabilizing cell membranes
  • Decreasing the influx of inflammatory cells

In addition to the glucocorticoid properties of mometasone furoate, it is a very potent agonist of the progesterone receptor as well as a partial agonist of the mineralocorticoid receptor.[29]

Mechanism of action

Mometasone — the metabolite of mometasone furoate.

Mometasone, like other corticosteroids, possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. For allergies, corticosteroids reduce the allergic reactions in various types of cells (mastocytes and eosinophils) that are responsible for allergic reactions. Mometasone and other corticosteroids circulate in the blood easily, crossing cellular membranes and binding with cytoplasmic receptors, resulting in the transcription and synthesis of proteins. It also inhibits the actions of the enzyme cytochrome P450 2C8 which participates in the activity of monooxygenase.[30]

The inflammation is reduced in decreasing the liberation of hydrolase acids of leukocytes, the prevention of the accumulation of macrophages in the sites of inflammation, the interference with adhesion of leukocytes to capillary walls, the reduction of the permeability of the capillary membranes and consequently edema, the reduction of complementary components, inhibition of histamine and kinin liberation, and interference with scar tissue formation.[31] The proliferation of fibroblasts and collagen deposits is also reduced. It is believed that the action of corticosteroid anti-inflammatory agents is bound to inhibitive proteins of phospholipase A2, collectively called lipocortins. The lipocortins, in turn, control the biosynthesis of potent mediators of inflammation as the prostaglandins and leukotrienes, inhibiting the liberation of the molecular precursors of arachidonic acid. Intranasal mometasone alleviates symptoms such as rhinorrhea aquosa, nasal congestion, nasal drip, sneezing, and pharyngeal itching. Topical administration applied to skin reduces the inflammation associated with chronic or acute dermatosis.

Although mometasone furoate does not have significant systemic immunomodulatory effects, it can be considered a local immunosuppressive drug because clinical studies have shown reductions (vs. baseline ) in neutrophils (a white blood cell) in the nasal mucosa.[citation needed] It could be also considered an antihistamine along with its glucocorticoid effects because it significantly reduces histamine and eosinophil cationic protein levels.[citation needed]

Pharmacokinetics

Metabolism

Extensive metabolic hepatic metabolism of mometasone furoate to multiple metabolites occurs. No principal metabolites are detectable in plasma. After in vitro incubation, one of the minor metabolites formed is furoate 6β-hydroxymometasone. In human hepatic microsomes, the formation of these metabolites is regulated by CYP3A4.[4]

Mometasone

Mometasone by itself is a

furoate ester of mometasone, is the marketed medication.[32][33][34] Mometasone furoate acts as a prodrug of mometasone.[35] In addition to its glucocorticoid activity, mometasone also has very potent progestogenic activity and acts as a partial agonist of the mineralocorticoid receptor.[29]

Society and culture

Brand names

As of 2016, mometasone furoate is available worldwide in formulations for nasal, oral inhalation, and topical administration, for human and for veterinary use, and in combinations with other drugs, under many brand names.[1] It was available as the single active agent in the following brands: Alcom, Altosone, Asmanex, Atozon, Aureox, Belloseta, Bioelementa, Biometasona, Bloctimo, Borgasone, Breso, Broner, Codermo, Cortynase, Cutimom, Cutizone, Cutticom, Dance, Demoson, Dergentil, Derimod, Dermacortine, Dermaten, Dermome, Dermosona, Dermotasone, Dermovel, Desdek, Ecelecort, Ecural, Edelan, Elica, Elisone, Elisox, Elitasone, Elna, Elocan, Elocom, Elocon, Elocortin, Elofute, Elomet, Elomox, Eloskin, Eloson, Elosone, Elovent, Elox, Etacid, Eversone, Eztom, F-Din, Fenisona, Flazcort, Flogocort, Fremomet, Frondava, Fu Mei Song, Fulmeta, Furo, Furoato de Mometasona, Furoderm, Gistan-H, Honmet, Iflacort, Intercon, Ivoxel, Kalmente, Konex, Ladexol, Lisoder, Logren, Loksin, Lomeane, M-Furo, Makiren, Mefurosan, Melocort, Mena, Mesone, Metacortil, Metactiv, Metaflam, Metagra, Metasafe, Metason, Metasone, Metaspray, Metatop, Metaz, Metmin, Metsone, Midermin, Mifusin, Minyear, Mofacort, Mofulex, Mofur, Mofuroate, Molison, Momate, Momax, Momecon, Momecort, Momecutan, Momederm, MomeGalen, Momegen, Momekort, Momelab, Momentum, Momeplus, Momerid, Momeson, Momesone, Momester, Momet, Mometa, Mometagen, Mometason, Mometasona, Mometasona Furoato, Mometasone Furoate, Mometasone Furoate Hydrate, Mometasonfuroaat, Mometasonfuroat, Mometasoni Furoas, Mometasonum, Mometasyn, Mometasyn, Mometax, Mometazon, Mometazona, Mometazona Fuorat, Mometazonfuroat, Mometix-AQ, Momevate, Momexa, Mommex, Mommox, Momtas, Monaliz, Monez, Monovel, Monovo, Mosone, Motaderm, Motaneal, Movesan, Mtaz, Mundoson, Murozo, Myrey, Narinex, Nasamet, Nasehaler, Nasocure, Nasomet, Nasometin, Nasonex, Nassomet, Nazofix, Nazoster, Netonox, Nexomist, Novasone, Ovison, Ovixan, Oximax, Pharmecort, Pluster, Pronasal, Propel, Prospiril, Pydercon, Rinelon, Rinitek, Rino-Val, Rinobudex, Rinonex, Rinosal, Rinosona, Rinoval, Risonel, Rinocort, Sensicort, Septopic, Silkaren, Soneta, Suavicort, Suqi, Synaller, Tabunex, Topcort, Topison, Uniclar, Uniderm, Vizomet, Yperod, Zalconex, and Zynovate.[1]

