Mometasone furoate shares the actions of other topical corticosteroids and is used for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
For EENT uses of mometasone furoate, see 52:08.
Dosage and Administration
Topical mometasone furoate cream and ointment are applied sparingly in thin films and are rubbed into the affected area, usually once daily. The cream and ointment also have been applied twice daily. A few drops of mometasone furoate lotion are applied to the affected area once daily, holding the nozzle of the bottle close to the area and squeezing gently. It is recommended that mometasone furoate preparations not be used with occlusive dressings, and that patients be warned that treated areas of the skin not be bandaged or otherwise covered or wrapped as to be occlusive unless directed by their physician.
Mometasone furoate shares the toxic potentials of other topical corticosteroids, and the usual precautions for corticosteroid therapy should be observed.
Topical application of mometasone furoate cream or ointment in healthy individuals revealed little or no evidence of local irritation in most patients, and the potential for contact irritation from the preparations and their vehicles was minimal and comparable to that of other commonly used topical corticosteroid formulations. In addition, there was no evidence of contact sensitization, and the commercially available preparations appear to have minimal potential for inducing photoallergic or phototoxic reactions.
Mometasone furoate does not appear to suppress the hypothalamic-pituitary-adrenal (HPA) axis substantially following topical application of usual doses. In patients with psoriasis or atopic dermatitis, 15 g of the 0.1% cream or ointment (15 mg of mometasone furoate) applied without occlusion to at least 30% of the body twice daily for 7 days caused a slight reduction in adrenal corticosteroid secretion, although plasma cortisol concentrations remained within the normal range and there was no evidence of HPA-axis suppression. Plasma cortisol concentrations were not altered following topical application of 7.5 g of the 0.1% ointment (7.5 mg of drug) applied without occlusion to at least 30% of the body twice daily for 21 days or following topical application of 15 mL of the 0.1% lotion to diseased skin in patients with scalp and body psoriasis twice daily for 7 days.
Pending further accumulation of safety data, mometasone, like other topical corticosteroids, should not be used in the treatment of acne, rosacea, or perioral dermatitis. Mometasone furoate preparations are contraindicated in individuals with known hypersensitivity to the drug, other corticosteroids, or any ingredient in the respective formulation.
If mometasone furoate is used for topical treatment of various corticosteroid-responsive dermatoses in children, the usual precautions associated with topical corticosteroid therapy in pediatric patients should be observed.
Mutagenicity and Carcinogenicity
No evidence of mometasone-induced mutagenesis was seen in various in vitro test systems (e.g., Ames microbial mutagen test, mouse lymphoma assay, micronucleus test). Long-term studies to determine the carcinogenic potential of topical corticosteroids have not been performed to date.
Pregnancy, Fertility, and Lactation
The teratogenic potential of topical mometasone furoate is not known; however, the drug has produced teratogenic effects characteristic of corticosteroids in animals following topical application. For additional information, .
Percutaneous penetration of mometasone furoate varies among individuals and can be altered by using different vehicles; percutaneous penetration can be increased by the use of occlusive dressings and by inflammation and/or other disease of the epidermal barrier (e.g., psoriasis, eczema).
Following topical application of mometasone furoate to normal skin, only small amounts of the drug appear to reach the dermis and subsequently the systemic circulation with the usual dosage; about 0.7% of the drug reportedly reached systemic circulation during the 8-hour period after a single application of 880 mg of a 0.1% ointment in healthy individuals with normal skin. However, systemic absorption may be increased when the skin is inflamed or diseased. The extent of systemic absorption of the drug appears to be similar following topical application of the cream or ointment; the manufacturer states that a similar minimal degree of absorption would be expected with topical application of the lotion. Following topical application of 130 mg of mometasone furoate 0.1% cream or ointment in rabbits, approximately 5 or 6% of a topically applied dose, respectively, was absorbed systemically. In other studies, approximately 2.5 or 2% of a topically applied dose of the ointment was absorbed systemically in rats or dogs, respectively.
Following percutaneous penetration of mometasone furoate, drug that is systemically absorbed probably follows the metabolic pathways of systemically administered corticosteroids. However, systemic metabolism of mometasone has not been fully characterized or quantified; in animals, drug that is absorbed following topical application does not appear to accumulate in tissues. Systemically absorbed mometasone and its metabolites may be excreted in urine and, to some extent, in bile.