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Mometasone (Topical)

Pronunciation

Pronunciation

(moe MET a sone)

Index Terms

  • Mometasone Furoate

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Cream, External, as furoate:

Elocon: 0.1% (15 g, 45 g, 50 g) [contains soybean lecithin]

Generic: 0.1% (15 g, 45 g)

Lotion, External, as furoate:

Elocon: 0.1% (30 mL, 60 mL) [contains isopropyl alcohol, propylene glycol]

Ointment, External, as furoate:

Elocon: 0.1% (15 g, 45 g) [contains propylene glycol stearate]

Generic: 0.1% (15 g, 45 g)

Solution, External, as furoate:

Generic: 0.1% (30 mL, 60 mL)

Brand Names: U.S.

  • Elocon

Pharmacologic Category

  • Corticosteroid, Topical

Pharmacology

Topical corticosteroids have anti-inflammatory, antipruritic, and vasoconstrictive properties. May depress the formation, release, and activity of endogenous chemical mediators of inflammation (kinins, histamine, liposomal enzymes, prostaglandins) through the induction of phospholipase A2 inhibitory proteins (lipocortins) and sequential inhibition of the release of arachidonic acid. Mometasone has intermediate range potency.

Absorption

Cream: 0.4% (increased by inflammation)

Lotion, ointment: 0.7% (increased by inflammation)

Use: Labeled Indications

Corticosteroid-responsive dermatoses: Relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses (medium potency topical corticosteroid)

Contraindications

There are no contraindications listed within the manufacturer’s U.S. product labeling.

Canadian labeling: Hypersensitivity to mometasone furoate, other corticosteroids, or any component of the formulation; viral (eg, herpes or varicella) lesions of the skin, fungal or bacterial skin infections, parasitic infections, skin manifestations relating to tuberculosis or syphilis, eruptions following vaccinations, acne vulgaris, rosacea, pruritus without inflammation; ophthalmic use; use with occlusive dressings

Dosing: Adult

Corticosteroid-responsive dermatoses: Topical: Apply sparingly, do not use occlusive dressings. Therapy should be discontinued when control is achieved; consider reassessment of diagnosis if no improvement is seen within 2 weeks.

U.S. labeling:

Cream, ointment: Apply a thin film to affected area once daily

Lotion: Apply a few drops to affected area once daily

Canadian labeling:

Cream, ointment: Apply a thin film to affected area once daily; do not use on face, axillae or scrotum for more than 5 days and on the body for more than 3 weeks

Lotion: Apply a few drops to the affected area once daily; do not use on the face, scalp, axillae or scrotum for more than 5 days and on the body for more than 3 weeks

Dosing: Geriatric

Refer to adult dosing. Use with caution as elderly patients may be more susceptible to systemic effects.

Dosing: Pediatric

Corticosteroid-responsive dermatoses: Topical: Apply sparingly, do not use occlusive dressings. Therapy should be discontinued when control is achieved; consider reassessment of diagnosis if no improvement is seen within 2 weeks.

Cream, ointment: Children ≥2 years and Adolescents: Refer to adult dosing. Do not use in pediatric patients for longer than 3 weeks. Canadian labeling does not approve for use in patients <18 years.

Lotion: Children ≥12 years and Adolescents: Refer to adult dosing. Canadian labeling does not approve for use in patients <18 years.

Dosing: Renal Impairment

U.S. labeling: There are no dosage adjustments provided in the manufacturer’s labeling.

Canadian labeling: There are no specific dosage adjustments provided in the manufacturer’s labeling; however, the manufacturer recommends applying a minimum quantity for the shortest duration

Dosing: Hepatic Impairment

U.S. labeling: There are no dosage adjustments provided in the manufacturer’s labeling.

Canadian labeling: There are no specific dosage adjustments provided in the manufacturer’s labeling; however, the manufacturer recommends applying a minimum quantity for the shortest duration

Administration

Apply sparingly. Avoid mucous membranes; U.S. manufacturer labeling recommends avoiding application to the eyes, face, underarms, and groin (including diaper area). Do not wrap, cover, or bandage affected area.

Cream, ointment: Apply thin film to affected area.

Lotion: Apply a few drops to affected area and massage lightly until medication disappears.

Storage

Cream: Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Avoid excessive heat.

Lotion, ointment: Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F).

Drug Interactions

Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination

Ceritinib: Corticosteroids may enhance the hyperglycemic effect of Ceritinib. Monitor therapy

Corticorelin: Corticosteroids may diminish the therapeutic effect of Corticorelin. Specifically, the plasma ACTH response to corticorelin may be blunted by recent or current corticosteroid therapy. Monitor therapy

Deferasirox: Corticosteroids may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased. Monitor therapy

Hyaluronidase: Corticosteroids may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving corticosteroids (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. Consider therapy modification

Adverse Reactions

1% to 10%: Dermatologic: Bacterial skin infection, burning, furunculosis, pruritus, skin atrophy, tingling/stinging

<1% (Limited to important or life-threatening): Folliculitis, glucocorticoid concentrations decreased (pediatric patients), moniliasis, paresthesia, rosacea, skin depigmentation, skin atrophy

Cataract formation, reduction in growth velocity, and HPA axis suppression have been reported with other corticosteroids

Warnings/Precautions

Concerns related to adverse effects:

• Adrenal suppression: May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis.

•Contact dermatitis: Allergic contact dermatitis can occur and is usually diagnosed by failure to heal rather than clinical exacerbation; discontinue use if irritation occurs and treat appropriately.

• Immunosuppression: Prolonged use may result in fungal or bacterial superinfection; discontinue if dermatological infection persists despite appropriate antimicrobial therapy.

• Systemic effects: Topical corticosteroids may be absorbed percutaneously. Absorption of topical corticosteroids may cause manifestations of Cushing's syndrome, hyperglycemia, or glycosuria. Absorption is increased by the use of occlusive dressings, application to denuded skin, or application to large surface areas.

Special populations:

• Elderly: Because of the risk of adverse effects associated with systemic absorption, topical corticosteroids should be used cautiously in the elderly in the smallest possible effective dose for the shortest duration.

• Pediatric: Not for treatment of diaper dermatitis. Children may absorb proportionally larger amounts after topical application and may be more prone to systemic effects. HPA axis suppression, intracranial hypertension, and Cushing syndrome have been reported in children receiving topical corticosteroids. Prolonged use may affect growth velocity; growth should be routinely monitored in pediatric patients.

Dosage form specific issues:

• Appropriate use: Avoid use of topical preparations with occlusive dressings or on weeping or exudative lesions.

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events have been observed in animal reproduction studies. When topical corticosteroids are needed during pregnancy, low to mid potency preparations are preferred; higher potency preparations should be used for the shortest time possible and fetal growth should be monitored (Chi, 2011; Chi, 2013). Topical products are not recommended for extensive use, in large quantities, or for long periods of time in pregnant women (Leachman, 2006).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience itching, burning, or stinging. Have patient report immediately to prescriber signs of high blood sugar (confusion, feeling sleepy, more thirst, hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit), signs of skin changes (pimples, stretch marks, slow healing, or hair growth), or severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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