Combinations

The following combination medications are available as of 2022:[36]

  • mometasone furoate and azelastine as Nasaflex
  • mometasone furoate and clotrimazole and gentamicin for veterinary use as Mometamax and Mometavet
  • mometasone furoate and clotrimazole and mupirocin as Derma Q
  • mometasone furoate and florfenicol and terbinafine for veterinary use as Claro
  • mometasone furoate and formoterol as Dulera, Hexaler Bronquial Duo, and Zenhale
  • mometasone furoate and fusidic acid as Bactirest-M, Dermotil Fusid, and Momate-F
  • mometasone furoate and gentamicin and posaconazole for veterinary use as Mometamax Ultra[37][38]
  • mometasone furoate and hydroquinone and tretinoin as Acnezac-MH
  • mometasone furoate and miconazole as Elica M, Elica-M, and Sensicort-F
  • mometasone furoate and mupirocin as Sensicort-B
  • mometasone furoate and orbifloxacin and posaconazole for veterinary use as Posatex, Posatex voor honden, and Posatex für Hunde
  • mometasone furoate and salicylic acid as Cortimax-S, Elicasal, Elocom Plus, Elosalic, Mezo-S, Momate-S, Momesalic, Momtas-S, Monsalic, and Sensicort-S
  • mometasone furoate and terbinafine as Cutizone-T, Mezo-T, and MomelomTerbi-Humanity
  • mometasone furoate and
    tiotropium
    as Tiomom

References

  1. ^ a b c "International brands for Mometasone". Drugs.com. Archived from the original on 17 November 2016. Retrieved 17 November 2016.
  2. ^ "Mometasone Use During Pregnancy". Drugs.com. 14 February 2020. Archived from the original on 26 October 2020. Retrieved 1 April 2020.
  3. ^ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Retrieved 30 March 2024.
  4. ^ a b c d "Nasonex- mometasone furoate spray, metered". DailyMed. 26 January 2011. Archived from the original on 5 November 2022. Retrieved 19 June 2022.
  5. ^ "Nasonex- mometasone furoate spray". DailyMed. 15 December 2022. Archived from the original on 17 April 2023. Retrieved 17 April 2023.
  6. ^ "List of nationally authorised medicinal products" (PDF). European Medicines Agency. Archived (PDF) from the original on 7 March 2023. Retrieved 6 March 2023.
  7. PMID 17509041
    .
  8. ^ a b c d e f g "Mometasone Furoate Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 7 October 2016. Retrieved 11 March 2019.
  9. ^ a b c "Mometasone Furoate topical Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 5 August 2020. Retrieved 11 March 2019.
  10. ^ a b c "Mometasone Furoate eent Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 30 April 2016. Retrieved 11 March 2019.
  11. ^ "Mometasone". DrugBank. Archived from the original on 29 June 2019. Retrieved 30 April 2020.
  12. ISBN 9783527607495
    .
  13. hdl:10665/345533
    . WHO/MHP/HPS/EML/2021.02.
  14. ^ "Competitive Generic Therapy Approvals". U.S. Food and Drug Administration (FDA). 29 June 2023. Archived from the original on 29 June 2023. Retrieved 29 June 2023.
  15. ISBN 9780857113382
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  16. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  17. ^ "Mometasone - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
  18. PMID 35275399
    .
  19. PMID 19337427
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  20. ^
    S2CID 2040993
    .
  21. PMID 20371899
    .
  22. S2CID 43138631
    .
  23. ^
    PMID 27141307
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  24. PMID 15527669
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  25. S2CID 46976211
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  26. ^ "Mometasone Nasal Spray: MedlinePlus Drug Information". MedlinePlus. 19 March 2020. Archived from the original on 20 March 2020. Retrieved 19 March 2020. Mometasone nasal spray should not be used to treat symptoms (e.g., sneezing, stuffy, runny, itchy nose) caused by the common cold. Mometasone nasal spray is in a class of medications called corticosteroids. It works by blocking the release of certain natural substances that cause allergy symptoms.
  27. ISBN 978-0-7637-7900-9
    .
  28. ISBN 978-1-932610-38-3
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  29. ^
    PMID 12503693
    .
  30. S2CID 670198
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  31. PMID 22221434
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    ISBN 978-1-4757-2085-3. Archived
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  33. ^
    ISBN 978-3-88763-075-1
    .
  34. ^
    ISBN 978-0-7514-0499-9. Archived
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  35. ISBN 978-0-12-411524-8
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  36. ^ "Mometasone". Archived from the original on 17 November 2016. Retrieved 17 November 2016.
  37. ^ "Mometamax Ultra: Pending EC decision". European Medicines Agency. 7 October 2022. Archived from the original on 8 October 2022. Retrieved 7 October 2022.
  38. ^ "Mometamax Ultra EPAR". European Medicines Agency. 7 October 2022. Retrieved 9 February 2024.
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